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Notification of Drug Policy Revisions Effective January 1, 2024 (Posted November 1, 2023)

Medical Drug Policy NameRevised Criteria
Fecal Microbiota, Live – jslm (Rebyota) Notification (PDF)Added requirement that positive stool test for Clostridioides difficile toxin or toxigenic Clostridioides difficile must be within the past 30 days. Policy notification given 11/1/2023 for effective date 1/1/2024.
Tezepelumab-ekko (Tezspire) Notification (PDF)Added requirement for use of the self-administered product unless certain criteria are met. Removed step requirements through Dupixent, Fasenra, Nucala, and Xolair for associated indications. Minor adjustments made to formatting with no change to policy intent. Policy notification given 11/1/2023 for effective date 1/1/2024.