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July 1, 2005
 
MEDICAID INFORMATION RELEASE 2005-26
 
TO:                 Prescribing Providers, Pharmacists, Pharmacies, Hospitals, and Long-Term Care Facilities
 
FROM:           Randy May, Deputy Administrator
 
SUBJECT:     PRIOR AUTHORIZATION CRITERIA FOR INHALED CORTICOSTEROID DRUG CLASS
 
Drug/Drug Class:
INHALED CORTICOSTEROIDS
Implementation Date:
Effective for dates of service on or after August 1, 2005
 

Idaho Medicaid is designating preferred agents for the Inhaled Corticosteroid therapeutic drug class as part of the Enhanced Prior Authorization Program.   Beginning August 1, 2005, the preferred agents for the Inhaled Corticosteroid drug class will be the following:
 
Preferred Agent(s)
Non-preferred Agents^
  • Flovent®
  • Flovent® Rotadisk
  • Pulmicort®
  • Aerobid®
  • Aerobid-M®
  • Azmacort®
  • Qvar®
^ Use of non-preferred agents must meet prior authorization requirements.
 
For those patients who do not meet the system approval criteria, it will be necessary for you to contact the Medicaid Drug Prior Authorization help desk at (208) 364-1829 or fax a PA request form to (208) 364-1864. 
To assist in managing patients affected by these changes, Medicaid will be sending in a separate mailing to prescribing providers, a list of their patients currently receiving therapy whose drug claims will be affected.
 
The Enhanced PA Program and drug class specific PA criteria are based on evidence-based clinical criteria and available nationally recognized peer-reviewed information.  The determination of medications to be considered preferred within a drug class is based primarily on objective evaluations of their relative safety, effectiveness, and clinical outcomes in comparison with other therapeutically interchangeable alternative drugs and secondarily on cost.
 
Questions regarding the Prior Authorization program may be referred to Medicaid Pharmacy at (208) 364-1829.

 
A current listing of all the preferred agents by drug class and prior authorization criteria is also available online at www.medicaidpharmacy.idaho.gov.  Thank you for your continued participation in the Idaho Medicaid program.
 
IDAHO MEDICAID PROVIDER HANDBOOK
This Information Release does not replace information in your Idaho Medicaid Provider Handbook.
 
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