AHCCCS Pharmacy Information

Pharmacy Updates

AHCCCS P&T JANUARY 25TH MEETING:

The AHCCCS Pharmacy & Therapeutics Committee Meeting is scheduled for January 25th from 12 PM to 5PM.

Generally, interested parties who wish to give public testimony, fill out the request to give public testimony form on the Magellan/Provider Synergies website under the State of Arizona page.

Magellan recently changed their website and they are having some technical difficulties.

For those who would like to submit a request to give public testimony, please submit your testimony to Robin and Suzi via email, Robin.Davis@azahcccs.gov and Suzanne.Berman@azahcccs.gov.

Please confirm whether you will be giving written or verbal testimony. You may also contact us through the following mailbox: AHCCCSPharmacyDept@azahcccs.gov

Continuous Glucose Monitor (CGM) Update

At the October 2021 AHCCCS Pharmacy and Therapeutics Committee meeting, the continuous glucose monitor (CGM) class was reviewed for potential addition by AHCCCS as a supplemental rebate class. After further review, AHCCCS has determined not to add the CGM class for supplemental rebate. AHCCCS is in the process of standardizing medical necessity criteria for the AHCCCS Fee-for-Service program and MCO contractors.

Updated Synagis Coverage 2022-2023

Human Respiratory Syncytial Virus (RSV) causes respiratory tract infections and serious lung disease in infants and children. Synagis (palivizumab) is available for children that are at high risk for RSV. Please view the link below for information regarding the 2022/2023 Synagis coverage

Synagis Coverage 2022-2023

Pharmacy & Therapeutics Committee

The AHCCCS Pharmacy & Therapeutics Committee (Committee) is advisory to the AHCCCS Administration and is responsible for evaluating scientific evidence of the relative safety, efficacy, effectiveness and clinical appropriateness of prescription drugs. The Committee makes recommendations to the AHCCCS Administration on the development and maintenance of a statewide drug list and prior authorization criteria as appropriate. The Committee may also evaluate individual drugs and therapeutic classes of drugs.

The meetings are open to the public.

P&T Meeting Public Testimony, for persons that are not representing a pharmaceutical company, pharmacy benefit manager or related entity, may be given orally or submitted as a written document in accordance with the AHCCCS P&T Operational Policy

Each person must fill out the Public Testimony Registration Form and the Conflict of Interest Form to register for the meeting. See the AHCCCS P&T Operational Policy for deadlines.

Meeting Schedule

Provider Synergies, LLC is an affiliate of Magellan Medicaid Administration contracted with AHCCCS to facilitate and collect rebates for the supplemental rebate program. For up to date information regarding therapeutic class reviews and public testimony registration, please visit the Provider Synergies Website.

P&T Application - Now Accepting New Members

The AHCCCS Pharmacy and Therapeutics Committee is now accepting new members for the following positions:

Health Care Providers - 3 Representatives
Public - 2 Representatives (Inter-Tribal Council of Arizona and Medicaid Member)
AHCCCS MCO's and TRBHA - 2 Representatives (TRBHA Pharmacy Director and/or TRBHA Medical Director)
University Representative - 1 Representative (Researcher)

Please fill out the P&T Application and send to the Arizona Pharmacy Department ( AHCCCSPharmacyDept@azahcccs.gov ) for consideration.