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Oxbryta Prior Authorization Criteria Updates Scheduled for April 5, 2022

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On April 5, 2022, the Texas Health and Human Services Commission (HHSC) will revise the prior authorization criteria in the Sickle Cell Disease Agents clinical prior authorization for Oxbryta (voxelotor), to ensure alignment with the US Food and Drug Administration (FDA)-approved indications and package inserts.

The criteria update includes the FDA’s recent age expansion to 4 years and older, and the removal of criteria step 6 relating to the drug interaction with CYP3A4 inhibitors or fluconazole. The updated criteria guide document also includes pediatric dosing information tables.

The authorization is optional for managed care organizations (MCOs). The Pharmacy Clinical Prior Authorization Assistance Chart indicates which prior authorization each MCO uses. The chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.

Contact vdp-formulary@hhsc.state.tx.us with comments or any questions.