June 2009 p&t minutes 7.23.09 final.web.xls

AmeriChoice Pharmacy & Therapeutics Committee Minutes
June 17, 2009
Meeting Date: June 17, 2009
Location: Via conference call
D. Morgan, J. Bellicini, R. Brekosky, J.Weiss, R. Justman, S. Nichols, C. Freed, M. Mahler, S. Stein, E. Francis, B. Selius, A. Burkins, M. Reich, J. Carlson, V. Members in Attendance:
Members Absent:
J. Hancovsky, S. Bush, G. Fleszar, D. Rose, K. Topolosky, S. Balog Agenda Item
Discussion
Conclusions/Recommendations
Voting Totals
Minutes of April Unison P&T, AMC March P&T Meetings were reviewed Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as Optional inclusion, remain non-preferred on the Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as essential class, remain non-preferred on the Medicaid Dr. Frances asked which agents we do cover.
Dr. Bellicini confirmed that generic fenofibrate tablets and capsules are preferred Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as Optional inclusion, remain non-preferred on the Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as Optional inclusion, remain non-preferred on the Motion made, seconded, and carried to accept recommendation Recommendation: Delete mephobarbital grandfather current users Recommendation: Delete Felbatol - grandfather current users Recommendation: Add Lyrica as preferred with prior authorization required.
Recommendation: Add levetiracetam as preferred with Step Therapy required.
Recommendation: Remove prior authorization requirement from topiramate, lamotrigine, Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as essential drug, add to Medicaid and Medicare PDLs Recommendation: Approve Lyrica and Gabatril PA guidelines, oxcarbazepine, Motion made, seconded, and carried to accept 16:0 levetiracetam, and Banzel Step Therapy guidelines.
Motion made, seconded, and carried to accept recommendation Recommendation: Delete bupropion SR (Zyban) - grandfather current users, remove PA from bupropion SR (Wellbutrin SR), add Pristiq as Preferred with Step Therapy.
Recommendation: Approve Cymbalta, Effexor XR and Pristiq Step Therapy guidelines.
Recommendation: Add paroxetine, fluvoxamine, and sertraline 50mg as preferred. Recommendation: Delete Lexapro, grandfather current users Recommendation: Delete Nardil, grandfather current users.
CONFIDENTAL
Agenda Item
Discussion
Conclusions/Recommendations
Voting Totals
Motion made, seconded, and carried to accept recommendation Recommendation: Delete Abilify Solution, grandfather current users.
Recommendation: Delete Orap, grandfather current users.
Recommendation: Add Risperdal Consta as preferred with a QL of 2 injections per 28 Motion made, seconded, and carried to accept recommendation Recommendations:Add Strattera as preferred with Step Therapy after a one month trial of a stimulant Add Ritalin LA as preferred with Step Therapy after a trial of two preferred stimulants, a one month trial of each agent (AZ Plan Only) Delete Metadate CD, grandfather currentusers.
Remove Step Therapy from Adderall XR.
Add an age edit to all stimulants. Member ≥21 years of age require PA to confirm Motion made, seconded, and carried to accept recommendation Recommendations:Add Symbicort as preferred with Step therapy Delete Azmacort, current users will be grandfathered.
Change the age edit for Pulmicort respules to require PA for members >8 years of age.
Approve Advair/Symbicort Step Therapy guidelines. Asthma after a 30 day trial of a preferred single agent ICS. For COPD a 60 day trial is required on a LABA plus an anticholinergic.
Motion made, seconded, and carried to accept recommendation Recommendations:Delete Alupent, Proventil HFA, albuterol respules 1.25mg and0.63mg, Xopenex HFA.
Add Xopenex Respules as preferred with Step Therapy after a trial of albuterol.
Exclusive Preferred agent Proair HFA or Ventolin HFA.
Motion made, seconded, and carried to accept recommendation Recommendation:Delete albuterol ER tablets, grandfather current users.
Motion made, seconded, and carried to accept recommendation Recommendations:Delete Accolate, grandfather current users.
Step Therapy requirements for Singulair. For Asthma, a 60 day trial of an ICS. For Allergic Rhinitis a 30 day trial on an antihistamine and a nasal steroid.
Motion made, seconded, and carried to accept recommendation Recommendation:Add Xolair as preferred with prior authorization, per the protocol (guideline reviewed in Motion made, seconded, and carried to accept recommendation Recommendations:Change Tev-Tropin to preferred.
Delete Nutropin and Nutropin AQ. No grandfathering.
Approve PA guidelines for Increlex and Growth Hormone.
CONFIDENTAL
Agenda Item
Discussion
Conclusions/Recommendations
Voting Totals
Motion made, seconded, and carried to accept recommendation Recommendations:Change cetrizine D to preferred.
Approve Step Therapy guidelines for fexofenadine. Mininmum of 14 day trial of Motion made, seconded, and carried to accept recommendation Recommendation:Add flunisolide as preferred.
Motion made, seconded, and carried to accept recommendation Recommendations:Add Enablex, Vesicare and Oxybutynin ER to preferred with Step Therapy after a 30 day trial of oxybutynin. Use as a first-line agent would be allowed for members > or equal to 65 years of age.
Delete Oxytrol and Detrol LA, no grandfathering.
Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as Optional inclusion, remain non-preferred on the Motion made, seconded, and carried to accept recommendation Recommendation: Categorize as esstential class, remain non-preferred on the Medicaid Motion made, seconded, and carried to accept recommendation Allow 14 day supply of Lovenox at the POS every 90 days Motion made, seconded, and carried to accept recommendation Recommendations:Remove PA requirement for fluconazole and terbinafine and add QLs.
Add itraconazole as preferred with PA.
Motion made, seconded, and carried to accept recommendation Recommendations:Add econazole cream and clotrimazole/betamethasone cream/ lotion as preferred.
Delete Oxistat and ciclopirox, no grandfathering.
Recommendations:Add Ampicillin as preferredDelete Amoxicillin 500mg & 875mg tablets, 200 and 400mg/5ml susp, Amoxicillin 200mg and 400mg chewable tablets. - Issue tabled. - No vote.
Motion made, seconded, and carried to accept recommendation Recommendations:Add Cefprozil and Suprax 400mg tablets as preferred. Suprax 400mg to have a QL of 1 tab per month.
Delete Ceclor CD, Suprax Suspension, and Vantin.
Motion made, seconded, and carried to accept recommendation Recommendations:Add clarithromycin to preferred.
CONFIDENTAL
Agenda Item
Discussion
Conclusions/Recommendations
Voting Totals
Motion made, seconded, and carried to accept recommendation Recommendations:Remove PA requirement for ofloxacin.
Motion made, seconded, and carried to accept recommendation Recommendations:Add Paromomycin as preferred.
Add Zyvox as preferred with PA, requiring documentation supporting MRSA or VRE with resistance to all other agents.
Approve Vancocin Step Therapy, requiring a trial of metronidazole.
Motion made, seconded, and carried to accept recommendation Recommendations:Add Mepron and Daraprim as Preferred.
Motion made, seconded, and carried to accept recommendation Recommendations:Delete Condylox Gel, no grandfathering.
Add Fuzeon as preferred (specialty pharmacy item).
Motion made, seconded, and carried to accept recommendation Recommendations:Delete Furadantin suspension, grandfather current chronic users.
Motion made, seconded, and carried to accept recommendation Recommendations:Add Utira-C, and Methenamine Hippurate as preferred.
Delete Methenamine Mandelate and Urised - no longer available on the market.
Motion made, seconded, and carried to accept recommendation Recommendations:Delete Axid Solution, granfather current users.
Motion made, seconded, and carried to accept recommendation Add oxaprozin, meloxicam, and ketorolac (QL 20 tabs per month) as preferred.
Add Celebrex as preferred with PA after a 14 day trial of 3 preferred NSAIDs, a diagnosis of adenomatous poluposis or members > 65 years of age, history of GI ulcers,
bleeding or perforation, or chronic use of systemic corticosteroids, anticoagulants or
antiplatelet agents - excluding ASA.
Delete Indocin SR, Diflunisal, Flurbiprofen, Tolmentin, Etodolac XL, Ketoprofen ER,
Naproxen EC, and Indomethacin Suspension.
Motion made, seconded, and carried to accept recommendation Recommendations:Remove Step Therapy from Ovide, apply QL of 120ml per month.
1) Medicare Formulary Brand to Generic Deletions Motion made, seconded, and carried to accept recommendation Recommendations: Approve the brand to generic deletion of Topamax Approve deletion of Raptiva - voluntary market withdrawal Motion made, seconded, and carried to accept recommendation Recommendation: Approve Mandatory Medicare adds. All were added as Tier 2, PA required for new starts: Vimpat tablets/ IV soln, Degarelix, Banzel, Sprycel 100mg, and Afinitor.
CONFIDENTAL
Agenda Item
Discussion
Conclusions/Recommendations
Voting Totals
Motion made, seconded, and carried to accept recommendation Recommendation: Approve proposed changes to 2010 Medicare Formulary. The following agents are being removed from the formulary: Lipitor, Prilosec OTC, Xalatan, Humulin products, Humalog, Lunesta, Oxycontin, Avandia, Enablex, Serevent, Fosamax D, Avandamet, Micardis, Rozerem, Oxytrol, Avandaryl. Remove prior authorization status on Aricept and Namenda. Changed Lexapro from requiring PA to Step Therapy. 1) Mr. Brekosky Opened the floor to comments on the proposed QLs distributed to the Motion made, seconded, and carried to accept Recommendation:Approve the proposed QLs as presented.
1) Mr. Brekosky outlined the reports distributed to the committee prior to the meeting Motion made, seconded, and carried to accept 12:0 Recommendation: Confirm review of Quality Monitoring reports.
1) Omeprazole tablets (generic Prilosec OTC tabs) will be maintained as preferred due to economics. Brand users will be moved to generic.
Votes not totaling 18 are the result of abstentions.
CONFIDENTAL

Source: http://americhoice.com/en/apps/find_drug/acpa/meeting_minutes/061709.pdf