July 2021 Drug Utilization Review Board Meeting Summary

Published on
August 6, 2021

The Texas Drug Utilization Review Board met Friday, July 23, to make recommendations about clinical prior authorizations and drugs on the Texas Medicaid Preferred Drug List. Available online are:

  • A recording of this meeting’s webcast
  • A report of this quarter’s clinical prior authorization and PDL recommendations
  • Approved minutes from the Friday, April 23, meeting
  • The PDL drug class review schedule for the Friday, October 22 meeting

Clinical Prior Authorization Updates

Clinical prior authorizations may implement for traditional Medicaid and Medicaid managed care at any time:

  • Providers and stakeholders will be notified once an implementation date has been set for traditional Medicaid.
  • Refer to MCO Resources for a link to each MCO’s list of active clinical prior authorizations.
  • The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) identifies which prior authorizations are utilized by each MCO and how those relate to those used by the Vendor Drug Program.

Presented

Approved as presented

Approved with recommendations

Preferred Drug List Updates

Preferred drugs are medications recommended by the board for their efficaciousness, clinical significance, safety, and cost effectiveness. PDL recommendations are pending until the final decision is released by the Texas HHS executive commissioner. HHS-approved decisions from the July and October 2021 board meetings will be incorporated into the PDL published in January 2022. MCOs have the same non-preferred prior authorization criteria requirements from following the Texas formulary and PDL.

The July 2021 PDL recommendations are available. Notable changes include:

PDL Class Drug Current PDL Status Recommended Status
Immunosuppressives, oral Rapamune tablet (oral) Non-Preferred Preferred
Immunosuppressives, oral Sirolimus tablet (AG) (oral) Preferred Non-Preferred
Immunosuppressives, oral Sirolimus tablet (oral) Preferred Non-Preferred
Ophthalmics, anti-inflammatories Lotemax drops (ophthalmic) Non-Preferred Preferred
Ophthalmics, anti-inflammatory/immunomodulators Xiidra (ophthalmic) Non-Preferred Preferred
Platelet Aggregation Inhibitors Aggrenox (oral) Preferred Non-Preferred
Platelet Aggregation Inhibitors Aspirin/Dipyridamole (oral) Non-Preferred Preferred
Stimulants and related agents Qelbree (oral) Non-Reviewed Preferred

About the Texas DUR Board

Board members meet quarterly in Austin to make recommendations about outpatient prescription drugs in the Medicaid program. The schedule of upcoming meetings, instructions on how to submit written materials to the board, and directions about publicly testifying before the board are available on the VDP website.