Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. ·...
Transcript of Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. ·...
Enterprise P&T Meeting
Committee Meeting Minutes
February 10, 2020
Voting Members Present
Antypas, Christopher PharmD Caton, Kirt MD Higgins, Lily MD Michael, Kendra MD Peterson, Andrew PharmD
Batluck, David, DO Caton, Cathryn MD Hockmuth, Robert MD Muller, Betty MD Weart, Wayne PharmD Beam, Donald MD Cooper, Don RPh Jordan, Karen MD Murphy, Michelle PharmD Whitfield, Rani MD Brinley, Floyd MD Elebra, Rogers PharmD Kryger, Emily PharmD Orr, Lavdena MD Wise, Rodney MD
Burnham, William MD Fecondo, Fury, PharmD Martin, Kelly PharmD Peters, Eric PharmD
Excused Voting Members
Smith, Kirby MD Lawyer, Lanaye MD Petkash, David MD Geraci, Gus MD McAlister, Susan MD
Invited Guests Present
Abad, Melissa CPhT Davis, Tracey PharmD Paul, Larry DMD Weiss, Erich PharmD Albandoz, Linda DeHoratius, Patrick Plante, Jeanine PharmD Wendt, Melwyn Cheely, George MD Geurruero, Monica Seitz, Ally PharmD Wiseman, Arlene PharmD Clement, Kathleen Holley, April Smith, Bryan MD Xiang, Ding PharmD Cohen, Bernard MD Hunter, Amanda PharmD Trumbower, Devon Colvin, Mike PharmD Megargell, Lauren PharmD Vodoor, Calla PharmD
Issue Discussion Conclusion/Results Vote Action/ Person
Responsible
1. Call to Order The meeting was called to order at 6:00 PM EST. Dr. Burnham welcomed all external and internal participants.
Informational Only
Dr. William
Burnham
2. Conflict of Interest
Disclosure
No conflicts announced Informational Only
Dr. William
Burnham
3. Enterprise P&T Charter and
Conflict of Interest Training
Informational Only
Dr. William
Burnham
4.
5. Review and approval of
October 28, 2019 and
December Proxy minutes
Committee approved October 28, 2019 and December Proxy approved the minutes as
presented
Committee approved as
recommended
Dr. William
Burnham
6. Old Business
Natpara PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Approve the Natpara prior authorization criteria
Extend the initial authorization period to 6 months
Add reauthorization criteria
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Sleep disorder PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Approve the Xyrem criteria Lower Xyrem age restriction to
align with the FDA-approved label
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Modulartors
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Remove prescriber attestation for liver function testing in the reauthorization criteria
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
7. New Business
8. Drug Reviews
Therapeutic Class
Gastrointestinal Antispasmodics PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Remove Proantheline 15 mg oral tablet from the formulary due to the presence of more cost effective alternatives available on the formulary
Remove Dicyclomine 10 mg/5 mL oral solution from the formulary due availability of the more cost effective tablet and capsule formulations of dicyclomine currently on the formulary
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Approve the newly developed glycopyrrolate prior authorization criteria to ensure appropriate utilization of Cuvposa and alternative glycopyrrolate strengths
First Generation Antihistamine PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Remove chlorpheniramine 2 mg/5 mL syrup from the formulary due to the lack of utilization and availability
Committee approved as recommended
PerformRx will
update the criteria and formulary/PDL with any changes
of more cost effective formulary agents.
Single Products
Methergine PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add a quantity limit for 28 tablets in 7 days to ensure appropriate utilization
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Ruzurgi with PA Criteria
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add Ruzurgi (amifampridine) to Tier 4 with drug specific prior authorization criteria.
Approve the Amifampridine prior authorization criteria as a new policy.
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Firdapse Prior Authorization Criteria PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Approve the Amifampridine criteria as a new policy.
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Baqsimi PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add a quantity limit of 2 kits per 30 days for glucagon emergency kits.
Add Baqsimi to the formulary due to the availability of preferred pricing, with a quantity limit of 2 spray devices per 30 days, and an age restriction to 4 years and older.
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Nourianz with PA Criteria PerformRx makes the following
recommendation:
Approve
KF/AHC/AHNE/
Make no changes to the formulary status of Nourianz (istradefylline)
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Inbrija with PA Criteria PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Make no changes to the formulary status of Inbrija (levodopa)
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Onpattro with PA Criteria PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add Onpattro (patrisian) to the non-PDL specialty tier with drug and indication specific prior authorization criteria.
Approve the newly developed Transthyretin-mediated Amyloidosis Agents prior authorization criteria
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Tegsedi with PA Criteria PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add Tegsedi (inotersin) to the non-PDL specialty tier with prior authorization
Approve the newly developed Transthyretin-mediated Amyloidosis Agents prior authorization criteria
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
Vyndaqel/Vyndamax with PA Criteria
PerformRx makes the following recommendation: PG 329
KF/AHC/AHNE/
Add Vyndaqel (tafamidis meglumine) and Vyndamax (tafamidis) to the non-PDL specialty tier with prior authorization
Approve the newly developed Transthyretin-mediated Amyloidosis Agents prior authorization criteria
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
7. New Products
PerformRx makes the following
recommendation:
Add to Specialty Tier with drug specific PA criteria for KF/AHC/AHN/
Adakveo Asceniv Asparlas Egrifta SV Enhertu Givlaari Kanjinti Ogivri Oxbryta Padcev Pretomanid Reblozyl Trikafta Truxima Vyondys 53
Committee approved as
recommended
PerformRx will
update the criteria and formulary/PDL with any changes
Xembify
9. Prior Authorization Criteria
Review
A. Prior Authorization Annual
Criteria
Alpha-1 Proteinase Inhibitors (Human)
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Remove age criteria from “other criteria” section to avoid duplication
Change predicted FEV1 requirement to 35-60% to correspond with latest COPD GOLD guidelines
Extend the authorization period to 12 months
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
:
any changes
Sprinraza PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add the length of time the initial and reauthorization requests will be approved for in addition to number of doses.
Clarify that the Hammersmith Infant Neurological Examination can be used in Type 1 SMA to align with clinical trial endpoint.
In the reauthorization criteria, clarifying that patients previously without ventilator support remain off of the ventilator
Committee approved as recommended
PerformRx will update the criteria
and formulary/PDL with any changes
:
B. Prior Authorization New
Criteria
Car-T Therapies PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Approve the newly developed Anti-CD19 CAR-T Immunotherapies prior authorization criteria
Committee approved as recommended
PerformRx will update the criteria and formulary/PDL with any changes
Benlysta PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Approve the newly developed Benlysta prior authorization
Committee approved as recommended
PerformRx will update the criteria and formulary/PDL with any changes
Blincyto PerformRx makes the following
recommendation:
KF/AHC/AHNE
Approve the newly developed criteria
Committee approved as recommended
PerformRx will update the criteria and formulary/PDL with any changes
Provenge PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Approve the newly developed Dendritic Cell Tumor Peptide Immunotherapy prior authorization criteria
Committee approved as recommended
PerformRx will update the criteria and formulary/PDL with any changes
________________________________ _______________ Dr. William Burnham, MD - Chair Date
10. Recalls
Non-lot level recalls. 1 nationwide DR Reddy Rantidine were posted
Informational
Chris Meny
11. Adjournment
William Burnham
The meeting adjourned at 7:59 PM EST
N/A
The next meeting
May 10, 2020 from 6:00 PM‐ 8:00 PM.