On December 14, 2021, HHSC will update the clinical prior authorization criteria for Nucala (mepolizumab), a monoclonal antibody that targets interleukin-5 (IL-5). The recent FDA approval allows the use of this drug as an add-on therapy for adults with chronic rhinosinusitis with nasal polyps who do not adequately respond to nasal corticosteroid alone.
This clinical prior authorization is optional for managed care. The Clinical Prior Authorization Assistance Chart indicates which prior authorization each MCO uses. The chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.