Utah Admin. Code R414-60B-7 - Clinical and Cost-Related Factors
The P& T Committee shall base its determinations on the following factors as established by the DURB:
(1) If clinical and therapeutic
considerations are substantially equal, then the P& T Committee shall
recommend to DMHF that it consider only cost.
(2) In making its recommendations to DMHF,
the P& T Committee may also consider whether the clinical, therapeutic
effects, and medical necessity requirements justify the cost differential
between drugs within a therapeutic class.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
The P& T Committee shall base its determinations on the following factors as established by the DURB:
(1) If clinical and therapeutic considerations are substantially equal, then the P& T Committee shall recommend to DMHF that it consider only cost.
(2) In making its recommendations to DMHF, the P& T Committee may also consider whether the clinical, therapeutic effects, and medical necessity requirements justify the cost differential between drugs within a therapeutic class.