Meeting Tue, 04/15/2025 - 12:00 Drug Prior Authorization Committee Meeting Information

Date
Media
Pharmacy April 2025
Edit Implementation Schedule For April 2025
Old Business- ADHD, Amphetamines Long Acting PDL Edit April 2025
Old Business- ADHD, Methylphenidate Long Acting PDL Edit April 2025
Old Business- ADHD, Methylphenidate Short Acting PDL Edit
PDL Recommendations April 2025
PDL Announcements July 2025
Conduent Reports April 2025
New Drugs April 2025
Agenda
DPAC Agenda April 2025
Minutes
DPAC Minutes April 2025 Approved
Criteria
DUR Criteria
Clinical and Fiscal Edits- Existing Criteria
Media
Acne and Rosacea – Select Topical Agents Step Therapy Edit April 2025
Antifungals, Systemic Clinical Edit April 2025
Cough and Cold Preparations Fiscal Edit April 2025
Fabry Disease Clinical Edit April 2025
Givlaari Clinical Edit April 2025
Isturisa Clinical Edit April 2025
Megestrol Acetate Clinical Edit April 2025
Nulibry Clinical Edit April 2025
Oxervate Clinical Edit April 2025
Pompe Disease Clinical Edit April 2025
Voxzogo Clinical Edit April 2025
DUR Criteria
Clinical and Fiscal Edits- New or Revised of Existing Criteria
Media
Imcivree Clinical Edit April 2025
Kebilidi Clinical Edit April 2025
Prior Authorization Required Fiscal Edit April 2025
Zokinvy Clinical Edit April 2025
DUR Criteria
Preferred Drug List Edit Proposals – Existing Criteria
Media
Actinic Keratosis Agents, Topical PDL Edit April 2025
Antibiotics, Inhaled PDL Edit April 2025
Anticholinergics, Long Acting Beta Adrenergic (LABA) Combinations PDL Edit April 2025
Anticholinergics, Long Acting Inhaled PDL Edit April 2025
Anticholinergics, Short Acting and Combinations Inhaled PDL Edit April 2025
Antifungals (Onychomycosis/Candidiasis), Oral PDL Edit April 2025
Antihistamines, Intranasal PDL Edit April 2025
Antihistamines, Ophthalmic PDL Edit April 2025
Antivirals, Herpes Oral PDL Edit April 2025
Antivirals, Topical PDL Edit April 2025
Benzoyl Peroxide/Antibiotic Combinations PDL Edit April 2025
Beta Adrenergic Agents, Long Acting PDL Edit April 2025
Beta Adrenergic Agents, Nebulized PDL Edit April 2025
Corticosteroids & Rhinitis Agents, Intranasal PDL Edit April 2025
Corticosteroids, Ophthalmic “Soft” PDL Edit April 2025
Corticosteroids, Oral Inhaled PDL Edit April 2025
Fluoroquinolones, Ophthalmic PDL Edit April 2025
Fluoroquinolones, Otic PDL Edit April 2025
Hepatitis C Agents PDL Edit April 2025
Inflammatory Bowel Disease Agents, Rectal PDL Edit April 2025
Leukotriene Receptor Modifiers PDL Edit April 2025
Mast Cell Stabilizers, Ophthalmic PDL Edit April 2025
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Ophthalmic PDL Edit April 2025
Pancreatic Enzyme Agents PDL Edit April 2025
DUR Criteria
Preferred Drug List Edit Proposals – New or Revised Criteria
Media
Androgenic Agents PDL Edit April 2025
Anticholinergics, Long Acting Beta Adrenergics (LABA)/ Inhaled Corticosteroid (ICS) Combinations PDL Edit April 2025
Antifungals, Topical PDL Edit April 2025
Antihistamines and Antihistamine/Decongestant Combinations, 2nd Generation PDL Edit April 2025
Anti-Migraine, Alternative Agents PDL Edit April 2025
Antiparasitics, Topical PDL Edit April 2025
Beta Adrenergic Agents, Short Acting PDL Edit April 2025
Corticosteroids, Topical PDL Edit April 2025
Epinephrine Self-Administered Agents PDL Edit (Formerly Epinephrine Self-Injectable Agents) April 2025
Glaucoma Agents PDL Edit April 2025
Inflammatory Bowel Disease Agents, Oral PDL Edit April 2025
Phosphodiesterase (PDE) Inhibitors for Chronic Obstructive Pulmonary Disease (COPD) PDL Edit April 2025
Retinoids, Topical PDL Edit April 2025
Page
Drug Prior Authorization Committee Meeting Information