Summary of Jan. 2024 Drug Utilization Review Board Meeting Now Available
The Texas Drug Utilization Review Board met Friday, Jan. 26, 2024, to recommend 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 Thursday, Oct. 12, and Friday, Oct. 13, 2023, meetings
- The PDL drug class review schedule for the Friday, April 26 meeting
Clinical Prior Authorization Updates
Clinical prior authorizations may implement for traditional Medicaid and managed care at any time:
- Providers and stakeholders will be notified once an implementation date has been set for traditional Medicaid.
- Refer to MCO Search for a link to each MCO’s clinical prior authorization page.
- The Pharmacy Clinical Prior Authorization Assistance Chart identifies which prior authorizations are utilized by each MCO and how those relate to those used by HHSC.
Presented:
- Antimigraine Agents, Triptans (PDF)
- Revisions
- Antipsychotic Agents (PDF)
- New criteria for Rykindo
- Colchicine Agents (PDF)
- New criteria for Lodoco
- Cytokine and CAM Antagonists (PDF)
- New criteria for Entyvio Pen
- Phosphate Binders (PDF)
- Revisions
- Topical Immunomodulators (PDF)
- New criteria for Zoryve
Approved as presented:
- Antimigraine Agents, Triptans (PDF)
- Revisions
- Antipsychotic Agents (PDF)
- New criteria for Rykindo
- Colchicine Agents (PDF)
- New criteria for Lodoco
- Cytokine and CAM Antagonists (PDF)
- New criteria for Entyvio Pen
- Topical Immunomodulators (PDF)
- New criteria for Zoryve
Not approved as presented:
- Phosphate Binders (PDF)
- Revisions
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. HHSC will incorporate the approved decisions from the Oct. 2023 board meetings into the Jan. 2024 PDL. MCOs have the same non-preferred prior authorization criteria requirements from following the Texas formulary and PDL.
The Oct. 2023 PDL recommendations are available. Notable changes include:
| PDL Class | Drug | Current PDL Status | Recommended Status |
|---|---|---|---|
| Acne Agents, Topical | Adapalene gel OTC (topical) | Non-Preferred | Preferred |
| Acne Agents, Topical | Cabtreo gel (topical) | Non-Reviewed | Preferred |
| Acne Agents, Topical | ZMA Clear Cleanser (topical) | Non-Reviewed | Preferred |
| Analgestics, Narcotics Long | Tramadol ER (Ryzolt) (oral) | Preferred | Non-Preferred |
| Bladder Relaxant Preparations | Vesicare (oral) | Preferred | Non-Preferred |
| Glucagon Agents | Gvoke Pen (subcutaneous) | Preferred | Non-Preferred |
| Glucagon Agents | Zegalogue Autoinjector (subcutaneous) | Non-Preferred | Preferred |
| Movement Disorders | Austedo XR (oral) Austedo XR (oral) | Non-Reviewed | Preferred |
| Movement Disorders | Tetrabenazine (oral) | Non-Preferred | Preferred |
| Movement Disorders | Xenazine (oral) | Preferred | Non-Preferred |
| Neuropathic Pain | Dermacinrx Lidocan patch (topical) | Non-Reviewed | Non-Preferred |
| Neuropathic Pain | Lidocaine (AG) (topical) Lidocaine (topical) | Non-Reviewed | Preferred |
| Neuropathic Pain | Lidocan II (topical) | Non-Reviewed | Non-Preferred |
| Neuropathic Pain | Xyliderm (topical) | Non-Reviewed | Non-Preferred |
| Oncology, Oral – Lung | Augtyro capsule (oral) | Non-Reviewed | Preferred |
| Oncology, Oral – Lung | Rozlytrek pellet pack (oral) | Non-Reviewed | Preferred |
| Oncology, Oral – Lung | Xalkori pellet (oral) | Non-Reviewed | Preferred |
| PAH Agents, oral and inhaled | Liqrev Suspension (oral) | Non-Reviewed | Non-Preferred |
| PAH Agents, oral and inhaled | Orenitram Titration Kit (oral) | Non-Reviewed | Non-Preferred |
| Phosphate Binders | Xphozah tablet (oral) | Non-Reviewed | Non-Preferred |
| Stimulants and Related Agents | Qelbree (oral) | Non-Preferred | Preferred |
| Stimulants and Related Agents | Relexxii (oral) | Non-Reviewed | Non-Preferred |
| Anticonvulsants | Motpoly XR (oral) | Not Reviewed | Preferred |
| Opiate Dependence Treatments | Narcan Spray OTC (Nasal) | Not Reviewed | Preferred |
| Antipsychotics | Rykindo (intramusc) | Not Reviewed | Non-Preferred |
| Cytokine and CAM Antagonists | Adalimumab-Adbm Kit (Injection) (Cf) 50 Mg/Ml | Not Reviewed | Non-Preferred |
| Cytokine and CAM Antagonists | Adalimumab-Adbm Pen Kit (Injection) (Cf) 50 Mg/Ml | Not Reviewed | Non-Preferred |
| Cytokine and CAM Antagonists | Entyvio Pen (Subcutane) | Not Reviewed | Non-Preferred |
| Erythropoiesis Stimulating Proteins | Jesduvroq Tablet (oral) | Not Reviewed | Non-Preferred |
| Glucocorticoids, Inhaled | Airsupra Hfa (Inhalation) | Not Reviewed | Non-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.