Pharmacy and therapeutics committee meeting minutes december, 2009 - pharmacy - keystone mercy health plan

Keystone/AmeriHealth Pharmacy & Therapeutic
Committee Meeting Minutes
December 8, 2009
Approval of Minutes
0 Against
Old Business
Committee requested in the October 2009 meeting to have a cardiologist/electrophysiologist to address efficacy, safety, and cost analysis of the Although several doctors were contacted, schedules did not permit them to attend the December 2009 meeting to address the issue. In the meantime, Multaq will remain non-formulary. Utilization and prior authorization request will be monitored. Committee requests bringing utilization and prior Committee requested cost analysis on Euflexxa and Synvisc. As a result of the cost analysis, committee agreed to keep Euflexxa as a preferred product, and Synvisc will remain a non-preferred product. HEDIS Results
Quality Management presented the P4P HEDIS 2009 Prior Authorization
Criteria –
Criteria for review unchanged and/or updated with 0 Against
informational changes: IV Bisphosphonates, Low Protocols
Molecular Weight Heparins, Rituxan, and Sutent. The approval duration for Fareston and Kineret has been extended from 6 months to 12 months. Nexavar: The updated PA criteria was presented for 0 Against
approval. New approval criterion was added that requires adequate trial of Votrient for patients with a predominant clear cell histology. The approval duration was also revised to allow 6 months for The updated PA criteria was presented for approval. New approval criterion was added that allows for the approval of Neulasta without prior trials of other White Blood Cell Stimulators if it is required for dose dense chemotherapy. In addition, Mozobil may be approved if an adequate trial of Neupogen exists. Pulmonary Arterial Hypertension Medications: The class review for Pulmonary Arterial Hypertension Medications was presented to the committee. A new approval criterion requires patients to try Letairis New prior authorization criteria for Avastin, Erbitux, 0 Against
Long-Acting Injectable Atypical Antipsychotic Atypical Antipsychotic Agents, committee Agents was developed and presented. The protocol Consta and Invega Sustenna to be presented Antipsychotic Agents will replace the Risperdal at the next P&T meeting to see which one is Consta PA Criteria. Committee requested for an analysis on Risperdal Consta and Invega Sustenna. This information will be presented at the next meeting to see which would be more cost effective. Prior Authorization
Criteria – Oral
Criteria for review unchanged and/or updated with 0 Against
Avinza, Ciprodex, Danocrine, Dostinex, Elmiron, Entocort EC, Flovent HFA, Hepsera, Zofran. DDAVP: The updated PA criterion was presented for 0 Against
point-of-sale for members ≥6 years old. requirement for DDAVP tablets and allow them to pay at the point of sale for members ≥6 years old. Recommended keeping the PA requirement for the Committee approved the updated PA criteria The updated PA criteria was presented for approval. 0 Against
Recommended adding Prevacid 24 HR OTC and Kapidex as second-line agents after omeprazole and removing Protonix and Prevacid SoluTab from SoluTab will continue to pay at point-of-sale formulary. However, Prevacid SoluTab will continue to pay at point-of-sale for members <8 years old. committee requested for utilization data on Discussion was held regarding PPI/Plavix drug Plavix and omeprazole for the next P&T interaction. Committee requested for utilization data Committee approved revised criteria with no Recommended removing the strengths listed under 0 Against
the approval criteria for oxycodone/acetaminophen New prior authorization criteria for Oral Diabetic 0 Against
Agents was developed and presented. Recommended adding the new criteria to replace existing individual Committee approved removing the following Criteria being presented with recommendation for 0 Against
removal: Actos/ActosPlus MET/Duetact, Avandia/Avandamet/Avandaryl, Januvia/Janumet, Januvia/Janumet and Starlix. All protocols will be replaced by Oral Diabetic Agents protocol. Migranal was also approved for New Business
Reviewed cost analysis and utilization data for Zyrtec 0 Against
(certirizine) chewable tablets from formulary. Drug Class Review
Utilization data and cost analysis for oral anti- and the addition of Savella (milnacipran) to 0 Against
influenza agents were presented. Recommended maintaining current formulary status of all Recommended adding Savella (milnacipran) tablets Utilization data and cost analysis were presented for Pancreatic Enzymes. Recommended keeping the maintaining current formulary status for all KMHP/AMHP
Formulary Review
The KMHP and AMHP formularies were presented 0 Against
2010 P&T
Committee approved the recommendation of Committee Charter
The 2010 P&T Committee Charter has been updated 0 Against
to reflect recommendation of decreasing the frequency of the P&T meetings to four times a year. New Products
New products approved by the FDA since the last P&T meeting were presented. The following 0 Against
medications were recommended to remain non- formulary: BenzEFoam, Bepreve, Intuniv, Invega Sustenna, Metozolv ODT, Onsolis, Twynsta,



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