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

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




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




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




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


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




Ruzurgi with PA Criteria


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.




Firdapse Prior Authorization Criteria PerformRx makes the following

recommendation:

KF/AHC/AHNE/

Approve the Amifampridine criteria as a new policy.




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.




Nourianz with PA Criteria PerformRx makes the following

recommendation:

Approve

KF/AHC/AHNE/

Make no changes to the formulary status of Nourianz (istradefylline)




Inbrija with PA Criteria PerformRx makes the following

recommendation:

KF/AHC/AHNE/

Make no changes to the formulary status of Inbrija (levodopa)




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




Tegsedi with PA Criteria PerformRx makes the following

recommendation:

KF/AHC/AHNE/

Add Tegsedi (inotersin) to the non-PDL specialty tier with prior authorization





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





7. New Products


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)


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




:

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




:

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


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



Blincyto PerformRx makes the following

recommendation:

KF/AHC/AHNE

Approve the newly developed criteria



Provenge PerformRx makes the following

recommendation:

KF/AHC/AHNE/

Approve the newly developed Dendritic Cell Tumor Peptide Immunotherapy prior authorization criteria



________________________________ _______________ 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.

Documents

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