Meeting Tue, 10/15/2024 - 12:00 Drug Prior Authorization Committee Meeting Information

Date
Media
MO Pharmacy Advisory Boards Slides October 2024
Edit Implementation Schedule through February 2025
PDL Announcements January 2025
PDL Recommendations October 2024
Conduent Reports October 2024
New Drug October 2024
Agenda
DPAC Agenda October 2024
Minutes
DPAC Minutes October 2024 Approved
Criteria
DUR Criteria
Preferred Drug List Edit Proposals – Existing Criteria
Media
ACE Inhibitors Diuretic Combinations PDL Edit October 2024
ACE Inhibitors and Calcium Channel Blocker Combinations PDL Edit October 2024
ADHD, Amphetamines Short Acting PDL Edit October 2024
ADHD, Methylphenidate Short Acting PDL Edit October 2024
Antiandrogenic Agents PDL Edit October 2024
Antihyperuricemic Agents PDL Edit October 2024
Antiplatelet Agents PDL Edit October 2024
ARB and ARB/Diuretic Combinations PDL Edit October 2024
ARB and Calcium Channel Blocker Combinations PDL Edit October 2024
Benign Prostatic Hyperplasia Agents PDL Edit October 2024
Calcium Channel Blockers, Non-Dihydropyridine PDL Edit October 2024
Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors PDL Edit October 2024
Direct Renin Inhibitors & Combinations PDL Edit October 2024
Homozygous Familial Hypercholesterolemia (HoFH) Agents PDL Edit October 2024
Mitogen-activated Extracellular Kinase Inhibitors (MEKi) & B-raf Kinase Inhibitors (BRAFi) PDL Edit October 2024
Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Inhaled PDL Edit October 2024
Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Injectable PDL Edit October 2024
Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Oral PDL Edit October 2024
Proprotein Convertase Subtilisin Kexin type 9 (PCSK9) Inhibitors PDL Edit October 2024
Triglyceride Lowering Agents PDL Edit October 2024
DUR Criteria
Preferred Drug List Edit Proposals – New or Revised Criteria
Media
GLP-1 Receptor Agonists & Combination Agents Indicated for Diabetes PDL Edit October 2024
GLP-1 Receptor Agonists Indicated for Obesity PDL Edit October 15, 2024
ADHD, Amphetamines Long Acting PDL Edit October 2024
ADHD, Methylphenidate Long Acting PDL Edit October 2024
ADHD, Non-Stimulants PDL Edit October 2024
Anticoagulants, Oral and Subcutaneous PDL Edit October 2024
Anticonvulsants, Rescue Agents PDL Edit October 2024
Beta Adrenergic Blockers & Beta Adrenergic Blockers/Diuretic Combinations PDL Edit October 2024
Bile Salt Agents PDL Edit October 2024
Bone Ossification Agents PDL Edit October 2024
Calcium Channel Blockers, Dihydropyridine PDL Edit October 2024
Electrolyte Depleting Agents, Phosphate Lowering PDL Edit October 2024
Electrolyte Depleting Agents, Potassium Lowering PDL Edit October 2024
Keratoconjunctivitis Agents PDL Edit October 2024
Lipotropics, Alternative Agents PDL Edit October 2024
Mineralocorticoid Receptor Antagonists (MRA) PDL Edit October 2024
Pulmonary Arterial Hypertension (PAH) Agents, Endothelin Receptor Antagonists (ETRAs) PDL Edit October 2024
Pulmonary Arterial Hypertension (PAH) Agents, Phosphodiesterase-5 (PDE5) and Soluble Guanylate Cyclase (SGC) Stimulators PDL Edit October 2024
Proton Pump Inhibitors (PPIs) PDL Edit October 2024
Statins (HMG-CoA Reductase Inhibitors) and Combinations PDL Edit October 2024
Sympatholytics PDL Edit October 2024
Systemic Enzyme Inhibitors, FGFR Inhibitors PDL Edit October 2024
Transthyretin Amyloidosis Agents PDL Edit October 2024
DUR Criteria
Clinical and Fiscal Edits- Existing Criteria
Media
Emsam Clinical Edit October 2024
Entresto Clinical Edit October 2024
Immunoglobulins (IVIG and SCIG) Clinical Edit October 2024
Lambert-Eaton Myasthenic Syndrome (LEMS) Clinical Edit October 2024
Nuedexta Clinical Edit October 2024
Ranolazine Clinical Edit October 2024
Skyclarys Clinical Edit October 2024
SNRI Clinical Edit October 2024
Spinal Muscular Atrophy (SMA) Clinical Edit October 2024
SSRI Step Therapy Clinical Edit October 2024
Xcopri Clinical Edit October 2024
DUR Criteria
Clinical and Fiscal Edits- New or Revised of Existing Criteria
Media
Allergenics, Oral Clinical Edit October 2024
Alpelisib Clinical Edit October 2024
Auvelity Clinical Edit October 2024
Diagnosis Code Required Policy Edit October 2024
Duchenne Muscular Dystrophy Clinical Edit October 2024
Enzyme Deficiency, Select Agents Clinical Edit October 2024
Epidermolysis Bullosa Clinical Edit October 2024
Hemophilia Gene Therapy Agents Clinical Edit October 2024
Metabolic Dysfunction-Associated Steatohepatitis (MASH) Clinical Edit October 2024
Narcolepsy Inhibitors Clinical Edit October 2024
Parathyroid Hormone and Bone Resorption Suppression Related Agents Clinical Edit October 2024
Prior Authorization Required Fiscal Edit October 15, 2024
Psychotropic Medications Polypharmacy Clinical Edit October 2024
Sickle Cell Disease Clinical Edit October 2024
Winrevair Clinical Edit October 2024
Xolremdi Clinical Edit October 2024
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Drug Prior Authorization Committee Meeting Information