Amarin Corp Plc (AMRN)

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From Texas Health and Human Services

HHSC Updates Clinical Prior Authorizations Criteria Guides

July 27, 2023

HHSC reviewed the following clinical prior authorization criteria guides and made the updates shown below. These clinical prior authorizations are optional for the MCOs. HHSC will notify providers when we implement any of these prior authorizations for Medicaid fee-for-service.

Omega-3 Fatty Acids

Clinical prior authorization criteria guide (PDF): https://paxpress.txpa.hidinc.com/lovazapdg.pdf

Vascepa (icosapent ethyl) 500 mg

Added GCNs for Icosapent Ethyl (33238, 42365).

https://www.txvendordrug.com/about/news/2023/hhsc-updates-clinical-prior-authorizations-criteria-guides

Generic Code Number (GCN) - A GCN is a standard number assigned by a drug pricing service called First DataBank. The GCN identifies each strength, formulation, and route of administration of a drug entity. Each drug has its own unique GCN.

(From https://www.findacode.com/articles/drug-classification-systems-35806.html)

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