Current information for pharmacists about the MassHealth Pharmacy program MassHealth Pharmacy Program Number 80 July 12, 2013 Pharmacy Facts MassHealth Pharmacy Program www.mass.gov/masshealth/pharmacy Editor: Vic Vangel Contributors: Chris Burke, Gary Gilmore, Paul Jeffrey, Kim Lenz, James Monahan, Nancy Schiff MHDL Update Below are certain updates to the MassHealth Drug List (MHDL). See the MHDL for a complete listing of updates. 1. Additions The following newly marketed drugs have been added to the MassHealth Drug List as of July 15, 2013. Afinitor Disperz (everolimus tablets for oral suspension) desvenlafaxine – PA Diclegis (doxylamine/pyridoxine delayed-release) – PA Fulyzaq (crofelemer) – PA INVOKANA (canagliflozin) – PA Kadcyla (ado-trastuzumab) – PA Kazano (alogliptin/metformin) – PA KYNAMRO (mipomersen) – PA Liptruzet (ezetimibe/atorvastatin) – PA NESINA (alogliptin) – PA Oseni (alogliptin/pioglitazone) – PA Pomalyst (pomalidomide) – PA Prolensa (bromfenac 0.07%) – PA RAVICTI (glycerol phenylbutyrate) – PA Rescula (unoprostone isopropyl ophthalmic solution) – PA Signifor (pasireotide) – PA Suclear Bowel Prep Kit (polyethylene glycol) – PA Tecfidera (dimethyl fumarate) – PA TOBI Podhaler (tobramycin inhalation powder) 2. Change in Prior-Authorization Status The following generic antiemetics will be covered without prior authorization for all quantities, effective July 15, 2013. Zofran # (ondansetron 4 mg, 8 mg) Zofran ODT # (ondansetron orally disintegrating tablet 4 mg) 3. MassHealth Over-the-Counter Drug List The following drug has been added to the MassHealth Over-the-Counter Drug List as covered. Doxylamine PA – Prior authorization is required. The prescriber must obtain prior authorization for the drug in order for the pharmacy to receive payment. Note: Prior authorization applies to both the brand-name and the FDA “A”-rated generic equivalent of listed product. # – This designates a brand-name drug with FDA “A”-rated generic equivalents. Prior authorization is required for the brand, unless a particular form of that drug (for example, tablet, capsule, or liquid) does not have an FDA “A”-rated generic equivalent Please direct any questions or comments (or to be taken off of this fax distribution) to Victor Moquin of Xerox at 617-423-9830. Document ends.