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.
Table of clinical edit documents listed by issue date and description. The
description is linked to the file. All files are in PDF.
| Issue Date |
Pharmacy Clinical Edit and PDL Description |
| Mar 20, 2007 |
15
Day Limitation |
| Jan 14, 2008 |
5-HT1
Agonist (Triptan) Therapy-PDL |
| Nov 23, 2004 |
5HT3
Receptor Antagonists-PDL |
| Jan 14, 2008 |
ACE
Inhibitors-PDL |
| Jan 14, 2008 |
ACE
Inhibitors/Calcium Channel Blocker Combinations-PDL |
| Mar 24, 2003 |
Actiq
Lozenges |
| Apr 29, 2008 |
ADHD
Therapy |
| Jul 07, 2003 |
Alinia
(Nitazoxanide) / antiparasitic/antimicrobial) |
| Jan 14, 2008 |
Alpha-GlucosidaseInhibitors-PDL |
| Jul 10, 2007 |
Amylin
Analogs-PDL |
| Dec 19, 2006 |
Amitiza® |
| Dec 06, 2007 |
Androgen Hormone Inhibitor-PDL |
| Jan 14, 2008 |
Angiotensin
II Receptor Blocker Diuretic Combinations-PDL |
| Jan 17, 2008 |
Angiotensin
II Receptor Blockers-PDL |
| Jul 29, 2003 |
Antibiotic
RTU Pack |
| Mar 29, 2004 |
Antiplatelet
Step Therapy Edit |
| Jul 10, 2007 |
Beta
Adrenergic Agents Long Acting - PDL |
| Jul 10, 2007 |
Beta
Adrenergic Agents Short Acting - PDL |
| Jul 10, 2007 |
Beta
Adrenergic Agents/Nebulized - PDL |
| Jul 10, 2007 |
Beta
Adrenergic Blockers- PDL |
| Nov 09, 2006 |
BiDil® Tablets |
| Jan 14, 2008 |
Biguanides-PDL |
| Jan 14, 2008 |
Bone
Deossification Suppression Agents - PDL |
| Apr 29, 2005 |
Botulinum
Toxin Type A (Botox) |
| Nov 07, 2007 |
Calcium
Channel Blockers (DHP)-PDL |
| Jul 10, 2007 |
Calcium
Channel Blockers (nonDHP)-PDL |
| Jul 29, 2003 |
Cold
Sore Treatment Fiscal Edit |
| Nov 17, 2005 |
Combunox® Tablets |
| Jul 10, 2007 |
COPD
Anticholinergics -PDL |
| Jul 26, 2006 |
COX-2
Inhibitors -PDL |
| Apr 10, 2008 |
Direct Renin Inhibitors -PDL |
| Jan 16, 2008 |
Disease-Modifying
AntiRheumatic Drug (DMARD) - PDL |
| Nov 13, 2003 |
Dolgic
LQ® (Acetaminophen/Butalbital/Caffeine) |
| Jul 10, 2007 |
DPP-IV
Inhibitors-PDL |
| Jan 14, 2008 |
Electrolyte
Depleters-PDL |
| Mar 23, 2007 |
Emend
(Aprepitant) / Chemotherapy Anti-emetic |
| May 16, 2007 |
Emsam® |
| Apr 26, 2007 |
Epoetins |
| Jan 19, 2006 |
Equetro® |
| Jul 29, 2003 |
Fluconazole
(Diflucan) |
| Jan 14, 2008 |
FluoroQuinolones-Oral-PDL |
| Jul 28, 2003 |
Forteo® (teriparatide
injection / Parathyroid Hormone) |
| Apr 04, 2007 |
Gardasil® Injection |
| Jul 07, 2003 |
Geodon
for Injection (ziprasidone mesylate)/Atypical Antipsychotic Agents, Injectible |
| Jul 10, 2007 |
GLP-1
Receptor Agonists -PDL |
| Dec 07, 2007 |
Growth Hormones-PDL |
| Jul 07, 2003 |
H2
Antagonists |
| Jul 26, 2006 |
Hepatitis
C Therapy-PDL |
| Jan 14, 2008 |
Herpes
Antivirals-PDL |
| Jul 10, 2007 |
HMG-Co
A reductase inhibitors (statins) -PDL |
| Dec 11, 2003 |
H-Pylori
Therapy |
| Nov 07, 2007 |
Inhaled
Corticosteroids - PDL |
| Jul 05, 2007 |
Insulin
Mix-PDL |
| Jul 10, 2007 |
Insulin
Rapid Acting-PDL |
| Jul 19, 2007 |
Insulins-PDL |
| Jul 10, 2007 |
Insulins
Long Acting-PDL |
| Jan 14, 2008 |
Intranasal
Steroids - PDL |
| Nov 13, 2003 |
Klonopin
Wafer® (clonazepam) |
| Nov 07, 2003 |
Lactulose
Step Therapy Edit |
| Jan 14, 2008 |
Leukotriene-PDL |
| Apr 29, 2008 |
Lyrica® |
| Nov 07, 2007 |
Low Molecular Weight Anticoagulants |
| Jan 14, 2008 |
Macrolides-PDL |
| Jan 14, 2008 |
Meglintinides
- PDL |
| Nov 03, 2004 |
Methadone |
| Apr 05, 2005 |
Miralax |
| Jan 16, 2008 |
Multiple
Sclerosis Agents-PDL |
| Jan 14, 2008 |
Narcotics,
Long Acting - PDL |
| Jan 14, 2008 |
Niacin
Preparations - PDL |
| Jan 02, 2008 |
Non-Ergot Dopamine Receptor Agonists-PDL |
| Jan 14, 2008 |
Non-Sedating
Antihistamines-PDL |
| Nov 19, 2004 |
NSAID
Step Therapy Edit |
| May 03, 2007 |
Nubain® |
| Jul 27, 2007 |
Onychomycosis
Antifungal Agents-PDL |
| Jun 20, 2007 |
Opana® Immediate-Release
Tablets |
| Jan 14, 2008 |
Ophthalmic
Antihistamines-PDL |
| Jan 14, 2008 |
Ophthalmic
Mast Cell Stabilizers-PDL |
| Jul 10, 2007 |
Ophthalmic
NSAIDs-PDL |
| Jan 14, 2008 |
Ophthalmic Prostaglandin Agonists PDL
|
| Aug 10, 2007 |
Oral
AntiDiabetics: Combinations-PDL |
| Jan 14, 2008 |
Otic
Quinolones-PDL |
| Jan 31, 2005 |
Oxandrin® |
| Sep 26, 2005 |
Prostin
VR® Pediatric |
| Jul 10, 2007 |
Proton
Pump Inhibitor-PDL |
| Jan 14, 2008 |
Quinolone
Ophthalmic Antibiotic-PDL |
| Jun 13, 2007 |
Ranexa® |
| Jan 12, 2005 |
Raniclor™ |
| Dec 23, 2004 |
Raptiva |
| Jun 22, 2005 |
Retinoic
Acid Products/Retinoid Analogues - Topical |
| Dec 05, 2005 |
Revatio® |
| Jul 26, 2006 |
Ribavirins
- PDL |
| Aug 19, 2007 |
Sedative
Hypnotics-PDL |
| Oct 26, 2005 |
Selective
Serotonin Reuptake Inhibitor (SSRI) |
| Aug 21, 2003 |
Suboxone |
| Jul 29, 2003 |
Sucralfate
(Carafate) |
| Jan 14, 2008 |
Sulfonylureas-PDL |
| Sep 28, 2006 |
Synagis
(palivizumab) |
| May 12, 2006 |
Tamiflu® |
| Jul 07, 2003 |
Thalomid
(thalidomide) |
| Jan 10, 2007 |
Thiazolidinediones
- PDL |
| Oct 29, 2007 |
Tindamax® |
| May 13, 2008 |
Topical
Agents for Psoriasis - PDL |
| Jul 26, 2006 |
Topical
Immunomodulators - PDL |
| Apr 14, 2006 |
Tramadol
Therapy |
| Jan 16, 2004 |
Tricyclic
Antidepressant Coordination of Care |
| Jul 10, 2007 |
TriGlyceride
Lower Agents-PDL |
| Jul 10, 2007 |
Urinary
Tract Antispasmodics - PDL |
| May 13, 2008 |
Vivitrol ® |
| Mar 07, 2003 |
Voriconazole
(Vfend) / Antifungal |
| Nov 13, 2003 |
Xanax
XR® (Alprazolam) |
| Mar 25, 2005 |
Xolair |
| Nov 13, 2003 |
Zometa® (zoledronic
acid) |
| Apr 11, 2007 |
Zostavax
Injection |
| Jan 13, 2005 |
Zyprexa
IM® |
