Beneficiary Advisory Panel Handout Uniform Formulary Decisions 23 June 2011

Transcription

1 Beneficiary Advisory Panel Handout Uniform Formulary Decisions 23 June 211 PURPOSE: The purpose of this handout is to provide BAP Committee members with a reference document for the relative clinical effectiveness presentations for each Uniform Formulary () Class review 23 June 211 Beneficiary Advisory Panel Meeting Page 1 of 8

2 Table 1: Uniform Formulary Recommendations from the May DoD P&T Committee meeting for the Atypical Antipsychotic Agents* Atypical Antipsychotic Agents Class Recommendation Generic Drug Name (Brand) Generic Available Clozapine (Clozaril, generics; Fazaclo) Risperidone (Risperdal, Risperdal orally disintegrating tablets) Olanzapine (Zyprexa, Zyprexa Zydis) Quetiapine (Seroquel, Seroquel XR) Ziprasidone (Geodon) Oral Atypical Antipsychotics Aripiprazole (Abilify; Abilify Discmelt) Olanzapine/Fluoxetine (Symbyax) Paliperidone (Invega) Iloperidone (Fanapt) NF Asenapine (Saphris) Lurasidone (Latuda ) Recommended implementation period 3-days *Oral agents only; injectable formulations excluded Figures 1: Atypical Antipsychotic Agents Utilization - Units at All POS SEROQUEL ABILIFY RISPERIDONE ZYPREXA SEROQUEL XR GEODON CLOZAPINE FANAPT RISPERDAL INVEGA SAPHRIS 35, 3, 25, 2, 15, 1, 5, 3/31/8 4/3/8 5/31/8 6/3/8 7/31/8 8/31/8 9/3/8 1/31/8 11/3/8 12/31/8 1/31/9 2/28/9 3/31/9 4/3/9 5/31/9 6/3/9 7/31/9 8/31/9 9/3/9 1/31/9 11/3/9 12/31/9 1/31/1 2/28/1 3/31/1 4/3/1 5/31/1 6/3/1 7/31/1 8/31/1 9/3/1 1/31/1 11/3/1 12/31/1 1/31/11 2/28/11 23 June 211 Beneficiary Advisory Panel Meeting Page 2 of 8

3 Table 2: Uniform Formulary Recommendations from the May 211 DoD P&T Committee meeting Nasal Allergy Drugs Nasal Allergy Drugs Subclass Recommendation Generic Name (Brand) Generics Available? Fluticasone propionate (Flonase) Mometasone furoate (Nasonex) Intranasal corticosteroids Intranasal Antihistamines: Intranasal Anticholinergic Flunisolide (Nasarel, generics) Ciclesonide (Omnaris) Fluticasone furoate (Veramyst ) NF Beclomethasone diproprionate (Beconase AQ) Budesonide(Rhinocort Aqua) Triamcinolone acetonide (Nasacort AQ) Olopatadine (Patanase) Azelastine.1% (Astelin; generics) NF Azelastine.15% (Astepro) Ipratropium bromide (Atrovent ) Recommended implementation period t applicable no drugs moved from to NF Figure 2: Nasal Allergy Drugs Utilization gms/mls at All POS 2,, 1,8, 1,6, 1,4, 1,2, 1,, 8, 6, 4, 2, BECONASE AQ FLONASE FLUNISOLIDE FLUTICASONEPROPIONATE NASACORT AQ NASALIDE NASONEX OMNARIS RHINOCORT AQUA VERAMYST 3/31/8 4/3/8 5/31/8 6/3/8 7/31/8 8/31/8 9/3/8 1/31/8 11/3/8 12/31/8 1/31/9 2/28/9 3/31/9 4/3/9 5/31/9 6/3/9 7/31/9 8/31/9 9/3/9 1/31/9 11/3/9 12/31/9 1/31/1 2/28/1 3/31/1 4/3/1 5/31/1 6/3/1 7/31/1 8/31/1 9/3/1 1/31/1 11/3/1 12/31/1 1/31/11 2/28/11 23 June 211 Beneficiary Advisory Panel Meeting Page 3 of 8

4 Table 3: Uniform Formulary Recommendations from the May 211 DoD P&T Committee meeting for the n-insulin Diabetes Drugs n-insulin Diabetes Drugs Subclass recommendation Generic Drug Name (Brand) DPP-4 GLP-1 TZDs Biguanides Sulfonylureas AGI Class step applies See note 1 Class and subclass step apply see note 1,2 Class step applies See note 1 NF Class step applies See note 1 Step Preferred NF Step Preferred Sitagliptin (Januvia) Sitagliptin+met (Janumet) Saxagliptin (Onglyza) Saxagliptin+met (Kombiglyze XR) recommended for May 211 Exenatide (Byetta) Liraglutide (Victoza) Pioglitazone (Actos) Pioglitazone+met (Actoplus Met) Pioglitazone+met ER (Actoplus Met XR) Pioglitazone/glimepiride (Duetact) Rosiglitazone (Avandia) Rosiglitazone/metformin (Avandamet) Rosiglitazone/glimepiride (Avandaryl) Metformin IR 5, 85, 1 mg Riomet liquid 5/5 Metformin ER 5, 75 mg Metformin ER (Fortamet ER) 5, 1 mg Metformin ER (Glumetza) 5, 1 mg Chlorpropamide Tolazamide Tolbutamide Glimepiride Glipizide Glipizide ER Glyburide Glyburide micronized Glipizide/met Glyburide/met Acarbose (Precose) Miglitol (Glyset) Generic Available Amylin Agonists Pramlintide (Symlin) Meglitinides Nateglinide Repaglinide +/- met (Prandin,Prandimet) tes: 1. Patient must have a documented trial or contraindication for metformin or a sulfonylurea prior to receiving a drug in this subclass. 2. Patient must have a documented trial or contraindication for Byetta prior to receiving Victoza Recommended implementation period 6 days 23 June 211 Beneficiary Advisory Panel Meeting Page 4 of 8

5 Figure 3: DPP-4 Utilization (3 day Equiv) All POS JANUMET JANUVIA ONGLYZA KOMBIGLYZE XR 7, 6, 5, 4, 3, 2, 1, 5/31/8 6/3/8 7/31/8 8/31/8 9/3/8 1/31/8 11/3/8 12/31/8 1/31/9 2/28/9 3/31/9 4/3/9 5/31/9 6/3/9 7/31/9 8/31/9 9/3/9 1/31/9 11/3/9 12/31/9 1/31/1 2/28/1 3/31/1 4/3/1 5/31/1 6/3/1 7/31/1 8/31/1 9/3/1 1/31/1 11/3/1 12/31/1 1/31/11 2/28/11 3/31/11 4/3/11 Table 4: Uniform Formulary Recommendations from the May 211 DoD P&T Committee meeting Nasal Allergy Drugs Ophthalmic 1 Drug Class Subclass Staus Generic Name (Brand) n-steroidal Anti-inflammatory drugs Bromfenac.9 once daily formulation (Bromday) recommended for May 211 Bromfenac.9% twice daily formulation (Xibrom) Ketorolac (Acular) Ketorolac (Acular PF) Ketorolac (Acular LS) Ketorolac (Acuvail) Diclofenac (Voltaren) Flurbiprofen (Ocufen) Nepafenac (Nevanac) Generics Available? Recommended implementation period N/A 23 June 211 Beneficiary Advisory Panel Meeting Page 5 of 8

6 Figure 4: Ophthalmic NSAIDs Utilization (ml) at All POS 4, ACULAR ACULARLS ACUVAIL BROMDAY NEVANAC XIBROM DICLOFENAC KETOROLAC 35, 3, 25, 2, 15, 1, 5, 3/31/8 4/3/8 5/31/8 6/3/8 7/31/8 8/31/8 9/3/8 1/31/8 11/3/8 12/31/8 1/31/9 2/28/9 3/31/9 4/3/9 5/31/9 6/3/9 7/31/9 8/31/9 9/3/9 1/31/9 11/3/9 12/31/9 1/31/1 2/28/1 3/31/1 4/3/1 5/31/1 6/3/1 7/31/1 8/31/1 9/3/1 1/31/1 11/3/1 12/31/1 1/31/11 2/28/11 Table 5: Uniform Formulary Recommendations from the May 211 DoD P&T Committee meeting BPH Drugs Benign Prostatic Hyperplasia (BPH) Drugs Subclass Status Generic (Brand Name) Generics Available Alpha Blockers Tamsulosin (Flomax) Terazosin Alfuzosin (Uroxatral) Doxazosin (Cardura) Doxazosin extended release (Cardura XL) Silodosin (Rapaflo) Tamsulosin/dutasteride (Jalyn) recommended for May 211 Finasteride (Proscar) 5-ARI NF Dutasteride (Avodart) Step therapy is in place: patient received a trial of tamsulosin or alfuzosin and had an inadequate response Recommended implementation period 6 days 23 June 211 Beneficiary Advisory Panel Meeting Page 6 of 8

7 Figure 5: BPH Drug Utilization (3 day equiv) All POS AVODART FINASTERIDE FLOMAX JALYN PROSCAR RAPAFLO TAMSULOSIN HCL UROXATRAL 8, 7, 6, 5, 4, 3, 2, 1, 3/31/8 4/3/8 5/31/8 6/3/8 7/31/8 8/31/8 9/3/8 1/31/8 11/3/8 12/31/8 1/31/9 2/28/9 3/31/9 4/3/9 5/31/9 6/3/9 7/31/9 8/31/9 9/3/9 1/31/9 11/3/9 12/31/9 1/31/1 2/28/1 3/31/1 4/3/1 5/31/1 6/3/1 7/31/1 8/31/1 9/3/1 1/31/1 11/3/1 12/31/1 1/31/11 2/28/11 23 June 211 Beneficiary Advisory Panel Meeting Page 7 of 8

8 Table 6 Table of Implementation Status of Recommendations/Decisions Summary Table Meeting Drug Class n-formulary Medications Total Beneficiaries Affected (# of patients affected) Beneficiaries Affected by POS MTF Retail Mail Order Implementation Plan First Wednesday X days after the decision date Step Therapy Saphris, May 211 Oral Anti- Psychotic Agents Fanapt days N/A Latuda May 211 Nasal Allergy Drugs Ciclesonide (Omnaris) Fluticasone furoate (Veramyst ) Beclomethasone (Beconase AQ) Budesonide(Rhinocort Aqua) Triamcinolone (Nasacort AQ) Azelastine.15% (Astepro) t applicable remains non formulary May 211 n-insulin Diabetes Drugs t applicable; saxagliptin/metformin ER (Kombiglyze) recommended for 56 (new users who will hit metformin or sulfonylurea step per quarter) 6 Days Automated PA applies with metformin or a sulfonylurea preferred May 211 Ophthalmic -1s t applicable. Bromfenac.9% ophthalmic solution (Bromday) recommended for May 211 Alpha-1 Blockers for BPH t applicable; tamsulosin/dutasteride (Jalyn) recommended for 2445 (new users who will hit tamsulosin or alfuzosin step per quarter) 6 Days Automated PA applies with alfuzosin (Uroxatral) or tamsulosin (Flomax generic) preferred 23 June 211 Beneficiary Advisory Panel Meeting Page 8 of 8