Meeting Tue, 07/15/2025 - 12:00 Drug Prior Authorization Committee Meeting Information

Date
Media
Pharmacy July 2025
Edit Implementation Schedule for July 2025
PDL Recommendations - July 2025
PDL Announcements October 2025
Conduent Reports Slides July 2025
New Drugs July 2025
Agenda
DPAC Agenda July 2025- Virtual Only
Minutes
DPAC Minutes July 2025 Approved
Criteria
DUR Criteria
Clinical and Fiscal Edits- Existing Criteria
Media
Ampyra Clinical Edit July 2025
Besremi Clinical Edit July 2025
Crysvita Clinical Edit July 2025
Daybue Clinical Edit July 2025
Filspari Clinical Edit July 2025
Gamifant Clinical Edit July 2025
Joenja Clinical Edit July 2025
Luxturna Clinical Edit July 2025
Neuromyelitis Optica Spectrum Disorder (NMOSD) Clinical Edit July 2025
Targeted Immune Modulators, Small Molecule Janus Kinase (JAK) Inhibitors Clinical Edit July 2025
Tepezza Clinical Edit July 2025
Tolvaptan Clinical Edit July 2025
Tzield Clinical Edit July 2025
Zometa Clinical Edit July 2025
DUR Criteria
Clinical and Fiscal Edits- New or Revised of Existing Criteria
Media
Iron – Injectable Step Therapy Edit July 2025
Journavx Clinical Edit July 2025
Myelodysplastic Syndromes Agents Clinical Edit (formerly Reblozyl) July 2025
Neurofibromatosis Type 1 Clinical Edit (formerly Koselugo)
Primary Hyperoxaluria Clinical Edit (formerly Oxlumo) July 2025
Prior Authorization Required Fiscal Edit July 2025
RSV Prophylaxis – Pediatric Clinical Edit (formerly the Synagis) July 2025
T-Cell Immunotherapy Clinical Edit (formerly CAR-T Cell Therapy) July 2025
DUR Criteria
Preferred Drug List Edit Proposals – Existing Criteria
Media
Alpha-Glucosidase Inhibitors PDL July 2025
Amylin Analogs PDL July 2025
Colony Stimulating Factors PDL July 2025
Cryopyrin-Associated Periodic Syndrome (CAPS) Agents PDL July 2025
Growth Hormone Releasing Factors, Select Agents PDL July 2025
Insulin, Long Acting PDL July 2025
Insulin, Mixed PDL July 2025
Insulin, Non-Analogs PDL July 2025
Luteinizing Hormone Releasing Hormone (LHRH)/Gonadotropin Releasing Hormone (GnRH) Agents, Oral PDL July 2025
Meglitinides Agents PDL July 2025
Methotrexate Agents PDL July 2025
Psoriasis Agents, Oral PDL July 2025
Sodium-Glucose Co-Transporter (SGLT) Inhibitors & Combination Agents PDL July 2025
Targeted Immune Modulators, Interleukin-6 (IL-6) Receptor Inhibitors PDL July 2025
Targeted Immune Modulators, Lupus Agents PDL July 2025
Thiazolidinediones & Combinations PDL July 2025
DUR Criteria
Preferred Drug List Edit Proposals – New or Revised Criteria
Media
Atopic Dermatitis Agents, Immunomodulators PDL Edit
Biguanides & Combination Agents PDL July 2025
Bleeding Disorder Agents PDL July 2025
Complement Inhibitors, Systemic PDL July 2025
DPP-IV Inhibitors & Combination Agents PDL July 2025
Erythropoiesis Stimulating Agents PDL July 2025
Growth Hormone Somatropin Agents, Long-Acting PDL July 2025
Growth Hormone Somatropin Agents, Short-Acting PDL July 2025
Inflammatory Bowel Disease Agents, Oral PDL July 2025
Insulin, Rapid Acting PDL July 2025
Luteinizing Hormone Releasing Hormone (LHRH)/Gonadotropin Releasing Hormone (GnRH) Agents, Non-Oral PDL July 2025
Multiple Sclerosis Agents, Injectable PDL July 2025
Multiple Sclerosis Agents, Oral PDL July 2025
Neonatal Fc Receptor Antagonists PDL July 2025
Psoriasis Agents, Topical PDL July 2025
Sulfonylurea Agents, Second Generation PDL July 2025
Targeted Immune Modulators, Interleukin (IL)-17A Antibody/IL-17 Receptor Antagonists PDL July 2025
Targeted Immune Modulators, IL-23 Inhibitors and IL-23/IL-12 Inhibitors PDL July 2025
Targeted Immune Modulators, Janus Kinase (JAK) Inhibitors PDL July 2025
Targeted Immune Modulators, Misc. Allergy and Asthma Related Monoclonal Antibodies
Targeted Immune Modulators, Select Agents PDL July 2025
Targeted Immune Modulators, Tumor Necrosis Factor (TNF) Inhibitors PDL July 2025
Thrombocytopenia Agents PDL July 2025
Urinary Tract Antispasmodics PDL July 2025
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Drug Prior Authorization Committee Meeting Information