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DRUG UTILIZATION REVIEW COMMITTEE CHAIR PHARMACY PROGRAM MANAGER DIVISION OF HEALTH CARE FINANCE KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT DATE Page 1 of 2 Biologic Agents Generic Name Brand Name Tofacitinib Xeljanz Xeljanz XR Apremilast Otezla Secukinumab Cosentyx Vedolizumab Entyvio. PA Criteria Initial Approval July 13 2016 CRITERIA FOR PRIOR AUTHORIZATION Taltz ixekizumab PROVIDER GROUP Pharmacy Professional MANUAL GUIDELINES The following drug requires prior authorization Ixekizumab...
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