Preferred Generic Stimulant Available on the TX Medicaid Formulary

Attention: All Providers Effective Date: July 30, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Effective Thursday, July 30, 2020, the Texas Vendor Drug Program (VDP) updated the Texas Medicaid formulary for STAR and STAR Kids members. The generic formulations of Adderall XR (amphetamine/dextroamphetamine ER) is now on the preferred drug list. Other generic stimulants available on the preferred drug list include:

amphetamine salt combinations IR (and now ER)
dexmethylphenidate IR and ER
dextroamphetamine IR
methylphenidate IR and ER

Other products like Vyvanse (lisdexamfetamine) are also on the preferred drug list, but do not have a generic formulation commercially available. There is a significant price difference among these different products, without a similar difference in efficacy or safety. TCHP encourages providers to consider prescribing generic products like amphetamine/dextroamphetamine ER rather than brand formulations without generics like Vyvanse for members new to therapy. TCHP also encourages switching current members from Vyvanse to a therapeutic alternative such as amphetamine/dextroamphetamine ER when clinically appropriate. Below is a suggested dose conversion chart to guide providers in switching from Vyvanse to amphetamine/dextroamphetamine. Conversions were calculated based on molecular weights, amphetamine base content, and available formulations of each drug. Providers should continue to consider patient-specific factors and use their professional judgement and expertise when switching from Vyvanse to amphetamine/dextroamphetamine ER. Suggested Dose Conversion Chart (1:1 conversion; 1-month supply is quantity of 30 units)

Vyvanse capsule (mg)	Vyvanse chewable tablet (mg)	amphetamine/dextroamphetamine ER capsule (mg)
10	10	--
20	20	5
30	30	10
40	40	15
50	50	20
60	60	25
70	--	30

Next steps for providers: Providers should continue to follow American Academy of Pediatrics guidelines when prescribing, while following new formulary guidelines for impacted members. Providers are encouraged to consider the available generic agents in the stimulant drug class when prescribing. The Texas Medicaid formulary preferred drug list can be found on the TX Vendor Drug Program website (https://www.txvendordrug.com/formulary/prior-authorization/preferred-drugs). If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org. For access to all provider alerts, log into:www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.