Clinical Criteria
ADD/ADHD Agents (Pending Implementation) (Revised September 5, 2024)*
ADD/ADHD Agents (Revised November 4, 2024)*
Aliskiren Containing Agents (Pending Implementation) (Revised July 5, 2022)*
Aliskiren Containing Agents (Revised September 3, 2024)*
Allergen Extracts (Pending Implementation) (Revised August 31, 2024)*
Allergen Extracts (Revised December 10, 2019)*
ALS Agents (Pending Implementation) (Revised August 31, 2024)*
Altabax (Revised July 5, 2022)*
Amantadine ER (Pending Implementation) (Revised February 28, 2024)*
Androgenic Agents (Pending Implementation) (Revised May 1, 2024)*
Antiemetic Agents (Revised July 5, 2022)*
Antifungal Agents, Topical (Pending Implementation) (Revised September 18, 2024)*
Antimigraine Agents, Ergot Derivatives (Pending Implementation) (Revised August 31, 2024)*
Antimigraine Agents, Ergot Derivatives (Revised January 9, 2024)*
Antimigraine Agents, Triptans (Pending Implementation) (Revised September 18, 2024)*
Antimigraine Agents, Triptans (Revised March 7, 2024)*
Antipsychotic Agents (Pending Implementation) (Revised November 20, 2024)*
Antipsychotic Agents (Revised November 20, 2024)*
Antiseizure Agents (Pending Implementation) (Diacomit, Epidiolex, and Fintepla) (Revised September 18, 2024)*
Anxiolytics and Sedative-Hypnotics (Pending Implementation) (Revised August 31, 2024)*
Anxiolytics and Sedative-Hypnotics (Revised July 18, 2023)*
Appetite Suppressant Agents (Pending Implementation) (Revised August 19, 2024)*
Arikayce (Pending Implementation) (Revised July 5, 2022)*
Biliary Cholangitis Agents (formerly IBAT Inhibitors) (Pending Implementation) (Revised October 25, 2024)*
Binge Eating Disorder (BED) Agents (Pending Implementation) (Revised February 13, 2024)*
Buprenorphine Agents (Revised September 18, 2024)*
Carisoprodol Overuse (Revised June 30, 2024)*
Carisoprodol-Containing Agents (Pending Implementation) (Revised June 30, 2024)*
CGRP Antagonists, Acute (Pending Implementation) (Revised August 31, 2024)*
CGRP Antagonists, Acute (Revised December 1, 2022)*
CGRP Antagonists, Prophylaxis (Pending Implementation) (Revised August 31, 2024)*
CGRP Antagonists, Prophylaxis (Revised January 9, 2024)*
CNS Stimulants (Pending Implementation) (Revised June 30, 2024)*
CNS Stimulants (Revised October 29, 2019)*
Colchicine (Pending Implementation) (Revised January 26, 2024)*
Corticotrophin (formerly HP Acthar) (Pending Implementation) (Revised August 31, 2024)*
Corticotrophin (formerly HP Acthar) (Revised August 31, 2024)*
Cortisol Receptor Antagonists (Pending Implementation) (Revised June 30, 2024)*
Cough & Cold Agents (Revised November 4, 2024)*
COX-2 Inhibitors (Revised May 24, 2022)*
Cyclobenzaprine (Revised May 1, 2024)*
Cymbalta (Pending Implementation) (Revised May 1, 2024)*
Cystic Fibrosis Agents (Revised July 31, 2024)*
Cytokine and CAM Antagonists (Pending Implementation) (Revised November 7, 2024)*
Cytokine and CAM Antagonists (Revised September 6, 2024)*
Daybue (Revised November 12, 2024)*
Desmopressin (Pending Implementation) (Revised May 1, 2024)*
Desmopressin (Revised February 1, 2023)*
Dextromethorphan Overutilization (Revised November 14, 2024)*
Diabetic Test Strips (Pending Implementation) (Revised March 27, 2019)*
Diclofenac (Pending Implementation) (Revised June 30, 2024)*
Dopamine Agonists (Pending Implementation) (Revised May 8, 2024)*
Doxylamine/Pyridoxine (Pending Implementation) (Revised July 31, 2024)*
DPP4 Inhibitors (Revised November 4, 2024)*
Drug Regimen Optimization (Retired)*
Duplicate Therapy (Revised July 15, 2024)*
Emflaza (Revised September 18, 2024)*
Enzymes (Pending Implementation) (Revised May 8, 2024)*
Enzymes (Revised October 18, 2022)*
Eohilia (Pending Implementation) (Revised July 26, 2024)*
Erythropoiesis-Stimulating Agents (Pending Implementation) (June 30, 2024)*
Erythropoiesis-Stimulating Agents (Revised October 28, 2022)*
Evrysdi (Pending Implementation) (Revised August 5, 2024)*
Fentanyl Agents (Revised June 10, 2024)*
Filspari (Pending Implementation) (Revised October 13, 2023)*
FMT Agents (Pending Implementation) (Revised July 26, 2023)*
Forteo (Pending Implementation) (Revised May 9, 2024)*
Gabapentin Agents (Pending Implementation) (Revised June 30, 2024)*
Gabapentin Agents (Revised October 30, 2023)*
Gattex (Revised February 13, 2024)*
Gaucher's Disease Agents (Pending Implementation) (Revised August 31, 2024)*
Gaucher's Disease Agents (Revised January 9, 2024)*
GI Motility Agents (Pending Implementation) (Revised June 10, 2024)*
GI Motility Agents (Revised June 10, 2024)*
Glatiramer Acetate Injection (Pending Implementation) (Revised August 31, 2024)*
GLP-1 Receptor Agonists (Revised August 9, 2023)*
Gonadotropin Releasing Hormone (GnRH) Receptor Antagonists (Pending Implementation) (Revised September 12, 2022)*
Growth Hormone Agents (Pending Implementation) (Revised July 25, 2024)*
Growth Hormone Agents (Revised November 4, 2024)*
Growth Hormone Quick Reference Guide
HAE Agents (Pending Implementation) (Revised August 31, 2024)*
HAE Agents (Revised January 11, 2024)*
Hemady (Pending Implementation) (Revised June 30, 2024)*
Hormonal Therapy Agents (Revised November 4, 2024)*
Hyperlipidemia Agents (Pending Implementation) (Revised August 31, 2024)*
Hyperlipidemia Agents (Revised January 9, 2024)*
Ileal Bile Acid Transporter (IBAT) Inhibitors (Pending Implementation) (Revised August 31, 2024)*
Imcivree (Pending Implementation) (Revised October 13, 2023)*
Imiquimod (Pending Implementation) (Revised May 9, 2024)*
Imiquimod (Revised December 13, 2023)*
Immunomodulator Agents for Dry Eye (Pending Implementation) (Revised June 25, 2024)*
Increlex (Revised October 19, 2022)*
Inhaled Antibiotics (Revised June 30, 2024)*
Ketorolac (Revised June 30, 2024)*
Keveyis (Pending Implementation) (Revised June 30, 2024)*
Leukotriene Modifiers (Pending Implementation) (Revised August 31, 2024)*
Leukotriene Modifiers (Revised January 9, 2024)*
Lidocaine Patches (Pending Implementation) (Revised August 31, 2024)*
Lupus Agents (Pending Implementation) (Revised July 3, 2024)*
Lyrica (Pending Implementation) (Revised July 31, 2024)*
Monoclonal Antibody Agents (Pending Implementation) (Revised November 7, 2024)*
Monoclonal Antibody Agents (Revised May 9, 2024)*
Monoclonal Antibody Agents - Dupixent (Revised March 10, 2022)*
Multiple Sclerosis Agents (Pending Implementation) (Revised June 1, 2023)*
Nitazoxanide (Formerly Alinia) (Revised September 7, 2021)*
Nitazoxanide (Pending Implementation) (Revised May 24, 2022)*
Nuedexta (Revised February 14, 2024)*
Nuplazid (Pending Implementation) (Revised July 31, 2024)*
Omega-3 Fatty Acids (Revised September 13, 2023)*
Opiate Overutilization (Revised November 13, 2024)*
Opiate/Benzodiazepine/Muscle Relaxant Combinations (Revised November 13, 2024)*
Orilissa (Pending Implementation) (Revised February 16, 2024)*
Oxervate (Pending Implementation) (Revised August 31, 2024)*
Oxybate Products (Pending Implementation) (Revised July 31, 2024)*
Oxycodone Extended-Release Agents (Revised November 13, 2024)*
Palforzia (Pending Implementation) (Revised October 19, 2022)*
PDE5-Inhibitors (Revised June 30, 2024)*
Phosphate Binders (Revised July 31, 2024)*
Plavix (Revised July 31, 2024) (Criteria retired November 10, 2024)*
Preferred Drug List (January 2024)*
Promethazine Utilization (Revised May 14, 2024)*
Propylthiouracil (Revised June 30, 2024)*
Proton Pump Inhibitors (Pending Implementation) (Revised February 16, 2024)*
Pulmonary Hypertension Agents (Pending Implementation) (Revised August 31, 2024)*
Pulmonary Hypertension Agents (Revised May 6, 2024)*
Pulmozyme (Pending Implementation) (Revised February 16, 2024)*
Ranexa (Revised June 30, 2024)*
Recurrent Vulvovaginal Candidiasis (RVVC) Agents (Pending Implementation) (Revised September 18, 2024)*
Retinoids (Pending Implementation) (February 23, 2024)*
Rezurock (Pending Implementation) (Revised October 13, 2023)*
Savella (Pending Implementation) (Revised February 20, 2024)*
SGLT2 Inhibitors (Pending Implementation) (Revised February 20, 2024)*
SGLT2 Inhibitors (Revised August 1, 2023)*
Sickle Cell Agents (October 17, 2024 - Retired due to product recall)*
Skyclarys (Pending Implementation) (Revised October 13, 2023)*
Sphingosine 1-phosphate (S1P) Receptor Modulators (Pending Implementation) (Revised April 26, 2024)*
Symlin (Revised July 31, 2024)*
Synagis (Revised November 14, 2024)*
Systemic Corticosteroids (Pending Implementation) (Revised October 25, 2024)*
Thiazolidinediones (Revised July 31, 2024)*
Topical Acne Agents (Pending Implementation) (Revised February 23, 2024)*
Topical Immunomodulators (Pending Implementation) (Revised May 14, 2024)*
Topical Immunomodulators (Revised June 24, 2020)*
Transthyretin Agents (Pending Implementation) (Revised August 31, 2024)*
Urea Cycle Disorder Agents (Pending Implementation) (Revised February 23, 2024)*
Valturna (Retired) (Revised August 23, 2017)*
Veozah (Pending Implementation) (Revised August 14, 2023)*
VMAT2 Inhibitors (Pending Implementation) (Revised August 16, 2024)*
VMAT2 Inhibitors (Revised November 4, 2024)*
Voxzogo (Pending Implementation) (Revised July 25, 2024)*
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Announcements
There are currently no new announcements