Meeting Wed, 10/15/2025 - 12:00 Drug Utilization Review Board Meeting Information

Date
Media
Pharmacy October 2025
Pharmacy Benefit Administration Services October 2025
Edit Implementation Schedule for October 2025
PDL Recommendations July 2025
PDL Announcements October 2025
PDL Recommendations October 2025
PDL Announcements January 2026
Relias BPM July 2025
Relias BPM October 2025
Conduent Reports October 2025
Conduent RDUR Report Presentation October 2025
New Drugs July 2025
New Drugs October 2025
Agenda
DUR Agenda October 2025- Virtual Only
Minutes
DUR Minutes October 2025 Draft
Criteria
DUR Criteria
Clinical and Fiscal Edits- Existing Criteria
Media
Ampyra Clinical Edit
Besremi Clinical Edit
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) July 2025
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 July 2025
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 PDL Edit July 2025
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
DUR Criteria
Clinical and Fiscal Edits- Existing Criteria
Media
Alpelisib Clinical Edit October 2025
Auvelity Clinical Edit October 2025
Diagnosis Code Required Policy Edit October 2025
Emsam Clinical Edit October 2025
Hemophilia Gene Therapy Agents Clinical Edit October 2025
Immunoglobulins (IVIG and SCIG) Clinical Edit October 2025
Lambert-Eaton Myasthenic Syndrome (LEMS) Clinical Edit October 2025
Narcolepsy Inhibitors Clinical Edit October 2025
Nuedexta Clinical Edit October 2025
Ranolazine Clinical Edit October 2025
Skyclarys Clinical Edit October 2025
Spinal Muscular Atrophy (SMA) Clinical Edit October 2025
SSRI Step Therapy Clinical Edit October 2025
Winrevair Clinical Edit October 2025
Xolremdi Clinical Edit October 2025
DUR Criteria
Clinical and Fiscal Edits- New or Revised of Existing Criteria
Media
Allergenics, Oral Clinical Edit October 2025
Benzodiazepine (Select Oral) Clinical Edit October 2025
Encelto Implant October 2025
Entresto Clinical Edit October 2025
Epidermolysis Bullosa Clinical Edit October 2025
Familial Chylomicronemia Syndrome (FCS) Clinical Edit October 2025
GABAA Modulators for Postpartum Depression Clinical Edit October 2025
Metabolic Dysfunction-Associated Steatohepatitis (MASH) Clinical Edit October 2025
Parathyroid Hormone and Bone Resorption Suppression Related Agents Clinical Edit October 2025
Psychotropic Medications Polypharmacy Clinical Edit October 2025
Prior Authorization Required Fiscal Edit October 2025
Sickle Cell Disease Clinical Edit October 2025
SNRI Clinical Edit October 2025
Spravato Clinical Edit October 2025
Vykat XR Clinical Edit October 2025
Xcopri Clinical Edit October 2025
DUR Criteria
Preferred Drug List Edit Proposals – Existing Criteria
Media
ACE Inhibitors and ACE Inhibitors/Diuretic Combinations PDL October 2025
ACE Inhibitor/Calcium Channel Blocker Combinations PDL October 2025
Angiotensin Receptor Blockers and Angiotensin Receptor Blocker/Diuretic Combinations PDL October 2025
Angiotensin Receptor Blocker/Calcium Channel Blocker Combinations PDL October 2025
Bone Ossification Agents PDL October 2025
Calcium Channel Blockers, Non-Dihydropyridine PDL October 2025
Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors PDL October 2025
Direct Renin Inhibitors and Combinations PDL October 2025
Homozygous Familial Hypercholesterolemia (HoFH) Agents PDL October 2025
Lipotropics, Alternative Agents PDL October 2025
Mitogen-activated Extracellular Kinase Inhibitors (MEKi) & B-raf Kinase Inhibitors (BRAFi) PDL October 2025
Proton Pump Inhibitors (PPIs) PDL October 2025
Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Injectable PDL October 2025
Statins (HMG-CoA Reductase Inhibitors) and Combinations PDL October 2025
Sympatholytics PDL October 2025
Systemic Enzyme Inhibitors, FGFR Inhibitors PDL October 2025
Triglyceride Lowering Agents PDL October 2025
DUR Criteria
Preferred Drug List Edit Proposals – New or Revised Criteria
Media
ADHD, Amphetamines Long Acting PDL October 2025
ADHD, Amphetamines Short Acting PDL October 2025
ADHD, Methylphenidate Long Acting PDL October 2025
ADHD, Methylphenidate Short Acting PDL October 2025
ADHD, Non-Stimulants PDL October 2025
Antiandrogenic Agents PDL October 2025
Anticoagulants, Oral and Subcutaneous PDL October 2025
Anticonvulsants, Rescue Agents PDL October 2025
Antihyperuricemic Agents PDL October 2025
Antiplatelet Agents PDL October 2025
Benign Prostatic Hyperplasia Agents PDL October 2025
Beta Adrenergic Blockers and Beta Adrenergic Blockers/Diuretic Combinations PDL October 2025
Bile Salt Agents PDL October 2025
Calcium Channel Blockers, Dihydropyridine PDL October 2025
Electrolyte Depleting Agents, Phosphate Lowering PDL October 2025
Electrolyte Depleting Agents, Potassium Lowering PDL October 2025
Gene Therapies for Sickle Cell Disease and Beta-Thalassemia PDL October 2025
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists & Combination Agents Indicated for Diabetes PDL October 2025
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Indicated for Obesity PDL October 2025
Keratoconjunctivitis Agents PDL October 2025
Mineralocorticoid Receptor Antagonists (MRA) PDL October 2025
Proprotein Convertase Subtilisin Kexin type 9 (PCSK9) Inhibitors PDL October 2025
Pulmonary Arterial Hypertension (PAH) Agents, Endothelin Receptor Antagonists (ETRAs) PDL October 2025
Pulmonary Arterial Hypertension (PAH) Agents, Phosphodiesterase-5 (PDE5) and Soluble Guanylate Cyclase (SGC) Stimulators PDL October 2025
Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Inhaled PDL October 2025
Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Oral PDL October 2025
Transthyretin Amyloidosis Agents PDL October 2025
Urea Cycle Disorder Agents PDL October 2025
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Drug Utilization Review Board Meeting Information