AHCCCS Pharmacy Information

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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

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.

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.

P&T Meeting and Class Review Schedule

May 23, 2023

  • Supplemental Rebate Classes Review:
    • Inhaled Glucocorticoids
    • Opiate Dependence Treatments
    • Hypoglycemics - Incretin Mimetics/Enhancers
    • Hypoglycemics -Insulin and Related Agents
    • COPD Agents
    • Antipsychotics - Oral 2nd Generation
    • Antipsychotics - Atypical Long-Acting Injectables
    • Stimulants and Related Agents
    • Pancreatic Enzymes
    • Anticoagulants
    • Hepatitis C Agents
    • Cytokine and CAM Antagonists
    • Long Acting Narcotic Analgesics
    • Growth Hormone
    • Epinephrine, Self-Injected
    • Antibiotics, Inhaled
    • Antimigraine – CGRPs
    • Glucagon

October 25, 2023

  • Non-Supplemental Repeat Classes Review:
    • Antimigraine Agents-Triptans
    • Leukotriene Modifiers
    • Phosphate Binders
    • Sedative Hypnotics
    • Topical Steroids by Potency (low, medium, high, very high)
    • Antifungals-Oral
    • Antifungals- Topicals
    • Beta Blockers
    • BPH Treatments
    • Calcium Channel Blockers
    • HIV-AIDS
    • Movement Disorders

January 24, 2024

  • Non-Supplemental Rebate Classes Review:
    • Antidepressants - Other
    • Antidepressants - SSRIs
    • Beta Agonist Bronchodilators
    • Bone Resorption Suppression and Related Agents
    • Colony Stimulating Factors
    • Enzyme Replacement - Gauchers Disease
    • Erythropoiesis Stimulating Proteins
    • Hypoglycemics - Alpha-Glucosidase Inhibitors
    • Hypoglycemics - Metformins
    • Hypoglycemics - SGLT2s
    • Immune Globulins
    • Oncology, Oral - Hematologic
    • Ophthalmics – Anti-Inflammatory/Immunomodulators
    • Otic Antibiotics
    • PAH Agents - Oral and Inhaled
    • Thrombopoiesis Stimulating Proteins

Agendas & Meeting Minutes

ANNOUNCEMENT: All AHCCCS P&T meetings will be held virtually until further notice.

Current P&T Committee Member Information

For more information, you may contact the Pharmacy Department at AHCCCSPHARMACYDEPT@AZAHCCCS.GOV.

Archived pharmacy documents are available under ‘Pharmacy Updates’ in the AHCCCS Document Archive.