Pharmacy Program staff work with the MO HealthNet’s Pharmacy Advisory Committees, the University of Missouri-Kansas City School of Pharmacy Drug Information Center, the Oregon Evidence-Based Drug Research Consortium, and contractors to perform evidence-based reviews and develop product recommendations for utilization management (UM) and preferred drug list (PDL), which includes both drug and non-drug products. The clinical information is paired with a fiscal evaluation and developed into edit criteria. The UM program and PDL is vital to the utilization management strategy for point-of-sale and physician-administered drugs available via the Fee-For-Service benefit. An effectively and efficiently managed Pharmacy Program will provide savings and promote clinical care and prescribing habits based on best practices.
Implementation Schedule PDL/DSP Searchable Database Preferred/Non-Preferred Products Drug Prior Authorization Forms
| Effective Date | Pharmacy Clinical Edit and PDL Description | Upcoming Policy Changes |
|---|---|---|
| Effective - 04/03/2025 Alzheimer’s Agents, Acetylcholinesterase Inhibitors, N-Methyl-D-Aspartate Receptor Antagonists & Combinations PDL Edit | ||
| Effective - 04/03/2025 Anti-Migraine, Alternative Agents PDL Edit | ||
| Effective - 04/03/2025 Anti-Migraine, Serotonin (5-HT1) Receptor Agonists PDL Edit | ||
| Effective - 04/03/2025 Anti-Parkinsonism, MAO-B Inhibitors PDL Edit | ||
| Effective - 04/03/2025 Anti-Parkinsonism, Non-Ergot Dopamine Agonists PDL Edit | ||
| Effective - 04/03/2025 Antibiotics, Gastrointestinal (GI) Oral PDL Edit | ||
| Effective - 04/03/2025 Antibiotics, Mupirocin Topical PDL Edit | ||
| Effective- 04/03/2025 Antibiotics, Vaginal PDL Edit | ||
| Effective - 04/03/2025 Anticonvulsants, Dravet Syndrome PDL Edit | ||
| Effective - 04/03/2025 Antiemetics, 5-HT3, NK1 and Other Select Non-Injectables PDL Edit | ||
| Effective - 04/03/2025 Antiemetics, 5-HT3 and NK1 Injectables PDL Edit |