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.
| Issue Date |
Pharmacy Clinical Edit and PDL Description |
| Jun 05, 2009 |
15 Day Limitation |
| Feb 07, 2013 |
5-HT1 Agonist (Triptan) Therapy-PDL |
| Feb 07, 2013 |
ACE Inhibitors-PDL |
| Feb 07, 2013 |
ACE Inhibitors/Calcium Channel Blocker Combinations-PDL |
| Mar 24, 2003 |
Actiq Lozenges |
| Aug 5, 2010 |
ADHD Therapy |
| Jul 07, 2003 |
Alinia (Nitazoxanide)/antiparasitic/antimicrobial) |
| Feb 07, 2013 |
Alpha-GlucosidaseInhibitors-PDL |
| Feb 07, 2013 |
Alzheimer’s Agents (Cholinesterase Inhibitors) -PDL |
| Feb 07, 2013 |
Amylin Analogs-PDL |
| Jul 03, 2012 |
Amitiza® |
| Jul 07, 2011 |
Ampyra |
| Aug 10, 2012 |
Antiemetics Agents -PDL |
| Feb 07, 2013 |
Angiotensin II Receptor Blocker Diuretic Combinations-PDL |
| Feb 07, 2013 |
Angiotensin II Receptor Blockers-PDL |
| Aug 10, 2012 |
Anticoagulants-PDL |
| Feb 07, 2013 |
Antihyperuricemic Agents-PDL |
| Jul 03, 2012 |
Atypical Antipsychotics |
| Aug 10, 2012 |
Beta Adrenergic Agents Long Acting - PDL |
| Aug 10, 2012 |
Beta Adrenergic Agents Short Acting - PDL |
| Jan 04, 2013 |
Beta Adrenergic Agents/Nebulized - PDL |
| Feb 07, 2013 |
Beta Adrenergic Blockers- PDL |
| Aug 10, 2012 |
BPH Agents-PDL |
| Nov 09, 2006 |
BiDil® Tablets |
| Feb 07, 2013 |
Biguanides-PDL |
| Feb 07, 2013 |
Bile Salts Agents-PDL |
| Feb 07, 2013 |
Bone Deossification Suppression Agents - PDL |
| Apr 08, 2013 |
Botulinum Toxin Type A (Botox) |
| Jul 05, 2011 |
Butorphanol |
| Feb 07, 2013 |
Calcium Channel Blockers (DHP)-PDL |
| Feb 07, 2013 |
Calcium Channel Blockers (nonDHP)-PDL |
| Feb 07, 2013 |
Calcium Channel Blockers/ARBS-PDL |
| Jul 29, 2003 |
Cold Sore Treatment Fiscal Edit |
| Nov 17, 2005 |
Combunox® Tablets |
| Aug 10, 2012 |
COPD Agents-PDL |
| Feb 07, 2013 |
COX-2 Inhibitors-PDL |
| Feb 07, 2013 |
Cryopyrin-Associated Periodic Syndrome (CAPS) Agents-PDL |
| Feb 07, 2013 |
Direct Renin Inhibitors -PDL |
| Feb 07, 2013 |
Disease-Modifying AntiRheumatic Drug (DMARD) - PDL |
| Nov 13, 2003 |
Dolgic LQ® (Acetaminophen/Butalbital/Caffeine) |
| Feb 07, 2013 |
DPP-IV Inhibitors-PDL |
| Feb 07, 2013 |
Electrolyte Depleters-PDL |
| May 16, 2007 |
Emsam® |
| Jan 19, 2006 |
Equetro® |
| Feb 07, 2013 |
Fibromyalgia Agents |
| Jul 29, 2003 |
Fluconazole (Diflucan) |
| Feb 07, 2013 |
FluoroQuinolones-Oral-PDL |
| Jul 28, 2003 |
Forteo® (teriparatide injection / Parathyroid Hormone) |
| Jul 07, 2003 |
Geodon for Injection (ziprasidone mesylate)/Atypical Antipsychotic Agents, Injectible |
| Feb 07, 2013 |
GLP-1 Receptor Agonists -PDL |
| Jul 13, 2010 |
Growth Hormones-PDL |
| Jul 07, 2003 |
H2 Antagonists |
| Aug 10, 2012 |
Hematopoietic Agents |
| Feb 07, 2013 |
Hepatitis C Therapy-PDL |
| Feb 07, 2013 |
Herpes Antivirals-PDL |
| Aug 10, 2012 |
HMG Co-A reductase inhibitors (statins) -PDL |
| Dec 11, 2003 |
H-Pylori Therapy |
| Apr 23, 2013 |
Human Papillomavirus Vaccines |
| Feb 07, 2013 |
Inhaled Antibiotics-PDL |
| Aug 10, 2012 |
Inhaled Corticosteroids - PDL |
| Aug 10, 2012 |
Insulin Mix-PDL |
| Aug 10, 2012 |
Insulin Rapid Acting-PDL |
| Aug 10, 2012 |
Insulins-PDL |
| Aug 10, 2012 |
Insulins Long Acting-PDL |
| Feb 07, 2013 |
Intranasal Antihistamines-PDL |
| Feb 07, 2013 |
Intranasal Steroids - PDL |
| Feb 07, 2013 |
Intravaginal Antibiotics - PDL |
| Nov 13, 2003 |
Klonopin Wafer® (clonazepam) |
| Nov 07, 2003 |
Lactulose Step Therapy Edit |
| Feb 07, 2013 |
Leukotriene-PDL |
| Feb 07, 2013 |
Macrolides-PDL |
| Feb 07, 2013 |
Meglintinides - PDL |
| Aug 25, 2010 |
Megestrol Acetate |
| Nov 03, 2004 |
Methadone |
| Feb 07, 2013 |
Multiple Sclerosis Agents-PDL |
| Feb 07, 2013 |
Narcotics, Long Acting - PDL |
| Apr 13, 2012 |
Narcotics, Short Acting |
| Feb 09, 2012 |
Narcotics, Short Acting Combinations |
| Feb 07, 2013 |
Niacin Preparations - PDL |
| Aug 10, 2012 |
Non-Ergot Dopamine Receptor Agonists-PDL |
| Jan 26, 2012 |
Non-Oral Contraceptives Fiscal Edit |
| Feb 07, 2013 |
Non-Sedating Antihistamines-PDL |
| Feb 07, 2013 |
NSAID Agents-PDL |
| Aug 24, 2010 |
NSAID Step Therapy Edit |
| May 03, 2007 |
Nubain® |
| Feb 07, 2013 |
Onychomycosis Antifungal Agents-PDL |
| Jun 20, 2007 |
Opana® Immediate-Release Tablets |
| Feb 07, 2013 |
Ophthalmic Antihistamines-PDL |
| Feb 07, 2013 |
Ophthalmic Mast Cell Stabilizers-PDL |
| Aug 10, 2012 |
Ophthalmic NSAIDs-PDL |
| Feb 07, 2013 |
Ophthalmic Prostaglandin Agonists PDL |
| Feb 07, 2013 |
Oral AntiDiabetics: Combinations-PDL |
| Feb 07, 2013 |
Otic Quinolones-PDL |
| Jan 31, 2005 |
Oxandrin® |
| Feb 07, 2013 |
Pancreatic Enzyme Agents-PDL |
| Sep 26, 2005 |
Prostin VR® Pediatric |
| Feb 07, 2013 |
Proton Pump Inhibitor-PDL |
| Nov 12, 2010 |
Psychotropic Medications Polypharmacy |
| Feb 07, 2013 |
Pulmonary Hypertension Agents-PDL |
| Apr 23, 2013 |
Pulmonary Hypertension Agents (Oral)-PDL |
| Feb 07, 2013 |
Quinolone Ophthalmic Antibiotic-PDL |
| Jul 07, 2011 |
Ranexa® |
| Jan 12, 2005 |
Raniclor™ |
| Dec 23, 2004 |
Raptiva |
| Jun 22, 2005 |
Retinoic Acid Products/Retinoid Analogues - Topical |
| Feb 07, 2013 |
Ribavirins - PDL |
| Aug 10, 2012 |
Sedative Hypnotics-PDL |
| Dec 08, 2010 |
Selective Serotonin Reuptake Inhibitor (SSRI) |
| Feb 07, 2013 |
Self Injecting Epinephrine Agents |
| Jul 07, 2011 |
Selzentry® (Maraviroc) |
| Jul 03, 2012 |
Serotonin-Norepinephrine Reuptake Inhibitors (SNRI) |
| Aug 10, 2012 |
Skeletal Muscle |
| Feb 25, 2011 |
Smoking Cessation |
| Jun 20, 2011 |
Suboxone |
| Jul 29, 2003 |
Sucralfate (Carafate) |
| Feb 07, 2013 |
Sulfonylureas-PDL |
| Sep 16, 2010 |
Synagis (palivizumab) |
| May 12, 2006 |
Tamiflu® |
| Feb 07, 2013 |
Tetracyclines-PDL |
| Jul 07, 2003 |
Thalomid (thalidomide) |
| Feb 07, 2013 |
Thiazolidinediones - PDL |
| Oct 29, 2007 |
Tindamax® |
| Feb 07, 2013 |
Topical Agents for Psoriasis - PDL |
| Feb 07, 2013 |
Topical Androgenic Agents |
| Jul 20, 2011 |
Topical Benzoyl Peroxide/Clindamycin Combination |
| Feb 07, 2013 |
Topical Immunomodulators - PDL |
| Feb 07, 2013 |
Topical Retinoids - PDL |
| Feb 07, 2013 |
Topical Steroids-PDL |
| Feb 07, 2013 |
Tramadol Like Agents-PDL |
| Jan 16, 2004 |
Tricyclic Antidepressant Coordination of Care |
| Jul 20, 2011 |
TriGlyceride Lower Agents-PDL |
| Feb 07, 2013 |
Ulcerative Colitis Oral Agents-PDL |
| Feb 07, 2013 |
Ulcerative Colitis-Rectal-PDL |
| Jul 20, 2011 |
Urinary Tract Antispasmodics - PDL |
| Jul 03, 2012 |
Vivitrol ® |
| Mar 07, 2003 |
Voriconazole (Vfend) / Antifungal |
| Nov 13, 2003 |
Xanax XR® (Alprazolam) |
| Dec 30, 2009 |
Xolair |
| Nov 13, 2003 |
Zometa® (zoledronic acid) |
| Jul 03, 2012 |
Zostavax Injection |
| Jan 13, 2005 |
Zyprexa IM® |