Pharmacy Clinical Edits and Preferred Drug Lists

MO HealthNet is continuing the state specific Preferred Drug List and Clinical Edit processes. The following is a listing of therapeutic classes that have been implemented. Please see the implementation schedule for proposed implementation dates for additional classes.

IMPORTANT NOTICE REGARDINIG PDL VENDOR - 7/18/18
Issue Date Pharmacy Clinical Edit and PDL Description
02/08/16 15 Day Limitation Clinical Edit
04/05/18 5-HTI Serotonin Receptor Agonists (Triptans) PDL
01/04/18 ACE Inhibitors PDL
01/04/18 ACE Inhibitors/Calcium Channel Blocker Combinations PDL
01/04/18 Ace Inhibitors Diuretic Combinations PDL
07/12/18 Actinic Keratosis Agents – Topical PDL
03/07/16 ADHD Therapy
04/05/18 Alzheimer’s Agents & Cholinesterase Inhibitors PDL 
07/07/11 Ampyra
10/5/17 Amylin Analogs PDL
07/12/18 Androgenic Agents – Topical PDL
04/05/18 Antiemetics Agents PDL
01/04/18 Angiotensin Receptor Blocker Diuretic Combinations PDL
01/04/18 Angiotensin Receptor Blockers PDL
01/04/18 Anticoagulants PDL
10/05/17 AntiDiabetic Combinations: Oral and Injectable PDL
07/12/18 Antibiotic Agents – Inhaled PDL
07/12/18 Antihistamines – Intranasal PDL
07/12/18 2nd Generation Antihistamines PDL
07/12/18 2nd Generation Antihistamine – Decongestant (Low Sedating) Combinations PDL
10/05/17 Antihyperuricemic Agents PDL
07/12/18 Antifungal Agents – Topical PDL
07/12/18 Atopic Dermatitis Agents (Immunomodulators)
01/12/18 Atypical Antipsychotics
07/12/18 Antiparasitic Agents – Topical PDL
07/12/18 Benzoyl Peroxide-Antibiotic Combination PDL
07/12/18 Beta Adrenergic Agents Long Acting PDL
07/12/18 Beta Adrenergic Beta Blockers - Short Acting PDL
07/12/18 Beta Adrenergic Agents/Nebulized PDL
01/04/18 Beta Adrenergic Blockers and Diuretic Combinations PDL
10/31/17 BiDil® Tablets Clinical Edit
10/05/17 Bile Salts Agents PDL
10/05/17 Bone Deossification Suppression Agents PDL
09/01/17 Botulinum Toxin Clinical Edit
10/05/17 BPH Agents PDL (formerly Androgen Hormone Inhibitors)
07/05/11 Butorphanol
02/02/15 Calcium Channel Blockers (DHP) PDL
01/04/18 Calcium Channel Blockers (nonDHP) PDL
02/02/15 Calcium Channel Blockers/ARBS PDL
10/05/17 Cephalosporin Antibiotics – Oral PDL
07/12/18 Corticosteroids and Rhinitis Agents – Intranasal PDL
07/12/18 Corticosteroids Oral – Inhaled PDL
07/12/18 COPD Anticholinergic Agents PDL
07/12/18 Corticosteroids-Topical PDL
07/01/13 Cough and Cold PDL
04/05/18 COX-2 Inhibitors PDL
10/05/17 Cryopyrin-Associated Periodic Syndrome (CAPS) Agents PDL
02/02/15 Direct Renin Inhibitors PDL
11/13/03 Dolgic LQ® (Acetaminophen/Butalbital/Caffeine)
10/05/17 DPP-IV Inhibitors PDL
10/05/17 Electrolyte Depleters PDL
05/16/07 Emsam®
07/12/18 Epinephrine Self-Injectable Agents PDL
07/12/18
01/19/06 Equetro®
08/01/17 Exondys 51® Clinical Edit
04/05/18 Fibromyalgia Agents PDL
07/12/18 Fluoroquinolones – Ophthalmic PDL
07/12/18 Fluoroquinolones – Otic PDL
07/28/03 Forteo® (teriparatide injection / Parathyroid Hormone)
10/05/17 Gastrointestinal(GI) Antibiotics – Oral PDL
04/05/18 GI Motility Agents PDL
10/05/17 GLP-1 Receptor Agonists PDL
10/05/17 Growth Hormones PDL
07/07/03 H2 Antagonists
10/05/17 Hematopoietic Agents PDL
11/01/17 Hep C (HCV) Therapy
07/12/18 Herpes Antivirals – Oral PDL
03/05/15 HMG Co-A reductase inhibitors (statins) PDL
02/02/15 Homozygous Familial Hypercholesterolemia
12/11/03 H-Pylori Therapy
04/23/13 Human Papillomavirus Vaccines
10/05/17 Insulins Long Acting PDL
10/05/17 Insulins Mix PDL
10/05/17 Insulins PDL
10/05/17 Insulins Rapid Acting PDL
10/05/17 Intravaginal Antibiotics PDL
11/13/03 Klonopin Wafer® (clonazepam)
04/05/18 Long-Acting Opioids PDL
07/12/18 Leukotriene Modifiers PDL
10/05/17 Macrolides - Adult PDL
10/05/17 Macrolides - Pediatric PDL
07/12/18 Mast Cell Stabilizers – Prostaglandin Agonists(Glaucoma Agents) PDL
08/25/10 Megestrol Acetate
10/05/17 Methotrexate Oral and Injectable (NEW) PDL
10/05/17 Multiple Sclerosis Agents PDL
08/22/16 Narcotics, Long Acting PDL
03/05/14 Narcolepsy Inhibitors
04/05/18 Neuropathic Pain Agents PDL
02/02/15 Niacin Preparations PDL
04/05/18 Non-Ergot Dopamine Receptor Agonists PDL
01/26/12 Non-Oral Contraceptives Fiscal Edit
04/05/18 NSAID Agents PDL
07/12/18 NSAIDs – Ophthalmic PDL
05/03/07 Nubain®
05/23/13 Onfi (clobazam)
07/12/18 Antifungal (Onychomycosis – Candidiasis) Agents PDL
07/12/18 Antihistamines and Allergy Agents – Ophthalmic PDL
04/05/18 Opiate Dependence Agents PDL
03/01/18 Opioids, Short Acting Clinical Edits
03/01/18 Opioids, Combination Short-Acting Clinical Edit
10/05/17 Oral AntiDiabetic: Alpha - Glucosidase Inhibitors PDL
10/05/17 Oral AntiDiabetic: Biguanides PDL
10/05/17 Oral AntiDiabetic: Meglintinides PDL
10/05/17 Oral AntiDiabetic: Sulfonylureas 2nd Generation PDL
10/05/17 Oral AntiDiabetic: Thiazolidinediones PDL
01/31/05 Oxandrin®
07/12/18 Pancreatic Enzyme Agents PDL
10/05/17 Penicillins (NEW) PDL
09/26/05 Prostin VR® Pediatric
01/04/18 Proton Pump Inhibitor PDL
07/12/18 Protaglandin Agonists (Glaucoma Agents) PDL
07/12/18 Psoriasis Agents – Topical PDL
11/12/10 Psychotropic Medications Polypharmacy
02/02/15 Pulmonary Hypertension Agents PDL
02/02/15 Pulmonary Hypertension Agents (Oral) PDL
07/07/11 Ranexa®
01/12/05 Raniclor™
12/23/04 Raptiva
08/02/17 Respiratory Monoclonal Antibodies Clinical Edit
10/12/16 Ribavirins PDL
04/05/18 Sedative Hypnotics PDL
12/08/10 Selective Serotonin Reuptake Inhibitor (SSRI)
07/07/11 Selzentry® (Maraviroc)
07/03/12 Serotonin-Norepinephrine Reuptake Inhibitors (SNRI)
04/05/18 Skeletal Muscle RelaxantsPDL
10/05/17 Sodium - Glucose Co - Transporter 2 (SGLT2) PDL
08/01/17 Spinraza® Clinical Edit
09/16/10 Synagis (palivizumab)
10/05/17 Targeted Immune Modulators (Formerly Biologics - DMARDs) PDL
10/05/17 Tetracyclines PDL
07/07/03 Thalomid (thalidomide)
07/12/18 Topical Antiviral Agents
07/12/18 Retinoids – Topical PDL
04/05/18 Tramadol-like Agents PDL
07/14/16 Transmucosal Immediate-Release Fentanyl (TIRF) Clinical Edit
01/16/04 Tricyclic Antidepressant Coordination of Care
02/02/15 TriGlyceride Lower Agents PDL
07/12/18 Ulcerative Colitis Oral Agents PDL
07/12/18 Ulcerative Colitis-Rectal PDL
10/05/17 Urinary Tract Antispasmodics PDL
03/07/03 Voriconazole (Vfend) / Antifungal
11/13/03 Xanax XR® (Alprazolam)
11/13/03 Zometa® (zoledronic acid)
07/03/12 Zostavax Injection