Connecticut Medicaid P&T Meeting Minutes March 20, 2008

Transcription

1 Connecticut Medicaid P&T Meeting Minutes March 20, 2008 The meeting started at 6:30 pm Attendance Present Members: Carl Sherter, MD Bennett Enowitch, MD Charles Thompson, MD Steven Marcham, RPh Lawrence Sobel, RPh Stella Cretella Absent Members: Richard T. Carbray, Jr., RPh Kenneth Marcus, MD Peggy Manning Memoli, Pharm D Lester Silberman, MD DSS: Evelyn Dudley Herman Kranc Robert Zavoski, MD MPH Jason Gott Jim Zakszewski Phyllis Hyman EDS/Provider Synergies: Chris Andrews Brian Rock Joy DeNardo Opening remarks: Dr. Sherter made the following announcements: Dr. Joseph Misiak and Holly Bessoni-Lutz have resigned from the P & T Committee. There are 3 new members of the P & T Committee. They are: Dr. Bennett Enowitch, filling the vacancy for a Practicing Physician, Psychiatrist, Dr. Charles Thompson, filling the vacancy for a Manufacturer Representative, and Dr. Lester Silberman, filling the vacancy for a Practicing Physician, Family Planning Specialist. Brian Rock will be replacing Chris Andrews as the Connecticut Clinical Account Manager from Provider Synergies. Evelyn Dudley made the following announcements: Welcome to the new members of the P & T Committee. DSS/EDS have a new computer system that went live January 25, Husky A, Husky B, and SAGA clients were transitioned to Medicaid Fee for Service on February 1, Only the Husky A clients are subject to PDL. Evelyn handed out enrollment count breakdowns for the Husky A and Husky B clients to the committee members. Steve Marcham and Dr. Sherter questioned why smoking cessation products are not currently covered on Connecticut Medicaid. Evelyn Dudley responded that the Commissioner is currently reviewing a report that was submitted to the legislature. The committee members requested that the report that was submitted to the legislature be discussed at the next meeting. Dr. Zavoski noted that a public hearing of the Tobacco and Health Trust Fund Board would be held on April 4, He also noted that the CDC would be releasing their new findings in April, Approval of minutes: Committee members approved the meeting minutes from the December 6, 2007 meeting.

2 Public Presentation: Dr. Karen Rubin from Connecticut Children s Medical Center addressed the committee regarding the preferred drugs in the Growth Hormone class. Her nurse, Marlene De Conti, also offered specific product choices of their practice setting. Dr. Rubin discussed the various factors that help determine which treatment is used, such as FDA approved indications, delivery devices, ease of use and patient support services. Dr. Sherter recommended reviewing the Growth Hormone class at this time. The outcome of the committee s review is listed under the therapeutic class reviews. New Generics: Brian Rock informed the committee members regarding the following new generic products: The generics for Combunox (ibuprofen/oxycodone), Loprox gel (ciclopirox gel), Kytril (granisetron), and Altace (ramipril) were recommended to be non-preferred products. The Committee motioned to approve and accepted Provider Synergies recommendations. The motion was passed unanimously. Therapeutic Class Reviews: Brian Rock, from Provider Synergies, presented clinical data and financial analysis, as well as answered questions from committee members on the following eleven therapeutic classes. Outcomes and votes are recorded below by class: Growth Hormones Brian Rock presented the evaluation and recommendation for this class after Dr. Rubin s presentation. There was some discussion of tabling this review until the next scheduled committee meeting in order to obtain more utilization data with the new Husky population, but the committee ultimately decided to vote at this meeting. Larry Sobel motioned to approve and accept Provider Synergies recommendations with the addition of Genotropin and Serostim as preferred. The motion was passed unanimously. Genotropin, Norditropin, Nutropin, Nutropin AQ, Saizen, Serostim, Tev-Tropin Humatrope, Omnitrope, Zorbtive Acne Agents, Topical the changes in this class since the last review are the addition of a lower strength for Differin and the new products of Inova, Clindareach and Atralin. The committee motioned to approve and accepted Provider Synergies recommendations. The motion was passed unanimously. benzoyl peroxide, clindamycin phosphate, erythromycin, sulfacetamide, tretinoin, Azelex, Clinac BPO, Differin, Retin-A Micro erythromycin-benzoyl peroxide, Akne-Mycin, Atralin, Benzaclin, BenzamycinPak, Clindagel, Clindareach, Duac, Evoclin, Inova, Lavoclen, Neobenz Micro, Nuox, Sulfoxyl, Tazorac, Triaz, Zaclir, Ziana

3 Antihistamines, Minimally Sedating Brian Rock presented the evaluation and recommendation for this class. Chris Andrews noted that cetirizine-d was also recommended as preferred since it was not listed on the slide. The committee members requested that the cetirizine chewable be listed separately on the PDL, as well as other pediatric formulations wherever possible, in order to clarify preferred products for our new Husky population. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously. cetirizine OTC, cetirizine-d OTC, loratadine/loratadine-d, Zyrtec syrup OTC fexofenadine, Allegra syrup, Allegra ODT, Allegra-D, Clarinex/Clarinex-D, Clarinex syrup, Claritin Chew OTC, Semprex-D, Xyzal, Zyrtec/Zyrtec-D, Zyrtec-D OTC, Zyrtec syrup Bone Resorption Inhibitors the most significant change in this class was the addition of a generic for Fosamax, alendronate. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously. alendronate, Actonel, Fosamax solution, Fosamax Plus D, Miacalcin Actonel with Calcium, Boniva, Didronel, Evista, Forteo, Fortical, Fosamax tablets Calcium Channel Blockers Brian Rock presented the evaluation and recommendation for this class. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously. amlodipine, diltiazem, felodipine ER, isradipine, nicardipine, nifedipine, verapamil, verapamil PM ER nimodipine, Cardene SR, Cardizem LA, Covera-HS, Dynacirc CR, Sular Erythropoiesis Stimulating Proteins Brian Rock presented the evaluation and recommendation for this class. Dr. Sherter noted that there have been no changes in this class. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously. Aranesp, Procrit Epogen

4 Intranasal Rhinitis Agents Veramyst is the only new product in this class and pointed out that it is indicated for use in children 2 years of age and older. Steve Marcham questioned why Flonase brand was not listed on the slide. Chris Andrews replied that Veramyst (fluticasone furoate) was being recommended as preferred in place of Flonase and its generic, fluticasone propionate. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously. ipratropium, Astelin, Nasacort AQ, Nasonex, Veramyst flunisolide, fluticasone, Beconase AQ, Flonase, Nasarel, Rhinocort Aqua Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) Brian Rock presented the evaluation and recommendation for this class. Larry Sobel questioned removing Celebrex from the PDL. Brian Rock cited the recommendations of the American Heart Association and a step therapy approach. Dr. Thompson asked what alternatives would be available on the PDL for patients at increased risk of GI bleeding who require long-term anti-inflammatory therapy. Dr. Thompson also asked if there are appropriately powered clinical studies looking at the rates of GI ulcers/bleeding for Prevacid NapraPAC vs. Celebrex. Brian Rock cited no clinical differences in the studies done comparing the risk of gastroduodenal ulcers with Celebrex versus Prevacid NapraPAC and Celebrex versus diclofenac/omeprazole. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed with Dr. Thompson voting against and Larry Sobel abstaining. diclofenac, fenoprofen, flurbiprofen, ibuprofen Rx, indomethacin, ketorolac, meloxicam, naproxen Rx, piroxicam, sulindac, Prevacid NapraPAC etodolac, ketoprofen, meclofenamate, mefenamic acid, nabumetone, oxaprozin, tolmetin, Arthrotec, Celebrex Otic Fluoroquinolones this is a new drug class being added to the PDL. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously. ofloxacin, Ciprodex Cipro HC Proton Pump Inhibitors the only change in this class since the last review was the introduction of a generic version for Protonix (pantoprazole). The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously.

5 Nexium, Nexium suspension, Prevacid, Prevacid Solutab, Prevacid suspension omeprazole, omeprazole OTC, pantoprazole, Aciphex, Zegerid Ulcerative Colitis Agents the generic, balsalazide, was now available for Colazal. Larry Sobel questioned removing Dipentum and Pentasa from the PDL citing possible pediatric usage. Brian Rock pointed out that balsalazide is approved for use in children 5 years of age and older and sulfasalazine is approved for use in children 2 years of age and older. The committee motioned to approve and accepted Provider Synergies recommendations as presented. The motion was passed unanimously, with Larry Sobel abstaining. balsalazide, mesalamine enema, sulfasalazine, Asacol, Canasa Colazal, Dipentum, Lialda, Pentasa Recommendations for next class reviews: Provider Synergies recommended the following classes be reviewed at the next P&T meeting: Analgesics, Narcotic Short Acting Analgesics, Narcotic Long Acting Angiotensin Modulators Anticoagulants, Injectable Atopic Dermatitis Beta Blockers Hypoglycemics, Incretin Mimetics/Enhancers Hypoglycemics, TZDs Lipotropics, Other Lipotropics, Statins Multiple Sclerosis Agents Schedule next meeting: Committee members agreed on Thursday, June 5, 2008 for the next P & T meeting Meeting adjourned at 7:45pm