Michigan Department of Health and Human Services Pharmacy and Therapeutics Committee June 14, 2016 Minutes Final Attendee: Dr. Tutag Lehr, Andrew Mac, James Miller, Brian Peltz, Dr. Anthony Ognjan, Dr. Steve Hadesman, Dr. Eggleston. Quorum was met The MDHHS P & T committee was called to order at 6:10 pm by the chair, Dr. Vicki Tutag Lehr. The agenda was reviewed and accepted. Introductions were made and quorum established. Conflict of interest statement was reviewed. None of the members had COI to report. Review of the March, 2016 meeting minutes were reviewed and approved. P & T business: The Committee was updated on the progress of the MCO Common Formulary. Old Business: A. Clinical significance of Oral coagulants were discussed. The Committee reviewed the literature and gained understanding of what oral anticoagulants were utilized in a variety of ER s in the state when initiating treatment for DVT. Each protocol included a Medicaid preferred agent. The Committee noted while the commercial health plans might be seeing a shift in utilization, MI Medicaid utilization was consistent with preferred agents. This led the Committee to recommend if cost is not a factor to prefer all NOACs. B. An ad hoc query addressing metabolic surveillance for antipsychotics prepared for the DUR board was reviewed. New Drugs with monographs: 1. Aptensio XR (methylphenidate) added to the Stimulants PDL class as non-preferred. 2. Belbuca (buprenorphine) added to the Analgesics, Narcotics Long as non-preferred. 3. Durlaza (aspirin extended-release) added to the Platelet Aggregation Inhibitors PDL class as nonpreferred. June 14, 2016 Page 1
4. Seebri Neohaler (glycopyrrolate) added to the COPD PDL Class as non-preferred. Of note: The Committee also asked that the COPD drug class be updated to reflect function. 5. Utibron Neohaler (indacaterol/glycopyrrolate) added to the COPD PDL Class as non-preferred. 6. Strensiq (asfotase alfa) Add to MPPL with PA required. Of note: the NSAID Class is not posted on the PDL. It is an older class with generics preferred. 7. Ticanase (fluticasone propionate) added to the Nasal Steroids PDL class as non-preferred. 8. Tivorbex (indomethacin, submicronized) added to the NSAIDS PDL class as non-preferred. 9. Vivlodex (meloxicam) - added to the NSAIDS PDL class as non-preferred. 10. Tresiba Flextouch (insulin degludec) added to the Hypoglycemics, Insulin and Related Agents PDL class as non-preferred] 11. Uptravi (selexipag) added to the PAH Agents PDL Class as non-preferred. 12. Varubi (rolapitant) added to the Antiemetic/Antivertigo Agents PDL class as non-preferred. 13. Veltassa (patiromer calcium sorbitex) - Add to MPPL with clinical PA required. 14. Viberzi (eluxadoline) Add to MPPL with clinical PA required. 15. Praluent (alirocumab) Added to the Lipotropics, Other PDL class as Non-preferred with Clinical PA required. 16. Repatha (evolucumab) Added to the Lipotropics, Other PDL class as Non-preferred with Clinical PA required. Review of Preferred Drug List Classes: the Committee concurred with the recommendations as note below. Antibiotics/Anti-Infectives: 1. Antibiotics- Inhaled 2. Antifungals Oral a. Move Gris-Peg to non-preferred 3. Antifungals Topical a. Move econazole to non-preferred 4. Antivirals Herpes a. Move acyclovir suspension to non-preferred b. Move Zovirax (acyclovir) suspension to preferred June 14, 2016 Page 2
5. Antivirals Influenza 6. Antivirals Topical 7. Cephalosporin 1 st Generation 8. Cephalosporin 2 nd Generation 9. Cephalosporin 3 rd Generation a. Move cefixime suspension to non-preferred b. Move Suprax (cefixime) chew tabs to preferred 10. Macrolide 11. Oxalodinones a. Move Zyvox (linezolid) tablets and suspension to non-preferred b. Keep linezolid tablets and suspension as preferred 12. Quinolones 13. Ophthalmic Fluoroquinolones 14. Ophthalmic Macrolides 15. Otic Quinolones a. Move ofloxacin to non-preferred 16. Topical Antibiotics 17. Gastrointestinal Antibiotics a. Move Vancocin (vancomycin) to preferred b. Move vancomycin to non-preferred Of note, medications used to treat Hepatitis C were delayed in review until December 2016. This would represent a review at one year from the most recent review of this drug category. The Department is currently covering Hep C for those individuals with greater severity of illness with a metavir score of F3 or greater or a condition which would be made worse by Hep C or the condition would worsen or hasten the progression of Hep C. The Department is interested in looking for the possibility to increase coverage at the next review. June 14, 2016 Page 3
Asthma/Allergy/COPD: 1. COPD Agents 2. Antihistamines 2 nd Generation 3. Antihistamines Nasal 4. Beta Adrenergics Short Acting 5. Beta Adrenergics Long Acting 6. Beta Adrenergics for Nebulizers 7. Beta Adrenergic/ Corticosteroid Inhaler Combinations 8. Inhaled Glucocorticoids 9. Leukotriene Inhibitors 10. Nasal Steroids a. Move mometasone (generic for Nasonex) to non-preferred. Public Comment: 1. Terry Dickson, MD, The Behavioral Medicine Clinic of NW Michigan, PC, TRIS Pharma: Dyanavel XR 2. Domenic Mantella, PharmD, MBA, NovoNordisk: Norditropin 3. Steve Woods, Medical Science Director, Relypsa: Veltassa 4. Paul McDermott, Medical Science Liaison, Celgene Corporation, Otezla (Apremilast) for use in Psoriasis and Psoriatic Arthritis. 5. Rick Detloff, Pharm.D, Pfizer, Xeljanz 6. Jeff Hurd, MS, PhD, Astra Zeneca, Brilenta ( ticagrelor) 7. Swarup Mehta, PharmD. Medical Affairs Director, Virology, Merck : Zepatier 8. Jenene Hunkele, Sr. Medical Science Liaison, Mid-West, Alexion Pharmaceuticals: Strensiq June 14, 2016 Page 4
Public Comments were heard. Meeting was then adjourned at 8:15 pm Next Meeting: Tuesday, September 13, 2016 Location: Kellogg Center Drug Classes: GI, Diabetes and Miscellaneous June 14, 2016 Page 5