Dr. Carl Sherter thanked the attendees for coming and called meeting to order at 6:24 pm.

Transcription

1 The meeting started at 6:24pm Attendance Connecticut Medicaid P&T Meeting Minutes April 30, 2014 Present Members: Carl Sherter, MD Charles Thompson, MD Emmett Sullivan, RPh Stella Cretella Kevin Chamberlin, PharmD Jeffrey Kamradt, MD Hilda Slivka, MD Absent Members: Angelo DeFazio, RPh Manage Nissanka, MD Elizabeth Rodríguez, RN Andrew Lustbader, MD Cynthia Conrad, MD Karen McMillan, RN DSS: Evelyn Dudley James Zakszewski, RPh HP/Magellan: Jason Young, PharmD Deven Shah, RPh Margaret Stroczkowski Kathy Novak, RPh (Magellan) Opening remarks: Dr. Carl Sherter thanked the attendees for coming and called meeting to order at 6:24 pm. Evelyn Dudley addressed requests that were received to make P&T recommendations for the Committee available to the public in advance of the meeting. She stated this is being discussed internally and no decisions have been made at this time. Evelyn motioned to remove P&T committee member Angelo Defazio from the committee due to lack of response and attendance to meetings. The committee was unanimously in favor. Vacancies on the committee were announced and current members were encouraged to recruit potential replacements. Evelyn announced that the State intends to extend Step-Therapy prior authorization criteria to additional classes this year, targeting the Antimigraine Triptans and Lipotropics Statins therapeutic classes. DSS and HP solicited the P&T Committee to provide input on specific criteria.

2 The minutes from the previous meeting, held October 23, 2013, were unanimously approved by the committee members present. Public Presentations: CT Oncology Association Antibiotics, Inhaled Class Testimony TOBI Podhaler Beta Blockers Bystolic Colony Stimulating Factors Neulasta Growth Hormone Genotropin Hepatitis C Agents Olysio Sovaldi Hypoglycemics, Incretin Mimetics/Enhancers GLP-1 Agonists Bydureon, Onglyza Victoza GLP-1 Agonists Hypoglycemics, SGLT2 Farxiga Invokana Lipotropics, Other Kynamro Multiple Sclerosis Agents Copaxone Gilenya Aubagio Ampyra Opiate Dependence Treatments Zubsolv Dawn Holcombe, Executive Director Dr. Craig Lapin, Central CT CF Center Beth D Ambrosio, PharmD Novartis Dr. Komsu Mamuya Tammy Curtice, PharmD Amgen Aniello Marotta, PharmD Pfizer Arlene Price, PharmD Janssen Dr. Martin Hoffman, St. Francis Hospital Dr. Elgis Bogdanovics Ron Jones, PharmD AstraZeneca Justin Bakshai, PharmD Novo Nordisk Angela Gaskins-Younger, APRN Joslin Ron Jones, PharmD AstraZeneca Arlene Price, PharmD Janssen Drew Revel, PhD Genzyme Elizabeth Destafney Teva Beth D Ambrosio, PharmD Novartis Pamela Salisbury, MSN NP-C Genzyme Elaine Alexander, MS Liaison Acorda Jake Nichols, PharmD Orexo US

3 PAH Agents, Oral and Inhaled Opsumit Adempas Platelet Aggregation Inhibitors Effient Ulcerative Colitis Agents Uceris Raymond Mastriani, PharmD Actelion Casimir Zygmunt, PharmD Bayer Health Ashish Trivedi, PharmD Eli-Lilly Matt Goodwin, Salix Pharmaceuticals The rest of the scheduled speakers waived their right to speak because their product was recommended as preferred on the PDL, or they were not in attendance. Therapeutic Class Reviews: Note: Brand name drugs listed in bold font. Antibiotics, Inhaled Kathy Novak from Magellan presented the recommendations for this class. Dr. Craig Lapin provided testimony in favor of adding Cayston to the formulary. Beth D Ambrosio from Novartis provided information on the benefits of TOBI Podhaler. Hilda Slivka motion to accept the recommendations as presented, along with the addition of Cayston and TOBI Podhaler to the PDL. Her motion was seconded by Carl Sherter and passed unanimously. ON Medicaid PDL: BETHKIS (INHALATION), CAYSTON (INHALATION), TOBI PODHALER (INHALATION), TOBI (INHALATION) Pancreatic Enzymes The recommendations were presented, and there were no changes from the previous year. A motion to accept the recommendations as presented was unanimously passed by the committee. ON Medicaid PDL: CREON (ORAL), PANCRELIPASE (AG) (ORAL), ZENPEP (ORAL) Anticoagulants The recommendations were presented to the committee, and there were no changes from the previous year. Scheduled speakers waived their right to speak. Stella Cretella motioned to accept the recommendations as presented, and was seconded by Charles Thompson. The committee passed the motion unanimously.

4 ON Medicaid PDL: ELIQUIS (ORAL), FRAGMIN DISP SYRIN (SUBCUTANE.), FRAGMIN VIAL (SUBCUTANE.), LOVENOX SYRINGE (SUBCUTANE.), LOVENOX VIAL (SUBCUTANE.), PRADAXA (ORAL), WARFARIN (ORAL), XARELTO (ORAL) Antiparasitics, Topical The recommendations were presented for this class, and both scheduled speakers waived their right to present. Stella Cretella motioned to accept the recommendations as presented. Kevin Chamberlin seconded and the motion passed unanimously. ON Medicaid PDL: NATROBA (TOPICAL), PERMETHRIN CREAM (TOPICAL), PERMETHRIN OTC (TOPICAL), PIPERONYL BUTOXIDE/PYRETHRINS SHAMPOO OTC (TOPICAL), SKLICE (TOPICAL), ULESFIA (TOPICAL) Beta Blockers The recommendations were presented, and Dr. Komsu Mamuya provided public testimony in support of adding Bystolic to the PDL. Emmett Sullivan motioned to accept the recommendations as presented, along with the addition of Nadolol. His motion was seconded and passed unanimously. ON Medicaid PDL: ATENOLOL (ORAL), ATENOLOL / CHLORTHALIDONE (ORAL), BETAXOLOL (ORAL), CARVEDILOL (ORAL), LABETALOL (ORAL), METOPROLOL (ORAL), NADOLOL (ORAL), NADOLOL / BENDROFLUMETHIAZIDE (ORAL), PROPRANOLOL ER (ORAL), PROPRANOLOL SOLUTION (ORAL), PROPRANOLOL TABLET (ORAL), SOTALOL (ORAL), TOPROL XL (ORAL) Bladder Relaxant Preparations The recommendations for this class were presented, and there were no changes from the previous year. Both scheduled speakers waived their right to present. Kevin Chamberlin motioned to approve as recommended and it was passed unanimously. ON Medicaid PDL: OXYBUTYNIN ER (ORAL), OXYBUTYNIN SYRUP (ORAL), OXYBUTYNIN TABLET (ORAL), TOVIAZ (ORAL), VESICARE (ORAL) Colony Stimulating Factors The recommendations were presented, and Tammy Curtice of Amgen provided testimony for the inclusion of Neulasta on the PDL. Jeffrey Kamradt discussed Neulasta being the standard of care and ease of administration. He motioned to accept the recommendations as presented, with the addition of Neulasta. Charles Thompson seconded the motion and it was passed unanimously. ON Medicaid PDL: GRANIX (INJECTION), NEULASTA (INJECTION), NEUPOGEN DISP SYRIN (INJECTION), NEUPOGEN VIAL (INJECTION)

5 Growth Hormone The recommendations were presented and Aniello Marotta from Pfizer provided testimony for the inclusion of Genotropin. Hilda Slivka motioned to approve the recommendations as presented, with Emmett Sullivan seconding. The motion passed unanimously. ON Medicaid PDL: NORDITROPIN PEN (INJECTION), NUTROPIN AQ CARTRIDGE (INJECTION) Hepatitis C Agents The recommendations were presented, and public testimony was provided by Dr. Hoffman and Arlene Price of Janssen in support of Sovaldi and Olysio, respectively. The committee deliberated and a motion was made to accept the recommendations as presented along with the addition of Olysio and Sovaldi. The motion passed unanimously. ON Medicaid PDL: INCIVEK (ORAL), OLYSIO (ORAL), PEGASYS KIT (SUBCUTANE.), PEGASYS PROCLICK (SUB-Q), PEGASYS SYRINGE (SUB-Q), PEGASYS VIAL (SUBCUTANE.), RIBAVIRIN TABLET (ORAL), SOVALDI (ORAL), VICTRELIS (ORAL) Hypoglycemics, Incretin Mimetics/Enhancers The recommendations were presented, and Dr. Bogdanovics provided testimony for the inclusion of the GLP-1 agonists on the PDL. Angela Gaskins-Younger also advocated for the GLP-1 Agonists to be on the PDL. Ron Jones of AstraZeneca and Justin Bakshai of Novo Nordisk provided testimony in support of their companies drugs in this class. The committee discussed the different GLP-1 agonists at length. Hilda Slivka motioned to accept the recommendations as presented, along with the addition of Bydureon and Victoza. The motion was seconded by Charles Thompson. Emmett Sullivan and Kevin Chamberlin opposed this motion, but it was upheld by a 5-2 vote. ON Medicaid PDL: BYDUREON (SUBCUTANE.), BYETTA PENS (SUBCUTANE.), JANUMET (ORAL), JANUMET XR (ORAL), JANUVIA (ORAL), JENTADUETO (ORAL), TRADJENTA (ORAL), VICTOZA (SUBCUTANE.) Hypoglycemics, SGLT2 The recommendations were presented for this class, with neither of the two agents being recommended as preferred. Ron Jones spoke in support of Farxiga, and Arlene Price in support of Invokana. Kevin Chamberlin motioned to accept the recommendations as presented, and was seconded by Jeffrey Kamradt. This motion passed unanimously. ON Medicaid PDL: NONE

6 Hypoglycemics, Insulin and Related Agents The recommendations were presented with no changes from the previous year. The scheduled speaker waived his right to speak. Hilda Slivka motioned to accept the recommendations as presented and the motion passed unanimously. ON Medicaid PDL: HUMALOG CARTRIDGE (SUBCUTANE.), HUMALOG MIX PEN (SUBCUTANE.), HUMALOG MIX VIAL (SUBCUTANE.), HUMALOG PEN (SUBCUTANE.), HUMALOG VIAL (SUBCUTANE.), HUMULIN 500 U/M VIAL (SUBCUTANE.), HUMULIN 70/30 PEN OTC (SUBCUTANE.), HUMULIN 70/30 VIAL OTC (SUBCUTANE.), HUMULIN PEN OTC (SUBCUTANE.), HUMULIN VIAL OTC (SUBCUTANE.), LANTUS SOLOSTAR PEN (SUBCUTANE.), LANTUS VIAL (SUBCUTANE.), LEVEMIR PENS (SUBCUTANE.), LEVEMIR VIAL (SUBCUTANE.), NOVOLIN 70/30 PEN OTC (SUBCUTANE.), NOVOLIN 70/30 VIAL OTC (SUBCUTANE.), NOVOLIN VIAL OTC (SUBCUTANE.), NOVOLOG CARTRIDGE (SUBCUTANE.), NOVOLOG MIX PEN (SUBCUTANE.), NOVOLOG MIX VIAL (SUBCUTANE.), NOVOLOG PEN (SUBCUTANE.), NOVOLOG VIAL (SUBCUTANE.) Irritable Bowel Syndrome The recommendations were presented and Dr. Peter Buch waived his right to speak. Hilda Slivka motioned to accept the recommendations as presented for this class, Kevin Chamberlin seconded and it passed unanimously. ON Medicaid PDL: AMITIZA (ORAL), LINZESS (ORAL) Lipotropics, Other The recommendations were presented and Dr. Drew Revel from Genzyme spoke in support of Kynamro. Emmett Sullivan motioned to accept the recommendations as presented and the motion passed unanimously. ON Medicaid PDL: CHOLESTYRAMINE/ASPARTAME (ORAL), CHOLESTYRAMINE/SUCROSE (ORAL), COLESTIPOL TABLET (ORAL), GEMFIBROZIL (ORAL), NIACOR (ORAL), NIASPAN (ORAL), TRICOR (ORAL), TRILIPIX (ORAL) Multiple Sclerosis Agents The recommendations were presented for this class and Kathy Novak clarified that Extavia and Betaseron were the same ingredient and manufactured in the same facility. Elizabeth Destafney from Teva spoke in support of Copaxone 40mg, Beth D Ambrosio from Novartis for Gilenya, Pamela Salisbury from Genzyme for Aubagio, and Elaine Alexander from Acorda for Ampyra. Kevin Chamberlin motioned to accept the recommendations as presented and the motion passed unanimously.

7 ON Medicaid PDL: AVONEX (INTRAMUSC.), AVONEX PEN (INTRAMUSC), COPAXONE SYRINGE KIT (SUBCUTANE.), EXTAVIA KIT (SUBCUTANE.), EXTAVIA VIAL (SUBCUTANE.), REBIF (SUBCUTANE.), REBIF REBIDOSE PEN INJCTR (SUBCUTANE.) Opiate Dependence Treatments The recommendations were presented and there were no changes from the previous year. Jake Nichols from Orexo spoke in support of including Zubsolv on the PDL. Hilda Slivka asked details about usage of the drug in pregnancy. A motion was made to accept the recommendations as presented, and it was passed unanimously. ON Medicaid PDL: NALTREXONE (ORAL), SUBOXONE FILM (SUBLINGUAL) PAH Agents, Oral and Inhaled The recommendations were presented and there were no changes from the previous year. Casimir Zygmunt from Bayer spoke in support of Adempas, and Raymond Mastriani from Actelion spoke in support of Opsumit. Stella Cretella motioned to accept the recommendations as presented and the motion was passed unanimously. ON Medicaid PDL: ADCIRCA (ORAL), LETAIRIS (ORAL), SILDENAFIL (ORAL), TRACLEER (ORAL), VENTAVIS (INHALATION) Platelet Aggregation Inhibitors The recommendations were presented and both scheduled speakers for Brilinta waived their right to speak. Ashish Trivedi from Eli Lilly spoke in support of Effient. Hilda Slivka motioned to accept the recommendations as presented and the motion passed unanimously. ON Medicaid PDL: AGGRENOX (ORAL), BRILINTA (ORAL), CLOPIDOGREL (ORAL), DIPYRIDAMOLE (ORAL) Ulcerative Colitis Agents The recommendations were presented and Matt Goodwin from Salix spoke in support of Uceris. Hilda Slivka mentioned that Pentasa and Lialda were needed for the pediatric population. Hilda motioned to accept the recommendations as presented, along with the additions of Lialda and Pentasa. Charles Thompson seconded, and the motion passed unanimously. ON Medicaid PDL: APRISO (ORAL), CANASA (RECTAL), DELZICOL (ORAL), LIALDA (ORAL), PENTASA (ORAL), SULFASALAZINE (ORAL), SULFASALAZINE DR (ORAL) Acne Agents, Topical

8 The recommendations for the class were presented. Hilda Slivka motioned to approve the recommendations as presented, along with the addition of Epiduo to the PDL. Her motion was seconded by Charles Thompson, and passed unanimously. ON Medicaid PDL: AZELEX (TOPICAL), BENZACLIN W/PUMP (TOPICAL), BENZOYL PEROXIDE CLEANSER (TOPICAL), BENZOYL PEROXIDE GEL (TOPICAL), CLINDAMYCIN PHOSPHATE GEL (TOPICAL), CLINDAMYCIN PHOSPHATE LOTION (TOPICAL), CLINDAMYCIN PHOSPHATE SOLUTION (TOPICAL), DIFFERIN CREAM (TOPICAL), DIFFERIN LOTION (TOPICAL), DUAC (TOPICAL), EPIDUO (TOPICAL), ERYTHROMYCIN GEL (TOPICAL), ERYTHROMYCIN SOLUTION (TOPICAL), TRETINOIN CREAM (TOPICAL), TRETINOIN GEL (TOPICAL) Analgesics, Narcotics Long Acting ON Medicaid PDL: FENTANYL (TRANSDERM), KADIAN (ORAL), METHADONE CONC (ORAL), METHADONE SOL TABLET (ORAL), METHADONE SOLUTION (ORAL), METHADONE TABLET (ORAL), MORPHINE ER TABLET (ORAL), TRAMADOL ER (ORAL) Analgesics, Narcotics Short Acting ON Medicaid PDL: APAP / CODEINE ELIXIR (ORAL), APAP / CODEINE TABLET (ORAL), BUTALBITAL / CAFFEINE / APAP W/CODEINE (ORAL), BUTALBITAL COMPOUND W/CODEINE (ORAL), BUTORPHANOL TARTRATE (NASAL), CODEINE (ORAL), HYDROCODONE / APAP SOLUTION (ORAL), HYDROCODONE / APAP TABLET (ORAL), HYDROCODONE / IBUPROFEN (ORAL), HYDROMORPHONE TABLET (ORAL), MORPHINE CONC SOLUTION (ORAL), MORPHINE IR TABLET (ORAL), MORPHINE SOLUTION (ORAL), MORPHINE SUPPOSITORIES (RECTAL), OXYCODONE / APAP CAPSULE (ORAL), OXYCODONE / APAP TABLET (ORAL), OXYCODONE / ASA (ORAL), OXYCODONE / IBUPROFEN (ORAL), OXYCODONE CAPSULE (ORAL), OXYCODONE SOLUTION (ORAL), OXYCODONE TABLET (ORAL), PENTAZOCINE / APAP (ORAL), ROXICET SOLUTION (ORAL), TRAMADOL (ORAL), TRAMADOL / APAP (ORAL) Androgenic Agents

9 ON Medicaid PDL: ANDROGEL GEL PACKET (TRANSDERM.), ANDROGEL GEL PUMP (TRANSDERM), TESTIM (TRANSDERM.) Angiotensin Modulator Combinations The recommendations were presented, and Kathy Novak highlighted the change from Lotrel brand to generic with preferred status and the removal of Tribenzor for preferred status. The committee unanimously passed a motion to accept the recommendations as presented. ON Medicaid PDL: AMLODIPINE / BENAZEPRIL (ORAL), AZOR (ORAL), EXFORGE (ORAL), EXFORGE HCT (ORAL) Angiotensin Modulators ON Medicaid PDL: BENAZEPRIL (ORAL), BENAZEPRIL HCTZ (ORAL), CAPTOPRIL (ORAL), CAPTOPRIL HCTZ (ORAL), DIOVAN (ORAL), DIOVAN HCT (ORAL), ENALAPRIL (ORAL), ENALAPRIL HCTZ (ORAL), LISINOPRIL (ORAL), LISINOPRIL HCTZ (ORAL), LOSARTAN (ORAL), LOSARTAN HCTZ (ORAL), MOEXIPRIL (ORAL), MOEXIPRIL HCTZ (ORAL), QUINAPRIL (ORAL), QUINAPRIL HCTZ (ORAL), RAMIPRIL (ORAL) Antibiotics, GI ON Medicaid PDL: METRONIDAZOLE TABLET (ORAL), NEOMYCIN (ORAL), VANCOCIN HCL (ORAL) Antibiotics, Topical ON Medicaid PDL: BACTROBAN OINTMENT (TOPICAL), GENTAMICIN CREAM (TOPICAL), GENTAMICIN OINTMENT (TOPICAL), NEOMYCIN / POLYMYXIN / PRAMOXINE (TOPICAL) Antibiotics, Vaginal The recommendations were presented and the changes were discussed. Charles Thompson motioned to accept the recommendations as presented, and it was passed unanimously.

10 ON Medicaid PDL: CLEOCIN OVULES (VAGINAL), METROGEL-VAGINAL (VAGINAL) Antiemetic/Antivertigo Agents The recommendations for this class were presented. Kathy Novak highlighted the change from brand Marinol to generic for preferred status. Hilda Slivka motioned to accept the recommendations as presented and the motion passed unanimously. ON Medicaid PDL: DRONABINOL (ORAL), EMEND (ORAL), EMEND PACK (ORAL), ONDANSETRON ODT (ORAL), ONDANSETRON SOLUTION (ORAL), ONDANSETRON TABLETS (ORAL) Antifungals, Oral The recommendations were presented, with the only change from previous year being the switch to non-preferred status for ketoconazole. Kevin Chamberlin motioned to accept the recommendations as presented and the motion passed unanimously. ON Medicaid PDL: CLOTRIMAZOLE (MUCOUS MEM), FLUCONAZOLE SUSPENSION (ORAL), FLUCONAZOLE TABLET (ORAL), GRISEOFULVIN SUSPENSION (ORAL), GRIS-PEG (ORAL), NYSTATIN SUSPENSION (ORAL), TERBINAFINE (ORAL) Antifungals, Topical The recommendations were presented and Kathy Novak pointed out the addition of some over the counter (OTC) agents that were not previously reviewed for inclusion on the PDL. Kevin Chamberlin motioned to accept the recommendations as presented and the motion passed unanimously. ON Medicaid PDL: CLOTRIMAZOLE CREAM OTC (TOPICAL), CLOTRIMAZOLE CREAM RX (TOPICAL), CLOTRIMAZOLE SOLUTION OTC (TOPICAL), CLOTRIMAZOLE SOLUTION RX (TOPICAL), CLOTRIMAZOLE-BETAMETHASONE CREAM (TOPICAL), ECONAZOLE (TOPICAL), KETOCONAZOLE CREAM (TOPICAL), KETOCONAZOLE SHAMPOO (TOPICAL), LOTRIMIN AF OTC (TOPICAL), MICONAZOLE CREAM OTC (TOPICAL), MICONAZOLE OINT OTC (TOPICAL), MICONAZOLE POWDER OTC (TOPICAL), NYSTATIN CREAM (TOPICAL), NYSTATIN OINT (TOPICAL), NYSTATIN POWDER (TOPICAL), NYSTATIN-TRIAMCINOLONE CREAM (TOPICAL), NYSTATIN-TRIAMCINOLONE OINT (TOPICAL) Antimigraine Agents, Other This class had only one agent for review and it was recommended as non-preferred. For review purposes it was included in the Antimigraine Triptans class. ON Medicaid PDL: NONE

11 Antimigraine Agents, Triptans The recommendations were presented, with the only change being removal of generic sumatriptan kit s preferred status. Kevin Chamberlin motioned to accept as presented, Emmett Sullivan seconded, and the motion passed unanimously. ON Medicaid PDL: IMITREX (NASAL), IMITREX KIT (SUBCUTANE.), IMITREX VIAL (SUBCUTANE.), RELPAX (ORAL), SUMATRIPTAN (ORAL) Antivirals, Oral ON Medicaid PDL: ACYCLOVIR CAPSULE (ORAL), ACYCLOVIR SUSPENSION (ORAL), ACYCLOVIR TABLET (ORAL), AMANTADINE CAPSULE (ORAL), AMANTADINE SYRUP (ORAL), RELENZA (INHALATION), RIMANTADINE (ORAL), TAMIFLU CAPSULE (ORAL), TAMIFLU SUSPENSION (ORAL), VALACYCLOVIR (ORAL) Antivirals, Topical motion was made to accept the recommendations as presented, and it was passed unanimously ON Medicaid PDL: DENAVIR (TOPICAL), ZOVIRAX OINTMENT (TOPICAL) Bone Resorption Suppression and Related Agents The recommendations were presented for the class. Hilda Slivka motioned to accept as presented, and the motion passed unanimously. ON Medicaid PDL: ALENDRONATE TABLETS (ORAL), FORTICAL (NASAL) BPH Treatments ON Medicaid PDL: ALFUZOSIN (ORAL), DOXAZOSIN (ORAL), FINASTERIDE (ORAL), TAMSULOSIN (ORAL), TERAZOSIN (ORAL) Calcium Channel Blockers

12 ON Medicaid PDL: AMLODIPINE (ORAL), DILTIAZEM CAPSULE ER (ORAL), DILTIAZEM TABLET (ORAL), NICARDIPINE (ORAL), NIFEDIPINE ER (ORAL), NIFEDIPINE IR (ORAL), VERAPAMIL CAPSULE ER (ORAL), VERAPAMIL ER PM (ORAL), VERAPAMIL TABLET (ORAL), VERAPAMIL TABLET ER (ORAL) Cephalosporins and Related Antibiotics The recommendations were presented and Kathy Novak pointed out the only status changes pertained to dosage forms of Suprax. The committee motioned to accept as presented, and it passed unanimously. ON Medicaid PDL: AMOXICILLIN/CLAV CHEW TABLET (ORAL), AMOXICILLIN/CLAV SUSPENSION (ORAL), AMOXICILLIN/CLAV TABLET (ORAL), CEFACLOR CAPSULE (ORAL), CEFACLOR SUSPENSION (ORAL), CEFACLOR TABLET ER (ORAL), CEFADROXIL CAPSULE (ORAL), CEFADROXIL SUSPENSION (ORAL), CEFADROXIL TABLET (ORAL), CEFDINIR CAPSULE (ORAL), CEFDINIR SUSPENSION (ORAL), CEFPODOXIME SUSPENSION (ORAL), CEFPODOXIME TABLET (ORAL), CEFPROZIL SUSPENSION (ORAL), CEFPROZIL TABLET (ORAL), CEFUROXIME TABLET (ORAL), CEPHALEXIN CAPSULE (ORAL), CEPHALEXIN SUSPENSION (ORAL), CEPHALEXIN TABLET (ORAL), SUPRAX CAPSULE (ORAL), SUPRAX SUSPENSION (ORAL), SUPRAX TAB CHEW (ORAL) Contraceptives, Oral The recommendations were presented and a motion was made to accept the recommendations as presented. The motion was passed unanimously. ON Medicaid PDL: ALYACEN MONOPHASIC (ORAL), ALYACEN TRIPHASIC (ORAL), AVIANE (ORAL), BREVICON (ORAL), CHATEAL (ORAL), CRYSELLE (ORAL), CYCLAFEM MONOPHASIC (ORAL), DASETTA MONOPHASIC (ORAL), DESOGEN (ORAL), ELINEST (ORAL), ENPRESSE (ORAL), ESTROSTEP FE (ORAL), FALMINA (ORAL), FEMCON FE (ORAL), GILDESS FE (ORAL), JUNEL FE (ORAL), LARIN FE (ORAL), LESSINA (ORAL), LEVONEST (ORAL), LEVONORGESTREL/ETHINYL ESTRADIOL MONOPHASIC (LUPIN) (ORAL), LEVORA (ORAL), LOESTRIN (ORAL), LOESTRIN FE (ORAL), LORYNA (ORAL), LOSEASONIQUE (ORAL), LOW- OGESTREL (ORAL), LUTERA (ORAL), MICROGESTIN FE (ORAL), MIRCETTE (ORAL), MY WAY (ORAL), MYZILRA (ORAL), NECON MONOPHASIC (ORAL), NORDETTE (ORAL), NORETHINDRONE/ETHINYL ESTRADIOL FE MONOPHASIC (LUPIN) (ORAL), NORGESTIMATE/ETHINYL ESTRADIOL TRIPHASIC (ORAL), NORINYL (ORAL), NOR- Q-D (ORAL), NORTREL MONOPHASIC (ORAL), NORTREL TRIPHASIC (ORAL), ORSYTHIA (ORAL), ORTHO TRI-CYCLEN LO (ORAL), ORTHO-NOVUM MONOPHASIC (ORAL), OVCON-35 (ORAL), PHILITH (ORAL), PORTIA (ORAL), SEASONALE (ORAL), SEASONIQUE (ORAL), SRONYX (ORAL), SYEDA (ORAL), TRI-

13 LINYAH (ORAL), TRI, NORINYL (ORAL), TRI-PREVIFEM (ORAL), TRI-SPRINTEC (ORAL), TRIVORA (ORAL), VESTURA (ORAL), WERA (ORAL), YASMIN (ORAL), YAZ (ORAL), ZARAH (ORAL), ZENCHENT FE (ORAL) Erythropoiesis Stimulating Proteins ON Medicaid PDL: ARANESP DISP SYRIN (INJECTION), ARANESP VIAL (INJECTION), PROCRIT (INJECTION) Fluoroquinolones, Oral ON Medicaid PDL: CIPRO SUSPENSION (ORAL), CIPROFLOXACIN TABLET (ORAL), LEVOFLOXACIN TABLET (ORAL) Growth Factors ON Medicaid PDL: EGRIFTA (SUB-Q), INCRELEX (SUB-Q) H. Pylori Treatments The recommendations were presented and Kathy Novak pointed out there is a new generic for the Prevpac. Previously there were no preferred agents in this class, but due to high generic cost there are now 3 preferred recommendations. The committee motioned to accept the class as presented, and the motion passed unanimously. ON Medicaid PDL: HELIDAC (ORAL), PREVPAC (ORAL), PYLERA (ORAL) Hypoglycemics, Alpha-glucosidase Inhibitors The recommendations were presented for this class. This is a new class to the PDL. The committee motioned to accept the recommendations as presented, and it was passed unanimously. ON Medicaid PDL: ACARBOSE (ORAL), GLYSET (ORAL) Hypoglycemics, Meglitinides

14 ON Medicaid PDL: NATEGLINIDE (ORAL), PRANDIN (ORAL) Hypoglycemics, Metformins The recommendations were presented for this class. This is a new class to the PDL. The committee motioned to accept the recommendations as presented, and it was passed unanimously. ON Medicaid PDL: GLIPIZIDE-METFORMIN (ORAL), METFORMIN (ORAL), METFORMIN ER (GLUCOPHAGE XR) (ORAL) Hypoglycemics, TZD ON Medicaid PDL: PIOGLITAZONE (ORAL) Immunosuppressives, Oral The recommendations and status changes were presented for this class. Stella Cretella motioned to accept the class as presented, and the motion passed unanimously. ON Medicaid PDL: AZATHIOPRINE (ORAL), CYCLOSPORINE CAPSULE (ORAL), CYCLOSPORINE SOFTGEL (ORAL), CYCLOSPORINE, MODIFIED CAPSULE (ORAL), CYCLOSPORINE, MODIFIED SOLUTION (ORAL), MYCOPHENOLATE MOFETIL CAPSULE (ORAL), MYCOPHENOLATE MOFETIL TABLET (ORAL), NEORAL CAPSULE (ORAL), PROGRAF (ORAL), RAPAMUNE SOLUTION (ORAL), SANDIMMUNE CAPSULE (ORAL), SANDIMMUNE SOLUTION (ORAL), SIROLIMUS (AG) (ORAL), SIROLIMUS (ORAL) Lipotropics, Statins The recommendations and changes in status were presented. Charles Thompson noted that this class was one that is targeted for future step therapy requirements. Kevin Chamberlin motioned to approve as recommended and the committee passed the motion unanimously. ON Medicaid PDL: ATORVASTATIN (ORAL), CRESTOR (ORAL), LOVASTATIN (ORAL), PRAVASTATIN (ORAL), SIMVASTATIN (ORAL) Macrolides/Ketolides

15 ON Medicaid PDL: AZITHROMYCIN PACKET (ORAL), AZITHROMYCIN SUSPENSION (ORAL), AZITHROMYCIN TABLET (ORAL), CLARITHROMYCIN TABLET (ORAL), E.E.S. 400 TABLET (ORAL), ERY-TAB (ORAL), ERYTHROCIN (ORAL), ERYTHROMYCIN BASE TABLET (ORAL) Phosphate Binders The recommendations were presented and a motion was made to accept the recommendations as presented. The motion was passed unanimously. ON Medicaid PDL: CALCIUM ACETATE CAPSULE (ORAL), CALCIUM ACETATE TABLET (ORAL), ELIPHOS (ORAL), PHOSLYRA (ORAL), RENAGEL (ORAL) Pituitary Suppressive Agents, LNRH ON Medicaid PDL: LEUPROLIDE ACETATE (SUB-Q), LUPRON DEPOT (INTRAMUSC), LUPRON DEPOT KIT (INJECTION), LUPRONJ DEPOT-PED (INJECTION), LUPRONJ DEPOT-PED KIT (INJECTION), ZOLADEX (SUB-Q) Prenatal Vitamins The recommendations were presented and a motion was made to accept the recommendations as presented. The motion was passed unanimously. ON Medicaid PDL: CITRANATAL HARMONY (ORAL), COMPLETENATE (ORAL), CONCEPT DHA (ORAL), FE C (ORAL), FOLIVANE-OB (ORAL), NATAFORT (ORAL), NATALVIRT 90 DHA (ORAL), NESTABS (ORAL), OB COMPLETE WITH DHA (ORAL), ONE-A-DAY WOMEN'S PRENATAL DHA OTC (ORAL), PNV WITH CA,NO.71/IRON/FA (ORAL), PNV WITH CA,NO.72/IRON/FA (ORAL), PNV66/IRON FUMARATE/FA/DSS/DHA (ORAL), PNV80/IRON FUMARATE/FA/DSS/DHA (ORAL), PR NATAL 400 (ORAL), PREFERA-OB ONE (ORAL), PRENAISSANCE BALANCE (ORAL), PRENAISSANCE NEXT (ORAL), PRENATA (ORAL), PRENATAL VIT 15/IRON CB/FA/DSS (ORAL), PRENATAL VIT 18/IRON CB/FA/DSS (ORAL), PRENATAL VIT/FE FUMARATE/FA OTC (ORAL), PRENATAL VIT27&CALCIUM/IRON/FA (ORAL), PRENATAL VITAMIN + DHA OTC (ORAL), PRENATAL VITAMINS OTC (ORAL), PRENEXA (ORAL), SELECT-OB (ORAL), SE-NATAL 19 TAB CHEW (ORAL), SE- NATAL 19 TABLET (ORAL), TARON-BC (ORAL), TARON-C DHA (ORAL), VINATE AZ (ORAL), VINATE GT (ORAL), VINATE II (ORAL), VINATE-M (ORAL), VITAFOL-OB (ORAL), VITAFOL-ONE (ORAL), VOL-NATE (ORAL), VOL-TAB RX (ORAL), VP-CH-PNV (ORAL), VP-GGR-B6 (ORAL)

16 Proton Pump Inhibitors The recommendations were presented for this class. Hilda Slivka noted the need to maintain availability to Prevacid Solutab for use in pediatric population. She motioned to approve the recommendations as presented, along with the addition of Prevacid Solutab to the PDL with identical status to current (preferred for ages 0-20 and use in >20 with qualifying diagnosis). This motion was seconded and passed unanimously. ON Medicaid PDL: NEXIUM (ORAL), NEXIUM SUSPENSION (ORAL), PANTOPRAZOLE (ORAL), PREVACID SOLUTAB (ORAL), PRILOSEC OTC (ORAL), PROTONIX SUSPENSION (ORAL) Skeletal Muscle Relaxants ON Medicaid PDL: BACLOFEN (ORAL), CHLORZOXAZONE (ORAL), CYCLOBENZAPRINE (ORAL), METHOCARBAMOL (ORAL) Tetracyclines ON Medicaid PDL: DOXYCYCLINE HYCLATE CAPSULE (ORAL), DOXYCYCLINE HYCLATE TABLET (ORAL), DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE (ORAL), DOXYCYCLINE MONOHYDRATE 50 MG CAPSULE (ORAL), MINOCYCLINE CAPSULES (ORAL), TETRACYCLINE (ORAL) Vasodilators, Coronary The recommendations were presented and a motion was made to accept the recommendations as presented. The motion was passed unanimously. ON Medicaid PDL: ISOSORBIDE DINITRATE (ORAL), ISOSORBIDE DINITRATE (SUBLINGUAL), ISOSORBIDE MONONITRATE (ORAL), ISOSORBIDE MONONITRATE SR (ORAL), NITRO-BID OINT. (TRANSDERM), NITROGLYCERIN (SUBLINGUAL), NITROGLYCERIN (TRANSDERM), NITROGLYCERIN ER (ORAL), NITROLINGUAL SPRAY (TRANSLINGUAL), NITROSTAT (SUBLINGUAL) Recommendations for next class reviews: Magellan recommended the following classes be reviewed at the next P&T meeting:

17 Next Classes to Review: Alzheimer s Agents Anticonvulsants Antidepressants, Other Antidepressants, SSRIs Antihistamines, Minimally Sedating Antihypertensives, Sympatholitics Antihyperuricemics, oral Antiparkinson s Agents Antipsoriatics, oral Antipsoriatics, topical Antipsychotics Anxiolytics Bile Acid Salts Botulinum Toxins Bronchodilators, Beta Agonist COPD Agents Cytokine and CAM Antagonists Emollients Epinephrine, Self-Injected Glucocorticoids, Inhaled Glucocorticoids, oral Histamine II Recptor Blockers Immunomodulators, Atopic Dermatitis Immunomodulators, topical Intranasal Rhinitis Agents Iron, oral Leukotriene Modifiers Neuropathic pain NSAIDs Oncology Agents, Oral Ophthalmic Antibiotics Ophthalmic Antibiotic / Steroid Combinations Ophthalmic Anti-Inflammatories Ophthalmics for Allergic Conjunctivitis Ophthalmics, Glaucoma Agents Otic Antibiotics Otic Anti-Infectives Progestational Agents Sedative Hypnotics Smoking Cessation Steroids, Topical Stimulants and Related Agents

18 New Generics: Kathy Novak presented to the committee members the following new generic products which would be non-preferred on the Medicaid formulary: Natal Ob Vp-Heme Ob + Dha Vp-Heme Ob Prena1 Pearl Capecitabine Ceftibuten Rabeprazole Tablet Tobramycin Solution Dexmethylphenidate Xr Duloxetine Telmisartan/Amlodipine Telmisartan Tolterodine Er Mycophenolic Acid Sirolimus Fluocinonide 0.1% Morphine Er Capsule Moxifloxacin Clocortolone Telmisartan Hctz Carbidopa Schedule next meeting: Committee members suggested that a set of available dates be ed to committee members for review. Available dates will be sent to the committee by Jason Young. Meeting adjourned at 8:47pm