Connecticut Medicaid P&T Meeting Minutes November 18 th, 2015

Transcription

1 Connecticut Medicaid P&T Meeting Minutes November 18 th, 2015 The meeting was called to order at 6:29 PM. Attendance: P&T Members Present: DSS: HP/Magellan: Carl Sherter Herman Kranc Jason Young Manage Nissanka Robert Zavoski Margaret Stroczkowski Emmett Sullivan James Zakszewski Kathy Novak Hilda Slivka Jason Gott Carly Whitehouse Kevin Chamberlin Charles Thompson Alexander Westphal Opening Remarks & New Business: Carl Sherter thanked the attendees for coming and called meeting to order at 6:29 pm. Carl Sherter began with opening remarks to welcome both, new P&T Member, Alexander Westphal, and new PDL Coordinator, Carly Whitehouse. Hilda Slivka motioned to approve the previous meeting minutes from the previous P&T Committee Meeting on May 13 th, 2015 meeting, and her motion was seconded by Manage Nissanka. The motion passed unanimously and the minutes were approved as written. The election of Vice Chair was held, with Carl Sherter nominating Kevin Chamberlin for the position. The committee unanimously approved and Kevin Chamberlin accepted the position. Public Presentations: 1. ANTIPSYCHOTICS a. Class Testimony Paul Desan, CT Psychiatric Society 2. ONCOLOGY AGENTS, BREAST CANCER a. Class Testimony Dawn Holcombe, CT Oncology Association 3. ONCOLOGY AGENTS, ORAL a. Class Testimony Dawn Holcombe, CT Oncology Association 4. COLONY STIMULATING FACTORS a. Class Testimony Dawn Holcombe, CT Oncology Association b. Neulasta Kit Kristi Cavaliere, Amgen 5. ANTICONVULSANTS a. Trokendi XR, Oxtellar XR Shannon Mendes, Supernus 6. ANTIDEPRESSANTS, OTHER a. Fetzima, Viibryd Bassam Awwa, CT Behavioral Health

2 b. Brintellix Jason Wagner, Takeda 7. COPD AGENTS a. Stiolto Respimat Daniel T. Foley, Boehringer Ingelheim 8. CYTOKINE AND CAM ANTAGONISTS a. Cosentyx Kwaku Marfo, Novartis b. Stelara Arlene Price, Janssen Scientific c. Xeljanz Cherylanne Kruse, Pfizer 9. INTRANASAL RHINITIS AGENTS a. QNASL Tyson Park, Teva 10. OPHTHALMICS, GLAUCOMA AGENTS a. Combigan Mike Cooper, Advanced Optometric Care The rest of the scheduled speakers waived their right to speak because either their drug was recommended to be preferred on the PDL, or they were not in attendance. Therapeutic Class Reviews: ANTIPSYCHOTICS The State s recommendations for the continued inclusion of all Antipsychotics on the PDL was presented by Kathy Novak. Paul Desan from CT Psychiatric Society provided testimony expressing his approval of the committees decision and his appreciation for all antipsychotics to be preferred on the PDL. Carl Sherter thanked him for his attendance and his commitment to patients within the practice of medicine. Kevin Chamberlin motioned to accept all products preferred as presented and Alexander Westphal seconded the motion. It was passed ON PDL: ABILIFY (INTRAMUSC), ABILIFY DISCMELT (ORAL), ABILIFY MAINTENA (INTRAMUSC.), ABILIFY SOLUTION (ORAL), ABILIFY TABLET (ORAL), ADASUVE (INHALATION), AMITRIPTYLINE / PERPHENAZINE (ORAL), ARIPIPRAZOLE TABLET (ORAL), CHLORPROMAZINE (ORAL), CLOZAPINE (ORAL), CLOZAPINE ODT (AG)(ORAL), CLOZARIL (ORAL), FANAPT TABLET (ORAL), FANAPT TITRATION PACK (ORAL), FAZACLO (ORAL), FLUPHENAZINE DECANOATE (INJECTION), FLUPHENAZINE ELIXIR/SOLN (ORAL), FLUPHENAZINE TABLET (ORAL), GEODON (INTRAMUSC), GEODON (ORAL), HALDOL (INJECTION), HALDOL DECANOATE (INTRAMUSC), HALOPERIDOL (ORAL), HALOPERIDOL DECANOATE (INJECTION), HALOPERIDOL LACTATE (INJECTION), HALOPERIDOL LACTATE CONC (ORAL), INVEGA (ORAL), INVEGA SUSTENNA (INTRAMUSC), INVEGA TRINZA (INTRAMUSC), LATUDA (ORAL), LOXAPINE (ORAL), OLANZAPINE (INTRAMUSC), OLANZAPINE ODT (ORAL), OLANZAPINE TABLET (ORAL), OLANZAPINE/FLUOXETINE (ORAL), ORAP (ORAL), PERPHENAZINE (ORAL), QUETIAPINE TABLETS (ORAL), REXULTI (ORAL), RISPERDAL CONSTA (INTRAMUSC.), RISPERDAL ODT (ORAL), RISPERDAL SOLUTION (ORAL), RISPERDAL TABLET (ORAL), RISPERIDONE ODT (ORAL), RISPERIDONE SOLUTION (ORAL), RISPERIDONE TABLET (ORAL), SAPHRIS (SUBLINGUAL), SEROQUEL (ORAL), SEROQUEL XR (ORAL), SYMBYAX (ORAL), THIORIDAZINE (ORAL), THIOTHIXENE (ORAL), TRIFLUOPERAZINE (ORAL), VERSACLOZ (ORAL), ZIPRASIDONE CAPSULE (ORAL), ZYPREXA (INTRAMUSC), ZYPREXA (ORAL), ZYPREXA RELPREVV (INTRAMUSC), ZYPREXA ZYDIS (ORAL) ONCOLOGY AGENTS, BREAST CANCER Dawn Holcombe from CT Oncology Association provided testimony in favor of changing all products to be preferred on the PDL. Charles Thompson raised the concern of limiting this class. Carl Sherter justified that for such a limited number

3 of prescriptions his preference would be to accept recommendations as presented. Emmett Sullivan motioned to accept the recommendations as presented, it was seconded by Kevin Chamberlin, and passed by all members of the committee except Charles Thompson who opposed. The motion passed 6-1. ON PDL: ARIMIDEX (ORAL), EXEMESTANE (ORAL), LETROZOLE (ORAL), TAMOXIFEN CITRATE (ORAL) ONCOLOGY AGENTS, ORAL The recommendations were presented to the committee with the following changes; Casodex, Purixan and Temovar to becoming non-preferred while leaving the generic equivalents as preferred and Afinitor Dispersz becoming nonpreferred leaving Afinitor Tablets as preferred. Dawn Holcombe from CT Oncology Association provided testimony in favor of changing all products to be preferred on the PDL. Charles Thompson raised the concern of limiting this class. Kevin Chamberlin motioned to accept the recommendations as presented, it was seconded by Emmett Sullivan, and passed by all members of the committee except Charles Thompson who opposed. The motion passed 6-1. ON PDL: AFINITOR (ORAL), ALKERAN (ORAL), BICALUTAMIDE (ORAL), BOSULIF (ORAL), CAPRELSA (ORAL), COMETRIQ (ORAL), ERIVEDGE (ORAL), FARYDAK (ORAL), FLUTAMIDE (ORAL), GILOTRIF (ORAL), GLEEVEC (ORAL), HYDROXYUREA (ORAL), IBRANCE (ORAL), ICLUSIG (ORAL), IMBRUVICA (ORAL), INLYTA (ORAL), IRESSA (ORAL), JAKAFI (ORAL), LENVIMA (ORAL), LYNPARZA (ORAL), MEKINIST (ORAL), MERCAPTOPURINE (ORAL), NEXAVAR (ORAL), NILANDRON (ORAL), SPRYCEL (ORAL), STIVARGA (ORAL), SUTENT (ORAL), TAFINLAR (ORAL), TARCEVA (ORAL), TASIGNA (ORAL), TEMOZOLOMIDE (AG) (ORAL), TEMOZOLOMIDE (ORAL), TYKERB (ORAL), VOTRIENT (ORAL), XALKORI (ORAL), XELODA (ORAL), XTANDI (ORAL), ZELBORAF (ORAL), ZOLINZA (ORAL), ZYDELIG (ORAL), ZYKADIA (ORAL), ZYTIGA (ORAL) COLONY STIMULATING FACTORS The recommendations were presented to the committee, and there were no changes from the previous meeting in May. This class was presented to the committee again in an attempt to realign the TOP$ class review schedule to align with review of oncology agents. Dawn Holcombe from CT Oncology Association and Kristi Cavaliere from Amgen provided testimony in favor of changing Neulasta Kit to be preferred on the PDL. Carl Sherter, along with other committee members questioned the pricing difference between the Neulasta Kit versus Syringe or Vial on the cost sheets. The decision was made to approve the addition of Neulasta Kit on the PDL if the price was within 20%, and deny, if it was of greater percentage. Hilda Slivka motioned to accept the recommendations as presented with proposed changes and Carl Sherter seconded the motion. It was passed Following up with the proposed changes to Neulasta Kit after the meeting, DSS has decided to make the Kit a preferred agent as well on the PDL. ON PDL: GRANIX (INJECTION), NEULASTA SYRINGE (INJECTION) 6mg/0.6ml syringe, NEUPOGEN DISP SYRIN (INJECTION), NEUPOGEN VIAL (INJECTION), NEULASTA KIT (INJECTION) ANTICONVULSANTS The recommendations were presented to the committee with the following changes; Depakote/Divalproex and Tegretol XR/Carbamazepine XR brand-generic swaps and Felbamate Suspension becoming non-preferred. Shannon Mendes from Supernus provided testimony in favor of changing Trokendi XR and Oxtellar XR to be preferred on the PDL. Manage Nissanka inquired about whether the number of prescriptions on the cost sheet was based on diagnosis and Kathy Novak responded that it was not. Hilda Slivka motioned to accept the recommendations as presented and Kevin Chamberlin seconded the motion. It was passed

4 ON PDL: CARBAMAZEPINE CHEWABLE TABLET (ORAL), CARBAMAZEPINE ER (GENERIC CARBATROL) (ORAL), CARBAMAZEPINE SUSPENSION (ORAL), CARBAMAZEPINE TABLET (ORAL), CARBATROL (ORAL), CELONTIN (ORAL), CLONAZEPAM (ORAL), DEPAKOTE (ORAL), DEPAKOTE SPRINKLE (ORAL), DIASTAT (RECTAL), DIASTAT ACUDIAL (RECTAL), DILANTIN INFATAB (ORAL), DIVALPROEX ER (ORAL), ETHOSUXIMIDE SYRUP (ORAL), GABITRIL (ORAL), LAMOTRIGINE TABLET (ORAL), LAMOTRIGINE TABLET DOSE PACK (ORAL), LEVETIRACETAM SOLUTION (ORAL), LEVETIRACETAM TABLETS (ORAL), OXCARBAZEPINE SUSPENSION (ORAL), OXCARBAZEPINE TABLETS (ORAL), PEGANONE (ORAL), PHENOBARBITAL ELIXIR (ORAL), PHENOBARBITAL TABLET (ORAL), PHENYTOIN CAPSULE (ORAL), PHENYTOIN EXT CAPSULE (GENERIC PHENYTEK) (ORAL), PHENYTOIN SUSPENSION (ORAL), PRIMIDONE (ORAL), TEGRETOL XR (ORAL), TOPIRAMATE SPRINKLE (ORAL), TOPIRAMATE TABLETS (ORAL), VALPROATE SYRUP (ORAL), VALPROIC ACID (ORAL), VIMPAT SOLUTION (ORAL), VIMPAT TABLET (ORAL), ZONISAMIDE (ORAL) ANTIDEPRESSANTS, OTHER The recommendations were presented to the committee with the following changes; Brintellix, Viibryd and Fetzima to become non-preferred. Bassam Awwa from CT Behavioral Health provided testimony in favor of leaving Fetzima and Viibryd as preferred agents. Jason Wagner from Takeda provided testimony in favor of leaving Brintellix as a preferred agent. Manage Nissanka commented on the benefits of open access in this category and Carl Sherter agreed. Manage Nissanka motioned to accept as presented with the addition of Brintellix, Viibryd and Fetzima to the formulary and Alexander Westphal seconded the motion. It was passed ON PDL: BUPROPION (ORAL), BUPROPION SR (ORAL), BUPROPION XL (ORAL), BRINTELLIX (ORAL), FETZIMA (ORAL), MARPLAN (ORAL), MIRTAZAPINE ODT (ORAL), MIRTAZAPINE TABLET (ORAL), PARNATE (ORAL), PHENELZINE (ORAL), PRISTIQ (ORAL), TRAZODONE (ORAL), VENLAFAXINE ER CAPSULES (ORAL), VIIBRYD (ORAL), VIIBRYD DOSE PACK (ORAL) BOTULINUM TOXINS The recommendations were presented to the committee, and there were no changes from the previous year. Hilda S motioned to accept the recommendations as presented and the motion was passed ON PDL: BOTOX (INTRAMUSC) COPD AGENTS The recommendations were presented to the committee with the following changes; Daliresp and Anoro Ellipta to become non-preferred. Carl Sherter commented on the unique benefits of Daliresp, having positive impact on decreasing COPD exacerbations. Daniel Foley from Boehringer Ingelheim provided testimony to change Stiolto Respimat to a preferred agent. Kevin Chamberlin motioned to accept the recommendations as presented with the addition of Daliresp and Stiolto Respimat. This was seconded by Hilda Slivka and was passed ON PDL: ATROVENT HFA (INHALATION), COMBIVENT RESPIMAT (INHALATION), DALIRESP (ORAL), IPRATROPIUM / ALBUTEROL (INHALATION), IPRATROPIUM NEBULIZER (INHALATION), SPIRIVA (INHALATION), STIOLTO RESPIMAT (INHALATION) CYTOKINE AND CAM ANTAGONISTS The recommendations were presented for this class with no changes from the previous year. Kwaku Marfo from Novartis provided testimony to change Cosentyx Pen Injector and Syringe to a preferred agent. Arlene Price from Janssen provided testimony to change Stelara to a preferred agent. Cherylanne Kruse from Pfizer provided testimony to

5 change Xeljanz to a preferred agent. Carl Sherter commented that considering the high cost of these medications, he felt it appropriate to continue to keep them as non-preferred, thus requiring a prior authorization for therapy. Hilda Slivka motioned to accept the recommendations as presented and Kevin Chamberlin seconded the motion. It was passed ON PDL: ENBREL KIT (INJECTION), ENBREL PEN (INJECTION), ENBREL SYRINGE (INJECTION), HUMIRA KIT (INJECTION), HUMIRA PEN KIT (INJECTION) EPINEPHRINE, SELF-INJECTED The recommendations were presented to the committee with no changes from the previous year. Emmett Sullivan motioned to accept the recommendations as presented and the motion was passed ON PDL: EPIPEN (INTRAMUSC), EPIPEN JR (INTRAMUSC) GLUCOCORTICOIDS, INHALED The recommendations were presented to the committee with the following changes; Aerospan to become preferred and Flovent Discus, Flovent HFA and Pulmicort Flexhaler to become non-preferred. Hilda Slivka pointed out that there is a large number of patients currently taking these medications and changing their therapy may be problematic. Carl Sherter agreed and suggested to keep Flovent Discus, Flovent HFA and Pulmicort Flexhaler as preferred. Hilda Slivka motioned to accept the recommendations as presented with the addition of Flovent Discus, Flovent HFA and Pulmicort Flexhaler Charles Thompson seconded the motion and was passed ON PDL: ADVAIR DISKUS (INHALATION), AEROSPAN (INHALATION), ASMANEX (INHALATION), DULERA (INHALATION), FLOVENT DISKUS (INHALATION), FLOVENT HFA (INHALATION), PULMICORT FLEXHALER (INHALATION), PULMICORT 0.25, 0.5 MG RESPULES (INHALATION), QVAR (INHALATION), SYMBICORT (INHALATION) INTRANASAL RHINITIS AGENTS The recommendations were presented to the committee with no changes from the previous year. Tyson Park from Teva provided testimony to change QNASL 40 to a preferred agent. Kevin Chamberlin motioned to accept the recommendations as presented and the motion was passed ON PDL: FLUNISOLIDE (NASAL), FLUTICASONE (NASAL), IPRATROPIUM (NASAL), NASONEX (NASAL), PATANASE (NASAL) NEUROPATHIC PAIN motioned to accept the recommendations as presented and the motion was passed ON PDL: DULOXETINE (CYMBALTA) (AG) (ORAL), DULOXETINE (CYMBALTA) (ORAL), GABAPENTIN CAPSULE (ORAL), LIDODERM (TOPICAL), LYRICA CAPSULE (ORAL) NSAIDS

6 The recommendations were presented to the committee with the following changes; Etodolac Tablet EC and Naproxen Sodium (275mg/550mg) to become non-preferred. Emmett Sullivan motioned to accept the recommendations as presented and the motion was passed ON PDL: FLECTOR (TOPICAL), FLURBIPROFEN (ORAL), IBUPROFEN SUSPENSION (ORAL), IBUPROFEN TABLET (ORAL) RX, INDOCIN SUSPENSION (ORAL), INDOMETHACIN CAPSULE (ORAL), KETOPROFEN (ORAL), KETOROLAC (ORAL), MELOXICAM SUSPENSION (ORAL), MELOXICAM TABLET (ORAL), MOBIC SUSPENSION (ORAL), NABUMETONE (ORAL), NAPROXEN SUSPENSION (ORAL), NAPROXEN TABLET (250mg/375mg/500mg) (ORAL), PIROXICAM (ORAL), SULINDAC (ORAL), VOLTAREN (TOPICAL) OPHTHALMICS, GLAUCOMA AGENTS The recommendations were presented to the committee with the following change; Betaxolol to become non-preferred. Mike Cooper from Advanced Optometric Care provided testimony to change Combigan to a preferred agent. Hilda Slivka motioned to accept the recommendations as presented with the addition of Combigan and the motion was passed ON PDL: ALPHAGAN P 0.15% (OPHTHALMIC), AZOPT (OPHTHALMIC), BETIMOL (OPHTHALMIC), BETOPTIC S (OPHTHALMIC), BRIMONIDINE (OPHTHALMIC) 0.2%, CARTEOLOL (OPHTHALMIC), COMBIGAN (OPHTHALMIC), DORZOLAMIDE (OPHTHALMIC), DORZOLAMIDE / TIMOLOL (OPHTHALMIC), ISTALOL (OPHTHALMIC), LATANOPROST 2.5 ML (OPHTHALMIC), LEVOBUNOLOL (OPHTHALMIC), METIPRANOLOL (OPHTHALMIC), PILOCARPINE (OPHTHALMIC), SIMBRINZA (OPHTHALMIC), TIMOLOL (OPHTHALMIC), TRAVATAN Z 2.5 ML (OPHTHALMIC), TRAVATAN Z 5 ML (OPHTHALMIC) SEDATIVE HYPNOTICS The recommendations were presented to the committee with no changes from the previous year. Lindsay Varga Hermany from Merck & Co provided testimony to change Belsomra to a preferred agent. Kevin Chamberlin motioned to accept the recommendations as presented and the motion was passed ON PDL: FLURAZEPAM (ORAL), TEMAZEPAM (ORAL) (15 & 30 mg), ZOLPIDEM (ORAL) SMOKING CESSATION The recommendations were presented to the committee with no changes from the previous year. Hilda Slivka motioned to accept the recommendations as presented and the motion was passed ON PDL: BUPROPION SR (ORAL), CHANTIX (ORAL), CHANTIX DOSE PACK (ORAL), NICOTINE GUM OTC (BUCCAL), NICOTINE LOZENGE OTC (BUCCAL), NICOTINE LOZENGE OTC (MUCOUS MEM.), NICOTINE PATCH OTC (TRANSDERMAL) STIMULANTS AND RELATED AGENTS The recommendations were presented to the committee with the following changes; Intuniv/Guanfacine ER brandgeneric swap and Daytrana becoming non-preferred. Hilda Slivka raised the concern of the error potential of using Guanfacine. Emmett Sullivan responded saying that pharmacies now have specific error messages that helps to prevent errors. Carl Sherter mentioned the cost saving potential of brand-generic swaps. Emmett Sullivan motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed unanimously by the committee.

7 ON PDL: ADDERALL XR (ORAL), AMPHETAMINE SALT COMBO (ORAL) (IR), DEXMETHYLPHENIDATE (AG) (ORAL) (IR), DEXMETHYLPHENIDATE (ORAL) (IR), DEXTROAMPHETAMINE TABLET (ORAL), FOCALIN (ORAL), FOCALIN XR (ORAL), GUANFACINE ER (ORAL), METADATE CD (ORAL), METHYLIN CHEWABLE TABLETS (ORAL), METHYLPHENIDATE (ORAL), METHYLPHENIDATE ER (CONCERTA) (AG) (ORAL), METHYLPHENIDATE ER (CONCERTA) (ORAL), METHYLPHENIDATE ER (ORAL) (Generic Metadate ER), METHYLPHENIDATE SOLUTION (AG) (ORAL), METHYLPHENIDATE SOLUTION (ORAL), PROCENTA (ORAL), PROVIGIL (ORAL), QUILLIVANT XR (ORAL), RITALIN LA (ORAL), RITALIN LA 10 MG CAPSULE (ORAL), STRATTERA (ORAL), VYVANSE (ORAL) ALZHEIMER'S AGENTS The recommendations were presented to the committee with the following changes; Namenda/Memantine brand generic swap. Kevin Chamberlin motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: DONEPEZIL ODT (ORAL), DONEPEZIL TABLET (ORAL) (5 & 10 MG), EXELON (TRANSDERM.), GALANTAMINE ER (ORAL), MEMANTINE TABLET (AG) (ORAL), MEMANTINE TABLET (ORAL), NAMENDA SOLUTION (ORAL), NAMENDA TABLET DOSE PACK (ORAL), RIVASTIGMINE CAPSULES (ORAL) ANTIDEPRESSANTS, SSRIs The recommendations were presented to the committee with the following changes; Fluoxetine Tablets to become nonpreferred. Carl Sherter raised the question about potential differences between the Tablets and Capsules. Alexander Westphal commented on their equivalence. Emmett Sullivan motioned to accept the recommendations as presented and the motion was passed ON PDL: CITALOPRAM SOLUTION (ORAL), CITALOPRAM TABLET (ORAL), ESCITALOPRAM TABLET (ORAL), FLUOXETINE CAPSULE (ORAL), FLUOXETINE SOLUTION (ORAL), FLUVOXAMINE (ORAL), LEXAPRO SOLUTION (ORAL), PAROXETINE TABLET (ORAL), SERTRALINE CONC (ORAL), SERTRALINE TABLET (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING The recommendations were presented to the committee with no changes from the previous year. Emmett Sullivan motioned to accept the recommendations as presented and Hilda Slivka seconded the motion. It was passed ON PDL: CETIRIZINE SOLUTION (ORAL) 1mg/1ml, CETIRIZINE SOLUTION OTC (ORAL) 1mg/1ml, CETIRIZINE-D OTC (ORAL), FEXOFENADINE-D 12-HOUR OTC (ORAL), LORATADINE ODT OTC (ORAL), LORATADINE SOLUTION OTC (ORAL), LORATADINE TABLETS OTC (ORAL), LORATADINE-D OTC (ORAL) ANTIHYPERTENSIVES, SYMPATHOLYTICS motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: CATAPRES-TTS (TRANSDERM), CLONIDINE (ORAL), GUANFACINE (ORAL), METHYLDOPA (ORAL), METHYLDOPA/HYDROCHLOROTHIAZIDE (ORAL)

8 ANTIHYPERURICEMICS motioned to accept the recommendations as presented and Charles Thompson seconded the motion. It was passed ON PDL: ALLOPURINOL (ORAL), PROBENECID (ORAL), PROBENECID / COLCHICINE (ORAL) ANTIPARKINSON'S AGENTS motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: AMANTADINE CAPSULE (ORAL), AMANTADINE SYRUP (ORAL), BENZTROPINE (ORAL), BROMOCRIPTINE (ORAL), CARBIDOPA / LEVODOPA (ORAL), CARBIDOPA / LEVODOPA ER (ORAL), CARBIDOPA / LEVODOPA ODT (ORAL), CARBIDOPA/LEVODOPA/ENTACAPONE (ORAL), PRAMIPEXOLE (ORAL), ROPINIROLE (ORAL), SELEGILINE CAPSULE (ORAL), SELEGILINE TABLET (ORAL), TRIHEXYPHENIDYL ELIXIR (ORAL), TRIHEXYPHENIDYL TABLET (ORAL) ANTIPSORIATICS, ORAL motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: OXSORALEN-ULTRA (ORAL), SORIATANE (ORAL) ANTIPSORIATICS, TOPICAL The recommendations were presented to the committee with the following changes; Dovonex Cream/Calcipotriene Cream brand-generic swap. Kevin Chamberlin motioned to accept the recommendations as presented and Hilda Slivka seconded the motion. It was passed ON PDL: CALCIPOTRIENE OINTMENT (TOPICAL), CALCIPOTRIENE SOLUTION (TOPICAL), CALCITRIOL OINTMENT (TOPICAL), DOVONEX CREAM (TOPICAL) ANXIOLYTICS The recommendations were presented to the committee with no changes from the previous year. Emmett Sullivan motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: ALPRAZOLAM TABLET (ORAL), BUSPIRONE (ORAL), CHLORDIAZEPOXIDE (ORAL), CLORAZEPATE (ORAL), DIAZEPAM SOLUTION (ORAL), DIAZEPAM TABLET (ORAL), LORAZEPAM INTENSOL (ORAL), LORAZEPAM TABLET (ORAL) BILE SALTS

9 motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: URSODIOL TABLET (ORAL) BRONCHODILATORS, BETA AGONIST The recommendations were presented to the committee with the following changes; Serevent and Foradil to become preferred and Albuterol Tablets to become non-preferred. Emmett Sullivan motioned to accept the recommendations as presented and Hilda Slivka seconded the motion. It was passed ON PDL: ALBUTEROL NEB SOLN 0.63, 1.25 MG (INHALATION), ALBUTEROL NEB SOLN 100 MG/20 ML (INHALATION), ALBUTEROL NEB SOLN 2.5 MG/3 ML (INHALATION), ALBUTEROL SYRUP (ORAL), FORADIL (INHALATION), PROAIR HFA (INHALATION), PROVENTIL HFA (INHALATION), SEREVENT (INHALATION), STRIVERDI RESPIMAT (INHALATION), TERBUTALINE (ORAL) EMOLLIENTS The recommendations were presented to the committee with no changes from the previous year. Hilda Slivka motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed unanimously by the committee. ON PDL: AMMONIUM LACTATE CREAM/LOTION (TOPICAL), LACTIC ACID CREAM/LOTION (TOPICAL) ERYTHROPOIESIS STIMULATING PROTEINS motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: ARANESP DISP SYRIN (INJECTION), ARANESP VIAL (INJECTION), PROCRIT (INJECTION) GLUCOCORTICOIDS, ORAL The recommendations were presented to the committee with the following changes; Entocort EC/Budesonide EC brandgeneric swap and Veripred 20 to become non-preferred. Kevin Chamberlin motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed ON PDL: BUDESONIDE EC (ORAL), DEXAMETHASONE SOLUTION (ORAL) 0.5 MG/5 ML, DEXAMETHASONE TABLET (ORAL), HYDROCORTISONE (ORAL), METHYLPREDNISOLONE 16 MG TABLET (ORAL), METHYLPREDNISOLONE 32 MG TABLET (ORAL), METHYLPREDNISOLONE 8 MG TABLET (ORAL), METHYLPREDNISOLONE TAB DS PK (ORAL) (4mg), METHYLPREDNISOLONE TABLET (ORAL) 4mg, ORAPRED (ORAL), ORAPRED ODT (ORAL), PREDNISOLONE SODIUM PHOSPHATE (ORAL), PREDNISOLONE SOLUTION (ORAL), PREDNISONE SOLUTION (ORAL) 5mg/5ml, PREDNISONE TABLET (ORAL) HISTAMINE II RECEPTOR BLOCKER

10 The recommendations were presented to the committee with the following changes; Famotidine Suspension to become non-preferred. Kevin Chamberlin motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: CIMETIDINE TABLET (ORAL), CIMETIDINE TABLET OTC (ORAL), FAMOTIDINE TABLET (ORAL), FAMOTIDINE TABLET OTC (ORAL), PEPCID SUSPENSION (ORAL), RANITIDINE SYRUP (ORAL), RANITIDINE TABLET (ORAL), RANITIDINE TABLET OTC (ORAL) IMMUNOMODULATORS, ATOPIC DERMATITIS motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: ELIDEL (TOPICAL) IMMUNOMODULATORS, TOPICAL The recommendations were presented to the committee with no changes from the previous year. Emmett Sullivan motioned to accept the recommendations as presented and Kevin Chamberlin seconded the motion. It was passed ON PDL: ALDARA (TOPICAL) IRON, ORAL The recommendations were presented to the committee with the following changes; Ferrous Fumarate Tablet OTC, Ferrous Sulfate Drops OTC and Fer-in-sol Drops OTC to become preferred. Hilda Slivka motioned to accept the recommendations as presented and Emmett Sullivan seconded the motion. It was passed unanimously by the committee. ON PDL: FEOSOL TABLET OTC (ORAL), FER-IN-SOL DROPS OTC (ORAL), FERRALET 90 DUAL-IRON TABLET (ORAL), FERRAPLUS 90 TABLET (ORAL), FERRIMIN 150 TABLET OTC (ORAL), FERROCITE PLUS TABLET (ORAL), FERROUS FUMARATE TABLET OTC (ORAL), FERROUS FUMARATE/ASCORBIC ACID/B12-IF/FA CAPSULE (ORAL), FERROUS FUMARATE/FA/MULTIVITAMIN & MINERALS CAPSULE (ORAL), FERROUS FUMARATE/IRON POLYSACCHARIDES/FA/MULTIVITAMIN CAPSULE (ORAL), FERROUS GLUCONATE TABLET OTC (ORAL), FERROUS SULFATE DROPS OTC (ORAL), FERROUS SULFATE SOLUTION OTC (ORAL), FERROUS SULFATE TABLET ER OTC (ORAL), FERROUS SULFATE TABLET OTC (ORAL), FERROUS SULFATE, RIED TABLET ER OTC (ORAL), FERROUS SULFATE/ASCORBIC ACID/FA TABLET ER OTC (ORAL), FOLIVANE-F CAPSULE (ORAL), HEMATOGEN CAPSULE (ORAL), HEMATOGEN FA CAPSULE (ORAL), HEMOCYTE PLUS CAPSULE (ORAL), HEMOCYTE-F TABLET (ORAL), INTEGRA CAPSULE OTC (ORAL), INTEGRA F CAPSULE (ORAL), INTEGRA PLUS CAPSULE (ORAL), IRON CARBONYL/ASCORBIC ACID TABLET OTC (ORAL), IRON POLYSACCHARIDES CAPSULE OTC (ORAL), IRON POLYSACCHARIDES/B12/FA CAPSULE (ORAL), NEPHRON FA TABLET (ORAL), NOVAFERRUM 50 CAPSULE OTC (ORAL), NOVAFERRUM DROPS OTC (ORAL), NU-IRON 150 CAPSULE OTC (ORAL), TANDEM DUAL ACTION CAPSULE OTC (ORAL), TANDEM PLUS CAPSULE (ORAL), TARON FORTE CAPSULE (ORAL), TL-HEM 150 TABLET ER 24H (ORAL), VITRON-C TABLET DR OTC (ORAL) LEUKOTRIENE MODIFIERS

11 The recommendations were presented to the committee with the following changes; Accolate/Zafirlukast brand-generic swap. Kevin Chamberlin motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: MONTELUKAST CHEWABLE TABLET (ORAL), MONTELUKAST TABLET (ORAL), ZAFIRLUKAST (ORAL) METHOTREXATE The recommendations were presented to the committee with the following changes; Methotrexate becoming a PDL reviewed Market Basket with Methotrexate PF Vial, Methotrexate Vial and Methotrexate Tablet as becoming preferred, while Rheumatrex Tablet Dose Pack, Trexall Tablet, Rasuvo Auto Injector and Otrexup Auto Injector as becoming nonpreferred. Kevin Chamberlin motioned to accept the new class and recommendations as presented and Hilda Slivka seconded the motion. It was passed ON PDL: METHOTREXATE PF VIAL (INJECTION), METHOTREXATE TABLET (ORAL), METHOTREXATE VIAL (INJECTION) OPHTHALMIC ANTIBIOTICS The recommendations were presented to the committee with no changes from the previous year. Emmett Sullivan motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: BACITRACIN/POLYMYXIN B SULFATE OINT. (OPHTHALMIC), ERYTHROMYCIN (OPHTHALMIC), GENTAMICIN DROPS (OPHTHALMIC), GENTAMICIN OINT. (OPHTHALMIC), MOXEZA (OPHTHALMIC), NEOMYCIN-POLYMYXIN- GRAMICIDIN (OPHTHALMIC), OFLOXACIN (OPHTHALMIC), POLYMYXIN/TRIMETHOPRIM (OPHTHALMIC), SULFACETAMIDE SOLUTION (OPHTHALMIC), TOBRAMYCIN (OPHTHALMIC), TOBREX OINTMENT (OPHTHALMIC), VIGAMOX (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS The recommendations were presented to the committee with the following changes; Blephamide S.O.P. to become nonpreferred. Emmett Sullivan motioned to accept the recommendations as presented and Kevin Chamberlin seconded the motion. It was passed ON PDL: BLEPHAMIDE (OPHTHALMIC) (DROPS), NEOMYCIN/BACITRACIN/POLY/HC (OPHTHALMIC), NEOMYCIN/POLYMYXIN/DEXAMETHASONE (OPHTHALMIC), PRED-G DROPS SUSP (OPHTHALMIC), PRED-G OINT. (OPHTHALMIC), SULFACETAMIDE / PREDNISOLONE (OPHTHALMIC), TOBRADEX OINTMENT (OPHTHALMIC), TOBRADEX SUSPENSION (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS The recommendations were presented to the committee with the following changes; Pazeo to become preferred. Hilda Slivka motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: ALREX (OPHTHALMIC), CROMOLYN SODIUM (OPHTHALMIC), PATADAY (OPHTHALMIC), PAZEO (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES

12 motioned to accept the recommendations as presented and Alexander Westphal seconded the motion. It was passed ON PDL: DEXAMETHASONE (OPHTHALMIC), DICLOFENAC (OPHTHALMIC), DUREZOL (OPHTHALMIC), FLAREX (OPHTHALMIC), FLUOROMETHOLONE (OPHTHALMIC), FLURBIPROFEN (OPHTHALMIC), FML FORTE (OPHTHALMIC), FML S.O.P. (OPHTHALMIC), ILEVRO (OPHTHALMIC), KETOROLAC (OPHTHALMIC), KETOROLAC LS (OPHTHALMIC), LOTEMAX DROPS (OPHTHALMIC), MAXIDEX (OPHTHALMIC), PRED MILD (OPHTHALMIC), PREDNISOLONE ACETATE (OPHTHALMIC), PREDNISOLONE SOD PHOSPHATE (OPHTHALMIC) OTIC ANTIBIOTICS The recommendations were presented to the committee with the following changes; Ofloxacin becomes non-preferred and Ciprofloxacin becomes preferred. Kevin Chamberlin motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: CIPRODEX (OTIC), CIPROFLOXACIN (OTIC), NEOMYCIN/POLYMYXIN/HC SOLN/SUSP (OTIC) OTIC ANTI-INFECTIVES & ANESTHETICS motioned to accept the recommendations as presented and Charles Thompson seconded the motion. It was passed ON PDL: ACETIC ACID (OTIC), ANTIPYRINE / BENZOCAINE (OTIC) STEROIDS, TOPICAL HIGH motioned to accept the recommendations as presented and Manage Nissanka seconded the motion. It was passed ON PDL: BETAMETHASONE DIPROPIONATE CREAM (TOPICAL), BETAMETHASONE DIPROPIONATE LOTION (TOPICAL), BETAMETHASONE VALERATE CREAM (TOPICAL), BETAMETHASONE VALERATE LOTION (TOPICAL), BETAMETHASONE VALERATE OINTMENT (TOPICAL), FLUOCINONIDE CREAM (TOPICAL), FLUOCINONIDE EMOLLIENT (TOPICAL), FLUOCINONIDE GEL (TOPICAL), FLUOCINONIDE SOLUTION (TOPICAL), TRIAMCINOLONE ACETONIDE CREAM (TOPICAL), TRIAMCINOLONE ACETONIDE OINTMENT (TOPICAL) STEROIDS, TOPICAL LOW motioned to accept the recommendations as presented and Hilda Slivka seconded the motion. It was passed ON PDL: CAPEX SHAMPOO (TOPICAL), DESONIDE CREAM (TOPICAL), DESONIDE LOTION (TOPICAL), DESONIDE OINTMENT (TOPICAL), DESOWEN LOTION (TOPICAL), FLUOCINOLONE 0.01% OIL (TOPICAL), HYDROCORTISONE / MIN OIL / PET OINTMENT (TOPICAL), HYDROCORTISONE CREAM (TOPICAL), HYDROCORTISONE GEL (TOPICAL), HYDROCORTISONE OINTMENT (TOPICAL)

13 STEROIDS, TOPICAL MEDIUM The recommendations were presented to the committee with the following change; Hydrocortisone Butyrate Ointment to become non-preferred. Emmett Sullivan questioned on the definition of (AG) and Kathy Novak replied it meant Authorized Generic. Kevin Chamberlin motioned to accept the recommendations as presented and Alexander Westphal seconded the motion. It was passed ON PDL: HYDROCORTISONE BUTYRATE CREAM (AG) (TOPICAL), HYDROCORTISONE BUTYRATE CREAM (TOPICAL), HYDROCORTISONE BUTYRATE SOLUTION (AG) (TOPICAL), HYDROCORTISONE BUTYRATE SOLUTION (TOPICAL), HYDROCORTISONE VALERATE CREAM (TOPICAL), HYDROCORTISONE VALERATE OINTMENT (TOPICAL), MOMETASONE FUROATE CREAM (TOPICAL), MOMETASONE FUROATE OINTMENT (TOPICAL), MOMETASONE FUROATE SOLUTION (TOPICAL) STEROIDS, TOPICAL VERY HIGH motioned to accept the recommendations as presented and Hilda Slivka seconded the motion. It was passed ON PDL: CLOBETASOL EMOLLIENT (TOPICAL), CLOBETASOL PROPIONATE CREAM (TOPICAL), CLOBETASOL PROPIONATE GEL (TOPICAL), CLOBETASOL PROPIONATE OINTMENT (TOPICAL), CLOBETASOL PROPIONATE SOLUTION (TOPICAL), CLOBEX SHAMPOO (TOPICAL), HALOBETASOL PROPIONATE CREAM (TOPICAL), HALOBETASOL PROPIONATE OINTMENT (TOPICAL) Recommendations for Next Class Reviews The following classes were recommended to be reviewed at the next P&T Meeting: 1. ACNE AGENTS, TOPICAL 2. ANALGESICS, NARCOTICS LONG 3. ANALGESICS, NARCOTICS SHORT 4. ANDROGENIC AGENTS 5. ANGIOTENSIN MODULATOR COMBINATIONS 6. ANGIOTENSIN MODULATORS 7. ANTIBIOTICS, GI 8. ANTIBIOTICS, INHALED 9. ANTIBIOTICS, TOPICAL 10. ANTIBIOTICS, VAGINAL 11. ANTICOAGULANTS 12. ANTIEMETICS/ANTIVERTIGO AGENTS 13. ANTIFUNGALS, ORAL 14. ANTIFUNGALS, TOPICAL 15. ANTIMIGRAINE AGENTS 16. ANTIPARASITICS, TOPICAL 17. ANTIVIRALS, ORAL 18. ANTIVIRALS, TOPICAL 19. BETA-BLOCKERS 20. BLADDER RELAXANT PREPARATIONS

14 21. BONE RESORPTION SUPPRESSION AND RELATED AGENTS 22. BPH TREATMENTS 23. CALCIUM CHANNEL BLOCKERS 24. CEPHALOSPORINS AND RELATED ANTIBIOTICS 25. CONTRACEPTIVES, ORAL 26. FLUOROQUINOLONES, ORAL 27. GROWTH HORMONE 28. H. PYLORI AGENTS 29. HEPATITIS C AGENTS 30. HYPOGLYCEMICS, INCRETIN MIMETICS/ENHANCERS 31. HYPOGLYCEMICS, INSULIN AND RELATED AGENTS 32. HYPOGLYCEMICS, MEGLITINIDES 33. HYPOGLYCEMIS, METFORMINS 34. HYPOGLYCEMICS, TZD 35. IMMUNOSUPPRESSANTS 36. IRRITABLE BOWEL SYNDROME 37. LIPOTROPICS, OTHER 38. LIPOTROPICS, STATINS 39. MACROLIDES/KETOLIDES 40. MULTIPLE SCLEROSIS AGENTS 41. OPIATE DEPENDENCE 42. PAH AGENTS, ORAL 43. PANCREATIC ENZYMES 44. PHOSPHATE BINDERS 45. PLATELET AGGREGATION INHIBITORS 46. PRENATAL VITAMINS 47. PROTON PUMP INHIBITORS 48. SKELETAL MUSCLE RELAXANTS 49. TETRACYCLINES, ORAL 50. ULCERATIVE COLITIS AGENTS 51. VASODILATORS, CORONARY Next Meeting Carly Whitehouse will send available dates to P&T Committee members via and determine which date can be best accommodated. Target is mid-april through May Carl Sherter commented that changing the meeting to either a Tuesday or Thursday would be beneficial for him. Robert Zavoski announced effective December 1 st 2015, the Department of Social Services will expand coverage of reimbursable Over-the-Counter formulary medications for individuals 21 years of age and older. A provider bulletin was published November 18 th 2015 containing the details. The meeting was adjourned at 8:42pm.