Jan. 2024 Preferred Drug List Updated

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Originally published Jan. 22, 2024.

HHSC made the following updates to the Jan. 25, 2024, Medicaid Preferred Drug List:

  • Antidepressant, Other Class
    • Removed discontinued Viibryd dose pack
  • Bronchodilators, Beta Agonist Class
    • Removed discontinued Proair albuterol inhaler
  • Smoking Cessation Class
    • Bupropion SR is now followed by the note "Discontinued brand (Zyban)" for clarification

The PDL includes changes approved at the July and Oct. 2023 Drug Utilization Review Board meetings. The document includes formulary and prior authorization information, notations for drugs requiring clinical prior authorization, the review schedule, and appendices for cough and cold products, iron oral agents, and prenatal vitamins products.

HHSC designates drugs on the Texas Medicaid formulary as preferred, non-preferred, or have neither designation. The preferred drug list includes only drugs identified as either preferred or non-preferred:

  • Drugs not on the preferred list, or drugs identified on the list as "preferred", are available to people without prior authorization.
  • Drugs on the list identified as "non-preferred" will require prior authorization.
  • Some preferred and non-preferred drugs may require clinical prior authorization.

Drugs with preferred status drugs may include brand name medication which would not require a PDL prior authorization nor the value of "1" in the "Dispense as Written (DAW) Product Selection code" field (408-D8). Refer to the Dispense as Written section of the Drug Policy chapter of the Pharmacy Provider Procedure Manual for more information.

The PDL changes will appear in the Epocrates drug information system. Epocrates does not mirror the HHSC designations differentiated by dosage form. In these situations, Epocrates accompanies the designation with an explanatory message.