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. ·...
![Page 1: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/1.jpg)
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
![Page 2: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/2.jpg)
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.
![Page 3: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/3.jpg)
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
![Page 4: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/4.jpg)
![Page 5: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/5.jpg)
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
![Page 6: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/6.jpg)
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
![Page 7: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/7.jpg)
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
![Page 8: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/8.jpg)
![Page 9: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/9.jpg)
7. New Business
![Page 10: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/10.jpg)
![Page 11: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/11.jpg)
![Page 12: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/12.jpg)
![Page 13: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/13.jpg)
![Page 14: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/14.jpg)
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
![Page 15: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/15.jpg)
Approve the newly developed glycopyrrolate prior authorization criteria to ensure appropriate utilization of Cuvposa and alternative glycopyrrolate strengths
![Page 16: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/16.jpg)
![Page 17: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/17.jpg)
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
![Page 18: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/18.jpg)
of more cost effective formulary agents.
![Page 19: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/19.jpg)
![Page 20: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/20.jpg)
![Page 21: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/21.jpg)
![Page 22: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/22.jpg)
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
![Page 23: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/23.jpg)
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
![Page 24: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/24.jpg)
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
![Page 25: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/25.jpg)
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
![Page 26: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/26.jpg)
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
![Page 27: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/27.jpg)
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
![Page 28: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/28.jpg)
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
![Page 29: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/29.jpg)
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
![Page 30: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/30.jpg)
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
![Page 31: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/31.jpg)
![Page 32: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/32.jpg)
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
![Page 33: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/33.jpg)
Xembify
![Page 34: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/34.jpg)
9. Prior Authorization Criteria
Review
![Page 35: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/35.jpg)
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
![Page 36: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/36.jpg)
:
![Page 37: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/37.jpg)
![Page 38: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/38.jpg)
![Page 39: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/39.jpg)
![Page 40: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/40.jpg)
any changes
![Page 41: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/41.jpg)
![Page 42: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/42.jpg)
![Page 43: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/43.jpg)
![Page 44: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/44.jpg)
![Page 45: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/45.jpg)
![Page 46: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/46.jpg)
![Page 47: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/47.jpg)
![Page 48: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/48.jpg)
![Page 49: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/49.jpg)
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
![Page 50: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/50.jpg)
![Page 51: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/51.jpg)
![Page 52: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/52.jpg)
:
![Page 53: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/53.jpg)
![Page 54: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/54.jpg)
![Page 55: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/55.jpg)
![Page 56: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/56.jpg)
![Page 57: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/57.jpg)
![Page 58: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/58.jpg)
![Page 59: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/59.jpg)
![Page 60: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/60.jpg)
![Page 61: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/61.jpg)
![Page 62: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/62.jpg)
![Page 63: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/63.jpg)
![Page 64: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/64.jpg)
![Page 65: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/65.jpg)
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
![Page 66: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/66.jpg)
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
![Page 67: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/67.jpg)
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
![Page 68: Enterprise P&T Meeting Committee Meeting Minutes February 10, … · 2020. 5. 28. · recommendation: KF/AHC/AHNE/ Add a quantity limit of 2 kits per 30 days for glucagon emergency](https://reader034.fdocuments.us/reader034/viewer/2022051917/6009af73007e6905cd6ee871/html5/thumbnails/68.jpg)
________________________________ _______________ 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.