P&T Committee updates
On July 19, the Pharmacy and Therapeutics (P&T) Committee met and reviewed several drugs, policies and prior authorization criteria. Get complete details, including notes on the drug changes and formulary designations by product.
The following prior authorization criteria were reviewed, changes are noted below:
- ADCIRCA® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- BOTOX® (Commercial and Medicaid) – Added coverage for gastroparesis for members who would otherwise require daily total parenteral nutrition (TPN) in the home. TPN medical prior authorization form must be submitted with Botox prior authorization form.
- FLOLAN® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- IMMUNOGLOBULIN (IVIG, SCIG) – Immunoglobulin medical policy incorporated into prior authorization form (medical policy to be retired in September 2011). Diagnoses aligned with Medicare local coverage determination.
- LETAIRIS® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- RECLAST® – Clarifications made for exceptions to step therapy requirements
- REMODULIN® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- REVATIO® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- TRACLEER® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- TYVASO® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- VELETRI® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
- VENTAVIS® – Modified prior authorization criteria to require pulmonary arterial hypertension diagnosis with a World Health Organization group 1 classification
Medications requiring prior authorization.
Topics: Priority Health updates
