Missouri Department of Social Services



DRUG UTILIZATION REVIEW BOARDApril 16, 2016Department of Natural Resources, LaCharrette/Nightengale Conference Rm, Jefferson City MODUR BOARD MEMBERS PRESENTMHD STAFF PRESENTSusan Abdel-Rahman, Pharm D Mark Roaseau, R.Ph, Clinical PharmacistCharlene Heyde, RPh Stephen Calloway, R. PhRandy Beckner, Pharm DJenna McTeer, RNSandra Bollinger, PharmD Andrew Haslag, Fiscal ManagerGinger NicolAngela Wilson, Manager Band IJennifer PassaniseLisa Smith, DUR CoordinatorMegan Goldthrite, Administrative AssistantElizabeth Short, DUR BOARD MEMBERS ABSENTCONTRACTED STAFF PRESENTKirk Nelson, MDJosh Moore, Clinical Pharmacist, XeroxStacy Mangum Katie Wilbers, Clinical Pharmacist, XeroxGlenn TalboyLuke Boehmer, XeroxKenneth Haller, MD1 Student OTHERS IN ATTENDANCEMary Rakers, AbbvieSteve Naut, Eli LillyGeri Roling, WiproJeff Knappen, AllergenTyler Cradool, The Medicine CompanyChris Stonefield, Supornus Shefali Patel, Wipro*Many names on the sign in sheet were illegible. 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 Approval Minutes of the January 2016 meeting were reviewed and approved as submitted. Pharmacy Program/Budget UpdateStephen Calloway presented a brief PowerPoint with support by Elizabeth Short. 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. Information on the Blind Pension was also presented, with support from Angela Wilson and Lisa Smith. Generic dispensing rates were shared with the Committee. Mr. Calloway also mentioned that MO HealthNet is working to implement expansion of Medicaid Managed Care and Telehealth, while continuing to manage expenses. Mark Roaseau spoke about what is going on with ICD-10 and October 1st official start date.Review of Prior Authorization MeetingCopies of the agenda and draft minutes, including public hearing, from the April 2016 Drug Prior Authorization Committee Meeting were included in the members' meeting packet. Implementation ScheduleAn updated copy of the Proposed Implementation Schedule for Edits, including PDL classes was included in the Members’ meeting packet and provided as a handout to all attending. The schedule included the therapeutic classes will be implemented July 2016. PDL decisions from December/January will be implemented April 2016. 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 October, November, and December 2015, 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 for discussion and action. This listing was also provided as a handout to all attending. Public Hearing – No public hearing on these drugs. Decision – Members voted to accept the new drug recommendations as presented. (See Roll Call Vote)Old BusinessStephen Calloway informed the Board that the approved Preferred Drug List (PDL) from December/January will be implemented in April 2016. Clinical EditOrkambi● Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.● Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)Transmucosal Immediate – Release Fentanyl (TIRF)● Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.● Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)Short – Acting Narcotics● Discussion – Mr. Calloway went over the criteria document and advised this needs to be an in depth discussion and that this edit will be brought back again at the next meeting. ● Decision – This was voted on separately to say that it will be revisited. (See Roll Call Votes)Preferred Drug List (PDL) Annual ReviewProducts and classes under review this quarter have existing contracts through June 30, 2016. Recommended changes to the edits were bolded for easy identification. Benzoyl Peroxide Clindamycin Discussion – Mr. Calloway reviewed 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)Beta Adrenergic LA Discussion – Mr. Calloway reviewed 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)Beta Adrenergic Nebulized Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Beta Adrenergic SA Discussion – Mr. Calloway reviewed 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)COPD Anticholinergics Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Cough and Cold Agents Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Herpes Antivirals Discussion – Mr. Calloway reviewed 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)Inhaled Antibiotics Discussion – Mr. Calloway reviewed 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)Inhaled Corticosteroids Discussion – Mr. Calloway reviewed 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)Intranasal Antihistamines Discussion – Mr. Calloway reviewed 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)Leukotriene Modifiers Discussion – Mr. Calloway reviewed 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)Low Sedating Antihistamines Discussion – Mr. Calloway reviewed 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)LS Antihistamine Decongestant taps Discussion – Mr. Calloway reviewed 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)Nasal Steroids Discussion – Mr. Calloway reviewed 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)Onychomycosis Antifungals Discussion – Mr. Calloway reviewed 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)Ophthalmic Antihistamines Discussion – Mr. Calloway reviewed 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)Ophthalmic Mast Cell Stabilizers Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Ophthalmic NSAIDS Discussion – Mr. Calloway reviewed 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)Ophthalmic Prostaglandin Agonists Discussion – Mr. Calloway reviewed 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)Ophthalmic Quinolones Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Otic Quinolones Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Pancreatic Enzymes Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Self-Injectable Epinephrine Agents Discussion – Mr. Calloway reviewed 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)Topical Agents for Psoriasis Discussion – Mr. Calloway reviewed 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)Topical Androgenic Agents Discussion – Mr. Calloway reviewed 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)Topical Antifungals Discussion – Mr. Calloway reviewed 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)Topical Antiparasitics Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Topical Antivirals Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Topical Immunomodulators Discussion – Mr. Calloway reviewed 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)Topical Retinoids Discussion – Mr. Calloway reviewed 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)Topical Steroids Discussion – Mr. Calloway reviewed 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)Ulcerative Colitis Agents – Oral Discussion – Mr. Calloway reviewed 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)Ulcerative Colitis Agents Rectal Discussion – Mr. Calloway stated there are no changes recommended for this class.● Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)Xerox UpdateLuke Boehmer, PharmD reviewed clinical edits, utilization data and trends for DMARDS. Also, spoke about the different reasons for denials. Then he spoke about the Opiate Dependence Agents.Preferred Drug List Discussion/Therapeutic ClassesA handout of therapeutic categories to be reviewed for inclusion on the Preferred Drug List for the next phase and meeting was included in the meeting packet. This handout was also provided to all attendees and will be posted to the Division's web 25 Drugs by CostDr. Boehmer reviewed the Top 25 Drugs Summary Reports for the 3rd and 4th quarter of 2015. Two versions were presented: one report ranked drug spend by dollars and the other by utilization/claims.Call Center Statistics A 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. 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 meeting is scheduled for July 20, 2016.Roll Call Votes – January 20, 2015MEMBERMEETING MINUTESShort Acting NarcoticsALL RECOMMENDATIONS BLOCK VOTECLOSED SESSIONADJOURNSusan AbdelRahmanYYY2Y-Charlene HeydeY2YMYY-Sandra BollingerMYMYYY-Kenneth Haller-----Glenn Talboy-----Jennifer Passanise2YY2YY-Stacy Mangum-----Kirk Nelson-----Ginger NicolYYYMY-Randy BecknerYYY (Abstained from Beta Adrengergic Agents SA and LA, COPD Anticholinergic agents, Herpes Antivirals, Inhaled Corticosteroids, Intranasal Steroids and Allergy Agents, Topical Antiviral Agents )Y-EXECUTIVE SESSIONApril 16, 2016DUR BOARD MEMBERS PRESENTMHD STAFF PRESENTSusan Abdel-Rahman, Pharm D Mark Roaseau, R.Ph, Clinical PharmacistCharlene Heyde, RPh Stephen Calloway, R. PhRandy Beckner, Pharm DJenna McTeer, RNSandra Bollinger, PharmD Andrew Haslag, Fiscal ManagerGinger NicolAngela Wilson, Manager Band IJennifer PassaniseLisa Smith, DUR CoordinatorMegan Goldthrite, Administrative AssistantElizabeth ShortDUR BOARD MEMBERS ABSENTCONTRACTED STAFF PRESENTKirk Nelson, MDJosh Moore, Clinical Pharmacist, XeroxStacy Mangum Katie Wilbers, Clinical Pharmacist, XeroxGlenn TalboyLuke Boehmer, XeroxKenneth Haller, MD1 StudentMinutes ReviewMinutes of the January Executive Session were approved as submitted.Case ReviewsJenna McTeer, RN reviewed 2 case.AdjournExecutive session adjourned. ................
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