KMAP BULLETIN: Preferred Drug List Update April 2025

Date: 04/07/25

Effective with dates of service on or after April 1, 2025, the following medications will become non-preferred and require a Preferred Drug List (PDL) Prior Authorization (PA):

Alyftrek™ (vanzacaftor/tezacaftor/deutivacaftor)
Clobetasol Propionate topical 0.025%
Metaxolone 640mg
Metformin 750mg

Effective with dates of service on or after April 1, 2025, the following medications are considered preferred:

Anoro Ellipta® (umeclidinium/vilanterol)
Ebglyss™ (lebrikizumab-lbkz)
Kalydeco® (ivacaftor)
Lyfgenia (lovotibeglogene autotemcel)
Orkambi® (lumacaftor/Ivacaftor)
Otulfi (ustekinumab-aauz)
Pyzchiva (ustekinumab-ttwe)
Selarsdi (ustekinumab-aekn)
Steqeyma (ustekinumab-stba)
Symdeko® (tezacaftor/Ivacaftor; Ivacaftor)
Trikafta® (elexacaftor/tezacaftor/ivacaftor; Ivacaftor)
Xolair® (omalizumab)
Yesintek (ustekinumab-kfce)

Effective with dates of service on or after April 1, 2025, the following medications will be removed from the PDL as they have been discontinued by the manufacturer:

Nucynta® (tapentadol)
Nucynta ER® (tapentadol ER)
Xtampza ER® (oxycodone ER)

Note: The effective date of the policy is April 1, 2025. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.