Beneficiary Advisory Panel Handout Uniform Formulary Decisions 23 June 2011

Similar documents
MTF Quarterly Webcast September 9, CDR Joe Lawrence Director, DoD Pharmacoeconomic Center

DEPARTMENT OF DEFENSE PHARMACY AND THERAPEUTICS COMMITTEE RECOMMENDATIONS. May 2011

CRITERIA Trial of two generic formulary products from the following: atomoxetine or ADHD stimulant medication.

Victoza (Liraglutide) Solution for Injection

Pharmacy Benefit Management (PBM) Program FORMULARY/PRODUCT RESTRICTIONS

Secretary for Health and Family Services Selections for Preferred Products

Step Therapy Criteria 2019

Diabetes Medications: Oral Anti-Hyperglycemic Medications

DOD PHARMACY AND THERAPEUTICS COMMITTEE RECOMMENDATIONS INFORMATION FOR THE UNIFORM FORMULARY BENEFICIARY ADVISORY PANEL

Type II Diabetes Improving Blood Sugar Control. Geneva Clark Briggs, Pharm.D., BCPS

Non-Insulin Diabetes Medications Summary

ANGIOTENSIN RECEPTOR BLOCKERS

Triage Information: 1. Duration of HPSJ Membership 2. Age 3. Fill history of Seasonal Allergy Medications

Step Therapy Criteria (Criteria for Step Therapy-2 [ST-2] Drugs)

Oral and Injectable Medication Options for Diabetes Treatment

Uniform Formulary Decisions 9 January 2014

2018 PDP Premier Step Therapy Document September 2018 Y0114_18_33144_I_009

II. UF CLASS REVIEWS NASAL ALLERGY DRUGS

ADHD STIMULANTS - SCORE

Medications that Can Cause Weight Gain

FirstCarolinaCare Insurance Company Step Therapy Requirements

1/15/2018. Disclosures. Current Diabetes Medications. Objectives NON-INSULIN AGENTS. Diabetes Med Classes. Mealtime

Diabetes Medication Updates Erica Bukovich, PharmD, BC-ADM, CDE September 20, 2018

Antipsychotics Prior Authorization Criteria for Louisiana Fee for Service and MCO Medicaid Recipients

Objectives. How Medicine Works to Control Blood Sugar Levels. What Happens When We Eat? What is diabetes? High Blood Glucose (Hyperglycemia)

ADHD STIMULANTS - SCORE

Beneficiary Advisory Panel Handout Uniform Formulary Decisions 6 Jan 2011

Antipsychotic Medications Age and Step Therapy

The Medical Letter. on Drugs and Therapeutics. Drug Some Formulations OTC/Rx Usual Dosage Comments Class Comments Cost 1

RPCC Pharmacy Forum. The Type 2 Diabetes Issue. Type 2 Diabetes: The Basics

Cardiovascular Health and Diabetes Screening for People with Schizophrenia

PRINCIPLES OF ORAL ANTIDIABETIC AND

ARBS MEDICATION(S) SUBJECT TO STEP THERAPY DIOVAN HCT MG TAB, DIOVAN HCT MG TABLET

Pharmacy Medical Necessity Guidelines: Atypical Antipsychotic Medications. Effective: December 12, 2017

Oral Agents. Fml Limits. Available Strengths NF NF

Oral Medication for the Management of Diabetes Mechanism of. Duration of Daily Dosing Action

HOSPITAL BASED INPATIENT PSYCHIATRIC SERVICES (HBIPS) MEASURE SET

Slide 1. Slide 2. Slide 3. About this module. About this module. Antipsychotics: The Essentials Module 5 A Primer on Selected Antipsychotics

Supplementary Online Content

DIABETES. overview of pharmacologic agents used in the management of. Overview 4/3/2014 OBJECTIVES. Injectable Agents

Pharmacy Medical Necessity Guidelines: Atypical Antipsychotic Medications. Effective: February 20, 2017

How to Fight Diabetes and Win. Diabetes. Medications

Drugs requiring prior authorization: the list of drugs requiring prior authorization for this clinical criteria

Medicare Part D 2012 Formulary Changes Service To Senior and Total Fit

ABILIFY ABILIFY DISCMELT ACTONEL ACTOPLUS MET ACTOPLUS MET XR ACTOS ADCIRCA ADVAIR DISKUS ADVAIR HFA

ADHD STIMULANTS-S(SHC)

Fee-for-Service Pharmacy Provider Notice #216 ** March 2016 PDL Changes ** Existing Drug Classes

VNSNY CHOICE FIDA Complete Step Therapy Requirements. Effective: 01/01/2017

Oral and Injectable Non-insulin Antihyperglycemic Agents

BLUE SHIELD OF CALIFORNIA MARCH 2016 STANDARD DRUG FORMULARY CHANGES

ALLERGIC RHINITIS-NASAL

What s New in Diabetes Treatment. Disclosures

Generics. Lead with. Prescription Step Therapy Program

Step Therapy Group. Atypical Antipsychotic Agents

Thiazolidinedione Step Therapy Program

ANTIDIABETIC AGENTS - MISCELLANEOUS

Oral Agents. Formulary Limits. Available Strengths. IR: 4mg ER: 12mg Syrup: 2mg/5ml

AMANTADINE ER. Products Affected Step 2: OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, Details

The information in this guide comes from a government-funded review of research about pills for type 2 diabetes.

Quarterly Pharmacy Formulary Change Notice

What the Pill Looks Like. How it Works. Slows carbohydrate absorption. Reduces amount of sugar made by the liver. Increases release of insulin

Society for Ambulatory Anesthesia Consensus Statement on Perioperative Blood Glucose Management in Diabetic Patients Undergoing Ambulatory Surgery

TEST ANTICONVULSANT THERAPY. Products Affected. Step 2: Network Health Insurance Corporation NetworkCares Step Therapy Criteria Last Updated 11/2018

DM Fundamentals Class 4 Meds for Type 2

Byetta (Exenatide Injection)

Multiple Small Feedings of the Mind: Diabetes. Sonja K Fredrickson, MD, BC-ADM March 7, 2014

ANTIDIABETIC AGENTS - MISCELLANEOUS

Michael J. Bailey, M.D. OptumHealth Public Sector

II. UF CLASS REVIEWS SHORT-ACTING BETA AGONISTS (SABAs)

Pharmacologic Agents for Treatment of Type 2 Diabetes

Diabetes Treatment Guidelines

The Community Pharmacist s Role in Diabetes Treatment

Step Therapy Requirements. Effective: 03/01/2015

2014 Step Therapy Criteria (List of Step Therapy Criteria)

Pharmacy Medical Necessity Guidelines: Antipsychotic Medications

Step Therapy Requirements. Effective: 1/1/2019

Formulary Changes. One mission: you TABLE A. FORMULARY CHANGES 7/1/2018: Commercial 3-Tier Formulary. Commercial 4-Tier Formulary

TRICARE Uniform Formulary. Pre-Authorization Requirements

See Important Reminder at the end of this policy for important regulatory and legal information.

TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations

FirstCarolinaCare Insurance Company. Step Therapy Requirements

A Brief Overview of Psychiatric Pharmacotherapy. Joel V. Oberstar, M.D. Chief Executive Officer

Santa Clara Family Health Plan Cal MediConnect Formulary. List of Step Therapy Requirements Effective: 12/01/ E

AMANTADINE ER. Products Affected Step 2: OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, Details

ANTICONVULSANTS. Details

Clinical Policy: Olanzapine Long-Acting Injection (Zyprexa Relprevv) Reference Number: CP.PHAR.292 Effective Date: Last Review Date: 08.

VNSNY CHOICE FIDA Complete Step Therapy Requirements. Effective: 01/01/2017

AMANTADINE ER. Products Affected Step 2: OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, Details

STEP THERAPY ALGORITHMS PUP Select Formulary

ORAL AND INJECTABLE (NON-INSULIN) PHARMACOLOGICAL AGENTS FOR TYPE 2 DIABETES

ANTIDIABETIC AGENTS - MISCELLANEOUS

TABLE 1A: Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations

2013 Quantity Level Limits (QLL) Criteria

2013 Quantity Level Limits (QLL) Criteria

Transcription:

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

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

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

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

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

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

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

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, 45 132 45 36 May 211 Oral Anti- Psychotic Agents Fanapt 122 2 122 11 6 days N/A Latuda 12 12 2 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