Attention: All Providers
Effective Date: October 16, 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:
The Texas Vendor Drug Program (VDP) updated the Texas Medicaid formulary for STAR and STAR Kids members. The branded formulations of Concerta (methylphenidate ER) will be moved back to the non-preferred drug list.
VDP temporarily removed the non-preferred status for brand Concerta products in the Stimulants drug class on April 23 in response to reported drug shortages. VDP will reverse this change in status because of sufficient availability in the market. VDP made this determination after verifying the current availability of the preferred Methylphenidate ER tablet products, as well as the non-preferred brand Concerta products through multiple sources such as ASHP, FDA, manufacturers, wholesalers, and pharmacies in various regions around Texas.
VDP will restore the non-preferred status on the following:
NDC
Drug Name
50458058501
CONCERTA ER 18 MG TABLET
50458058801
CONCERTA ER 27 MG TABLET
50458058601
CONCERTA ER 36 MG TABLET
50458058701
CONCERTA ER 54 MG TABLET
How this impacts providers:
TCHP encourages switching current members from brand Concerta to generic equivalent methylphenidate ER when clinically appropriate.
Drug Class
Medication
Current Status
Status effective Oct 16, 2020
Medication on Preferred Drug List (PDL)
Stimulants
Concerta 18 mg, 27 mg, 36 mg, 54 mg
Preferred (PDL)
Non-Preferred (NPD)
methylphenidate ER 18 mg, 27 mg, 36 mg, 54 mg
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.
