Oseni and the Thiazolidinediones (TZD) Clinical Prior Authorization Update

Date: January 26, 2021 Attention: Primary Care Providers and Endocrinologists Effective Date: February 4, 2021Providers 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: Texas Children’s Health Plan (TCHP) would like to inform network providers that beginning February 4, 2021 Texas Medicaid will remove the Thiazolidinediones (TZD) prior authorization criteria from Oseni (alogliptin/pioglitazone).  Texas Medicaid will continue to require Dipeptidyl Peptidase-4 (DPP-4) Inhibitor prior authorization criteria.  Oseni is a combination ingredient product used to treat Type 2 Diabetes Mellitus. How this impacts providers: Oseni is currently subject to two clinical prior authorizations, DPP-4 Inhibitors and TZD.  Oseni is not recommended in patients with severe renal impairment or patients who have an end-stage renal disease (ESRD) requiring dialysis. While this recommendation is consistent with the current DPP-4 Inhibitors criteria documented in the package insert, it is not consistent with the TZD criteria, therefore TZD criteria are deemed inappropriate for Oseni. Next steps for providers: Providers should share this communication with their staff. Resource: Texas Prior Authorization Program Clinical CriteriaIf you have any questions, please email TCHP Pharmacy Department at: tchppharmacy@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers