June 1, 2021

Delivery Model Feedback

The Louisiana Department of Health (LDH) continues its commitment to transforming its Medicaid managed care program to provide better care and better health for its members. As part of this goal, LDH is reviewing the current transportation services and pharmacy benefit delivery models. LDH seeks input from the public about the key factors that must be considered when improving these models. This feedback can be provided at: https://ldh.la.gov/index.cfm/form/241. Feedback on NEMT/pharmacy benefits is due June 21, 2021.

Brand Over Generic List: PHARMACISTS — adjust your inventory accordingly

On May 7, 2021, LDH held a virtual Pharmaceutical & Therapeutics (P&T) Committee Review webinar via Zoom. LDH’s legal department authorized Pharmacy staff to host a review in lieu of an actual meeting due to the constraints of COVID and the current public meeting laws. We were unable to obtain a quorum of P&T Committee members for an in-person meeting, and the review was conducted without the P&T members voting. However, feedback from committee members, the public, and drug manufacturers was allowed and taken into consideration.

In addition, the Pharmacy Advisory Council (PAC) members reviewed the Brand over Generic list and provided feedback as well. There are times when brand products are preferred over generics because the net price to the state is less expensive after rebate. After considering the financial and clinical impacts as well as the feedback on the proposed recommendations, the Brand over Generic List will be as follows effective July 1, 2021:

 

 

Brand over Generic List for Spring 2021 –

Effective July 1, 2021

(bold is new to the list)

 

Spring/Fall

 

Unit of Use/Bulk

1

ADVAIR DISKUS (INHALATION)

Fall

UU

2

AFINITOR (ORAL)

Fall

UU

3

ALPHAGAN P 0.15% (OPHTHALMIC)

Fall

UU

4

AMITIZA (ORAL)

Spring

UU

5

APRISO (ORAL)

Spring

UU

6

BETHKIS (INHALATION)

Spring

UU

7

CARBATROL (ORAL)

Fall

Bulk

8

CATAPRES-TTS (TRANSDERM)

Fall

UU

9

CIPRODEX (OTIC)

Fall

UU

10

COPAXONE 20 MG/ML (SUBCUTANE.)

Spring

UU

11

DEPAKOTE SPRINKLE (ORAL)

Fall

Bulk

12

ELIDEL (TOPICAL)

Fall

UU

13

FELBATOL TABLET (ORAL)

Fall

Bulk

14

FOCALIN XR (ORAL)

Fall

Bulk

15

IMITREX (NASAL)

Spring

UU

16

NATROBA (TOPICAL)

Spring

UU

17

NEXIUM SUSPENSION (ORAL)

Spring

UU

18

PROTONIX SUSPENSION (ORAL)

Spring

UU

19

RAPAMUNE SOLUTION and TABLET (ORAL)

Spring

UU/Bulk

20

RENVELA TABLET (ORAL)

Spring

Bulk

21

RETIN-A CREAM (TOPICAL)

Spring

UU

22

SABRIL TABLET and POWDER PACK (ORAL)

Fall

Bulk/UU

23

SUBOXONE FILM (SUBLINGUAL)

Spring

Bulk

24

SYMBICORT (INHALATION)

Fall

UU

25

TECFIDERA and TECFIDERA STARTER PACK (ORAL)

Spring

UU/UU

26

TEGRETOL XR (ORAL)

Fall

Bulk

27

TOBRADEX SUSPENSION (OPHTHALMIC)

Fall

UU

28

TRAVATAN Z (OPHTHALMIC)

Fall

UU

29

TRILEPTAL SUSPENSION (ORAL)

Fall

UU

 

 

Brand Over Generic Products Removed – Spring 2021

Notes

1

TRANSDERM-SCOP (TRANSDERM)

Generic will be preferred

2

HUMALOG VIAL (SUBCUTANE.)

 

Both brands and generics will be preferred

3

HUMALOG PEN (SUBCUTANE.)

4

NOVOLOG MIX VIAL (SUBCUTANE.)

5

NOVOLOG MIX PEN (SUBCUTANE.)

6

NOVOLOG PEN (SUBCUTANE.)

7

NOVOLOG VIAL (SUBCUTANE.)

8

NOVOLOG CARTRIDGE (SUBCUTANE.)

9

REVATIO SUSPENSION (ORAL)

Generic will be preferred

 

Preferred Drug List (PDL) Updates

 The new PDL will be implemented on July 1, 2021.

 There are six new therapeutic classes added to the PDL. Those classes include:

  • Glucagon
  • Growth Factors ̶ previously on the back page with clinical criteria applied.
  • Hereditary
  • HIV/AIDS – all agents will have a preferred status with no prior
  • Infectious Disorders – Pleuromutilins – previously on the back page with clinical criteria
  • Potassium Binders – previously on the back page with clinical criteria