Missouri Department of Social Services



DRUG UTILIZATION REVIEW BOARDOctober 19, 2016Department of Natural Resources, LaCharrette/Nightengale Conference Rm, Jefferson City MODUR BOARD MEMBERS PRESENTMHD STAFF PRESENTSusan Abdel-Rahman, Pharm D – Board ChairMark Roaseau, R. Ph, Clinical PharmacistKenneth Haller, MD Stephen Calloway, R. Ph, Director of PharmacyRandy Beckner, Pharm DJenna McTeer, RN, Clinical ManagementSandra Bollinger, Pharm D Angela Wilson, Manager Band IKirk Nelson, MDTimothy Kling, MD, Assistant Medical Director EBUJennifer Passanise, FNPMegan Goldthrite, Administrative Office Support AssistantStacey Mangum, Pharm DElizabeth Short, Medicaid Specialist DUR BOARD MEMBERS ABSENTCONTRACTED STAFF PRESENTCharlene Heyde, R. PhJosh Moore, PharmD, XeroxGlenn Talboy, MD Katie Wilbers, PharmD, XeroxGinger Nicol, MDLuke Boehmer, PharmD, XeroxOTHERS IN ATTENDANCEDel Deem, Astra-ZenecaAshley Polce, AbbvieTodd Herman, MerckSteve Naert, Eli LillyEvan Rushing, AlkermesChelsea Pendleton, WiproJill Nitz, WiproEric Gardner, Vertex Randi Lewandowski, TevaTerry McCurren, Otsuka AmericaEdie Dodson, GenzymeJim Bauman, PfizerChristina Yuan, KU School of PharmacyPhil King, Pfizer Sign in sheet on file for review. Welcome, Introductions and Opening RemarksSusan Abdel-Rahman, Pharm D, called the meeting to order. A quorum was established. Stephen Calloway, R.Ph facilitated the meeting on behalf of the MO HealthNet Division (MHD). Minutes Review and Approval Minutes of the July 2016 DUR Board meeting were reviewed and approved as submitted. (See Roll Call Votes)Pharmacy Program/Budget UpdateStephen Calloway presented a brief PowerPoint including highlights and details of the Pharmacy Program. The presentation contained graphs representing an expenditure amount per member for all eligible participants, disabled participants, elderly participants, and other; a pie chart of participants; and expenditures by participants. The top four drug classes per FY were shared. Pharmacy expenditures were discussed, including Information on the Hepatitis C Expenditures FY 2015 thru FYTD 2017. Other program statistics were shared, along with discussion of pharmaceutical industry trends and observations. Calloway indicated MHD is working with other state agencies as part of the Prescription Drug Misuse Workgroup.Review of Prior Authorization MeetingCopies of the agenda and draft minutes, including public hearing, from the September 2016 Drug Prior Authorization Committee Meeting were included in the members' meeting packet. Old BusinessImplementation ScheduleAn updated copy of the Proposed Implementation Schedule for Edits, including PDL classes and Clinical Edits was included in the Members’ meeting packet and provided as a handout to all attending. Calloway informed the Board that the approved Annual Preferred Drug List (PDL) from June/July was implemented on October 6, 2016. Renewed Therapeutic Classes approved in Sept/Oct will be implemented January 2017. Upcoming PDL decisions from Dec/Jan will be implemented April 2017. Schedules may be found on the MHD web page at New Drug ReviewStephen Calloway reviewed the new drug products that were identified for the quarter April, May and June 2016 and the recommended status within the clinical program. Discussion - A listing of products recommended for open access, clinical edit, preferred drug list (PDL) product, or continued prior authorization was provided in the Members’ meeting packet, along with the Drug Prior Authorization Committee’s actions/decisions. Decision - The listing and recommendations were approved as part of a block vote by the DUR Board (See Roll Call Votes).Clinical EditsShort-Acting Narcotics Clinical Edit● Discussion – Mr. Calloway reviewed the Clinical Edit proposal, along with information on projected claims and call center impact. Implementation of the edit is not planned until 2017.● Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)Short-Acting Combination Narcotics Clinical Edit● Discussion – Mr. Calloway reviewed the Clinical Edit proposal, along with information on projected claims and call center impact. Implementation of the edit is not planned until 2017.● Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)Opiate Reversal Agents Clinical Edit● Discussion – Mr. Calloway reviewed the Clinical Edit proposal, along with stated intent of the edit. It was stated this could become a Preferred Drug List category in the near future.● Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)Preferred Drug List (PDL) Annual ReviewACE Inhibitor Agents Discussion –– Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)ACE Inhibitors/Calcium Channel Blocker Combination Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)ACE Inhibitors/Diuretic Combination Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Angiotensin Receptor Blocker Agents (ARB’s) Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Angiotensin Receptor Blocker/Diuretic Combination Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Angiotensin Receptor/Calcium Channel Blocker Combination Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Anticoagulant Agents: Oral and Subcutaneous Discussion –– Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents. This category was updated to separate out the Antiplatelet Agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Antiplatelet Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents. Antiplatelet Agents are now contained in a separate PDL category.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Beta Adrenergic Blockers and Diuretic Combination Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Calcium Channel Blocker Agents (Dihydropyridines) Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Calcium Channel Blocker Agents (Non-Dihydropyridines) Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Direct Renin Inhibitors and Combination Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Hepatitis C Therapy: Direct-Acting Antiviral Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents. It was emphasized that MHD is requesting decision on PDL status, but will continue with F3 criteria.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Homozygous Familial Hypercholesterolemia Products Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Lipotropic Agents: Niacin and Combination Preparations Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Lipotropic Agents: Statins (HMG Co-A Reductase Inhibitors) and Statin Combination Products Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Proton Pump Inhibitor Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Pulmonary Hypertension Agents: Inhaled/Injectable Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Pulmonary Hypertension Agents: Oral Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Sympatholytic Antihypertensive Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents. Although the agents in this category are not new, the PDL category is new to MHD.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Triglyceride Lowering Agents Discussion – Mr. Calloway presented the criteria document, reviewing preferred and non-preferred agents.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Preferred Drug List Discussion/Therapeutic ClassesA handout of therapeutic categories scheduled for Annual Review and Renewal on the Preferred Drug List at the December/January Advisory meetings was included in the meeting packet. This handout was also provided to all attendees and will be posted to the Division's web page.Xerox UpdateLuke Boehmer, Pharm D reviewed clinical 25 Drugs by CostDr. Boehmer reviewed the Top 25 Drugs Summary Reports for the 3rd quarter 2015 through the 2nd quarter 2016. Two versions were presented: one report ranked drug spend by dollars and the other by utilization/claims.Call Center Statistics Clinical Edit Summary ReportA handout detailing pharmacy help desk call center activity was provided for all attending. Cyber Access Active User Counts and Logging Information reports detailing activity were shared. Dr. Boehmer reviewed how many sites/physical locations are trained and have access to CyberAccess. Reports also detailed the number and type of prescribers and active users on CyberAccess. Board members were also updated on approved, denied, and total Prior Authorizations for New Drugs in August and September 2016, as well as PA transaction counts by PDL and Clinical Edit.AdjournThe DUR Board went into Executive Session for the sole purpose of discussing individual participant specific medical information. At the conclusion of these discussions the group adjourned entertaining no further business, actions or motions. (See attached roll call vote). The next DUR Board meeting is scheduled for January 18, 2017.Roll Call Votes – October 19, 2016MEMBERMEETING MINUTESALL RECOMMENDATIONS BLOCK VOTECLOSED SESSIONADJOURNSusan Abdel-Rahman, Pharm DYYYYCharlene Heyde, RPh----Sandra Bollinger, Pharm D2YYYYKenneth Haller, MDMYMYYYGlenn Talboy, MD----Jennifer Passanise, FNPY2YYYStacy Mangum, Pharm DYYMYYKirk Nelson, MDYYYYGinger Nicol, MD- ---Randy Beckner, Pharm DYY (3 Triglyceride, Pulmonary, Arterial Hypotension Agents, Beta Adrenergic, Diabetic Combo2YYEXECUTIVE SESSIONOctober 19, 2016DUR BOARD MEMBERS PRESENTMHD STAFF PRESENTSusan Abdel-Rahman, Pharm D Mark Roaseau, R.Ph, Clinical PharmacistKenneth Haller, MD Stephen Calloway, R.PhRandy Beckner, Pharm DJenna McTeer, RN., Clinical ManagementSandra Bollinger, Pharm D Angela Wilson, Manager Band IStacy Mangum, Pharm DJennifer Passanise, FNP Kirk Nelson, MD DUR BOARD MEMBERS ABSENTCONTRACTED STAFF PRESENTCharlene Heyde, R.PhGlenn Talboy, MDGinger Nicol, MDJosh Moore, Pharm D, XeroxKatie Wilbers, Pharm D, XeroxLuke Boehmer, Pharm D, Xerox Minutes ReviewMinutes of the July Executive Session were approved as submitted.Case ReviewsJenna McTeer, RN reviewed 1 case.AdjournExecutive session adjourned. ................
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