South Carolina Department of Health and Human Services Post Office Box 8206 Columbia, South Carolina
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1 South Carolina Department of Health and Human Services Post Office Box 8206 Columbia, South Carolina Pharmacy and Therapeutics (P&T) Committee Meeting MINUTES 1. Call To Order A meeting of the P & T Committee convened at 4:00 p.m. on Wednesday, June 2, Committee Members Present: Edward M. Behling, M.D. Joseph A. Horvath, M.D. Albert Humphrey, M.D. Robin K. LaCroix, M.D. James M. Lindsey, M.D. Mark A. O Rourke, M.D. Committee Members Absent: Matthew K. Cline, M.D. Thomas Phillips, R.Ph. Deborah J. Tapley, R.Ph. George E. Vess, Pharm.D. Wayne Weart, Pharm.D. Harry H. Wright, M.D. Jerome E. Kurent, M.D. Jamee Lucas, M.D. DHHS Staff Present: James Assey Susan Bowling Marion Burton Robert Kerr Deirdra Singleton Caroline Sojourner Linda Van Hoose Other Representation: First Health Services Corporation Mary Roberts, R.Ph. Pharmaceutical Industry Representatives 3. Welcome Dr. LaCroix, Chairperson welcomed all meeting attendees and Committee members introduced themselves. Dr. LaCroix opened the meeting by stating that the P&T Committee Meetings are held in compliance with the Freedom of Information Act s (FOIA) mandate that the public is notified when the public s business is being done, and that furthermore, the public has been notified that this facility is accessible to individuals with disabilities, and special accommodations could have been provided if requested in advance. 4. Discussion Topics A. Committee Meeting Minutes, Wednesday, April 7, 2004 Approved by the Committee without any changes. P & T Committee Meeting Minutes Page 1 of 7
2 B. General Issues The discussion began with Dr. LaCroix explaining to Committee Members and others present that there would be a slight variation from the set of guidelines established by the Committee for public comment because of the number of presenters scheduled to speak and that Dr. Burton would again serve as the official timekeeper. Furthermore, Dr. LaCroix asked that speakers attempt to limit their presentations to two minutes in order to allow sufficient time for all speakers to be heard. C. Public Comment The following speakers discussed those drugs or issues listed below: Company Speaker Drug Abbott Laboratories Andrea Hume Tarka Novartis Ray Lancaster Lotrel GlaxoSmithKline Dr. Ferrare Coreg AstraZeneca Tim Bristow Toprol XL Reliant Pharmaceuticals Penny Atwood Innopran XL, DynaCirc/CR Biovail Arlene Chico Cardizem LA Pfizer Dr. Brent Egan Norvasc Celltech Ron Dunbar Metadate CD Cephalon Dr. Richard Bogan Provigil Lilly Dr. Calvin Sumner Strattera McNeil Dr. Robert Richards Concerta Novartis Scott Chappell Focalin, Ritalin LA Shire Bradford Loo Adderall XR Pfizer Dr. Evan Eckman Celebrex Boehringer Ingelheim Dr. Ben Levinson Mobic USC School of Medicine Dr. Vladimir Maletic Anti-hyperkinesis drugs Following the period of public comment, Dr. LaCroix thanked each speaker for his or her individual presentation. D. PDL Discussions And Selections For The Following Drug Classes Mary Roberts, R.Ph., First Health Corporation led the discussion for the following drug classes: 1. Beta-Blockers 2. Calcium Channel Blockers 3. ACE Inhibitor, Calcium Channel Blocker Combinations 4. Non-Steroidal Anti-Inflammatory Drugs 5. COX-2 Inhibitors 6. Antihyperkinesis Agents P & T Committee Meeting Minutes Page 2 of 7
3 The P&T Committee agreed to submit the following recommendations to DHHS: No PA Required Preferred PA Required BETA-BLOCKERS ACEBUTOLOL (generic for Sectral ) ATENOLOL (generic for Tenormin ) ATENOLOL/CHLORTHALIDONE (generic for Tenoretic ) BETAXOLOL (generic for Kerlone ) BISOPROLOL FUMARATE (generic for Zebeta ) BISOPROLOL/HCTZ (generic for Ziac ) LABETALOL (generic for Normodyne, Trandate ) METOPROLOL TARTRATE (generic for Lopressor ) NADOLOL (generic for Corgard ) PINDOLOL (generic for Visken ) PROPRANOLOL (generic for Inderal ) PROPRANOLOL/HCTZ (generic for Inderide ) SOTALOL (generic for Betapace ) TIMOLOL (generic for Blocadren ) COREG *generic agents should be considered first-line when appropriate BETAPACE BETAPACE AF BLOCADREN CARTROL CORGARD CORZIDE INDERAL INDERAL LA INDERIDE INDERIDE LA INNOPRAN XL KERLONE LEVATOL LOPRESSOR LOPRESSOR HCT NORMODYNE SECTRAL TENORETIC TENORMIN TIMOLIDE TOPROL XL TRANDATE VISKEN ZEBETA ZIAC The Committee would like to advise prescribers that Coreg be reserved for hypertension in the presence of heart failure. CALCIUM CHANNEL BLOCKERS *DIHYDROPYRIDINE CALCIUM CHANNEL BLOCKERS (DHPCCB) DYNACIRC DYNACIRC CR NICARDIPINE (generic for Cardene ) NIFEDICAL XL NIFEDIPINE ER (generic for Procardia XL ) NIFEDIPINE SA (generic for Adalat CC ) NORVASC PLENDIL *Dr. Weart abstained from voting on this therapeutic class. ADALAT ADALAT CC CARDENE CARDENE SR NIFEDIPINE IMMEDIATE RELEASE NIMOTOP PROCARDIA PROCARDIA XL SULAR P & T Committee Meeting Minutes Page 3 of 7
4 No PA Required Preferred PA Required NONDIHYDROPYRIDINE CALCIUM CHANNEL BLOCKERS (NDHPCCB) CARTIA XT DILTIA XT DILTIAZEM (generic for Cardizem ) DILTIAZEM ER (generic for Cardizem SR q 12h) DILTIAZEM XR (generic for Cardizem CD, Dilacor XR ) TAZTIA XT (generic for Tiazac ) VERAPAMIL (generic for Calan, Isoptin ) VERAPAMIL SR/ER (generic for Isoptin SR ), (generic for Calan SR ), (generic for Verelan ) CALAN CALAN SR CARDIZEM CARDIZEM CD, LA, SR COVERA HS DILACOR XR ISOPTIN ISOPTIN SR TIAZAC VERELAN VERELAN PM ACE INHIBITOR PLUS CALCIUM CHANNEL BLOCKER COMBINATIONS LOTREL (Norvasc and Lotensin ) TARKA (Verapamil and Trandolapril) LEXXEL (Plendil and Enalapril) P&T Committee members discussed the implications of adding a clinical edit to this class, however, the Committee s final decision was to not include a clinical edit. NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) DICLOFENAC POTASSIUM (generic for Cataflam ) DICLOFENAC SODIUM (generic for Voltaren ) ETODOLAC (generic for Lodine and Lodine XL ) FENOPROFEN (generic for Nalfon ) FLURBIPROFEN (generic for Ansaid ) IBUPROFEN (generic for Motrin ) INDOMETHACIN (generic for Indocin ) INDOMETHACIN SR (generic for Indocin SR) KETOPROFEN (generic for Orudis ) KETOPROFEN ER (generic for Oruvail) KETOROLAC (generic for Toradol ) * MECLOFENAMATE SODIUM (generic for Meclomen ) NABUMETONE (generic for Relafen ) NAPROXEN (generic for Naprosyn ) NAPROXEN SODIUM (generic for Anaprox ) OXAPROZIN (generic for Daypro ) PIROXICAM (generic for Feldene ) SULINDAC (generic for Clinoril ) TOLMETIN SODIUM (generic for Tolectin and Tolectin DS ) ANAPROX ANAPROX DS ANSAID ARTHROTEC CATAFLAM CLINORIL DAYPRO DOLOBID FELDENE INDOCIN LODINE LODINE XL MOBIC MOTRIN NALFON NAPRELAN NAPROSYN ORUVAIL PONSTEL RELAFEN TOLECTIN TOLECTIN DS TORADOL VOLTAREN VOLTAREN XR P & T Committee Meeting Minutes Page 4 of 7
5 No PA Required Preferred PA Required *COX-2 INHIBITORS CELEBREX (No PA required if patient 60 or over) VIOXX (No PA required if patient 60 or over) BEXTRA P&T Committee members discussed side effect profiles and contraindications of the various agents in this class. *Dr. Weart abstained from voting on this therapeutic class; Dr. Humphrey was absent for the vote. ANTIHYPERKINESIS DEXTROAMPHETAMINE AND DEXTROAMPHETAMINE AND AMPHETAMINE MIXTURES ADDERALL XR AMPHETAMINE SALT COMBO (generic for Adderall ) DEXTROAMPHETAMINE (generic for Dexedrine immediate release) DEXTROAMPHETAMINE SR (generic for Dexedrine Spansules ) ADDERALL DESOXYN DEXEDRINE DEXTROSTAT METHYLPHENIDATE PRODUCTS CONCERTA METADATE CD METADATE ER (branded generic for Methylin ER) METHYLIN (equivalent to Ritalin IR) METHYLIN ER (equivalent to Ritalin-SR ) METHYLPHENIDATE (generic for Ritalin ) METHYLPHENIDATE SR (generic for Ritalin-SR ) RITALIN LA RITALIN FOCALIN (D-isomer of methylphenidate) MISCELLANEOUS PROVIGIL STRATTERA PEMOLINE (generic for Cylert - all brands and formulations) P&T Committee members discussed options for step therapy for Strattera. If the claims processing system will allow, the P&T Committee recommends the implementation of step edits to allow Strattera claims to pay if a stimulant product is found in the patient s Medicaid drug history. DHHS will report back to the Committee at the next meeting regarding availability of step edit. P & T Committee Meeting Minutes Page 5 of 7
6 5. Old Business No old business. 6. New Business A. Comments from the Director Robert Kerr thanked the Committee for their participation and diligence. Mr. Kerr updated the Committee on legislation regarding carve-outs and the continuation of the P&T Committee and its activities. B. Selection/Designation of Drug Classes for PDL Formulary The Committee agreed to discuss the following classes at the August 4th meeting: Intranasal Steroids Second Generation Antihistamines and Decongestant Combinations Leukotriene Modifiers Short Acting Beta 2 Agonists, Oral Inhalation and Nebulized Inhaled Long Acting Beta Agonists Inhaled Corticosteroids and Beta Agonists Combinations Serotonin Agonists Sedative Hypnotics C. General Discussion Brief discussion took place regarding the publication of criteria for prior authorization approval. Due to the lateness of the hour, the Committee agreed to postpone the discussion of pain management until the August 4 th meeting. Members were given a copy of the Medicaid Bulletin mailed out May 19, 2004 to providers highlighting the completion and implementation of Phase I of the PDL. 9. Resolved Items Recommendations regarding PDL status for drugs in the following drug classes were approved for submission to DHHS: Discussion on the following drug classes: 1. Beta-Blockers 2. Calcium Channel Blockers 3. ACE Inhibitor, Calcium Channel Blocker Combinations 4. Non-Steroidal Anti-Inflammatory Drugs 5. COX-2 Inhibitors 6. Antihyperkinesis Agents 10. Unresolved Items A. Information is requested regarding step edit availability for non-stimulant antihyperkinesis therapy. B. Draft guidelines are requested regarding acute pain management and chronic pain management treatments P & T Committee Meeting Minutes Page 6 of 7
7 12. Closing Comments The Committee was appreciative of the new location for this meeting and requested that future meetings be held at the SCPhA building. 13. Adjournment The meeting adjourned at 6:45 p.m. P & T Committee Meeting Minutes Page 7 of 7
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