Provider Alert! Oseni and the Thiazolidinediones (TZD) Clinical Prior Authorization Update
Date: January 26, 2021
Attention: Primary Care Providers and Endocrinologists
Effective Date: February 4, 2021
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: 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 Criteria
If 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
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