Georgia Department of Community Health. Department of Community Health 2 Peachtree Street - 5 th Floor Board Room Atlanta, Georgia 30303
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1 Georgia Department of Community Health DRUG UTILIZATION REVIEW BOARD MEETING Department of Community Health 2 Peachtree Street - 5 th Floor Board Room Atlanta, Georgia June 6, 2013
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3 DRUG UTILIZATION REVIEW BOARD MEETING AGENDA 2 Peachtree Street - 5 th Floor DCH Board Room Atlanta, Georgia June 6, :00 a.m. to 2:00 p.m. CALL TO ORDER COMMENTS FROM THE DEPARTMENT MINUTES FROM PREVIOUS MEETING CONSUMER COMMENTS SESSION ADJOURNMENT OF OPEN SESSION Laurel Ashworth, PharmD, Chair Linda Wiant, PharmD, Director Chair Chair Chair EXECUTIVE SESSION RECONVENING OF OPEN SESSION CLINICAL REVIEW AND DURB Manufacturers Forum Chair Emily Baker, PharmD, BCPS, MBA, MHA Tara R. Cockerham, PharmD New Drug Reviews Aubagio Bosulif Linzess Myrbetriq Stivarga Synribo Tudorza Xeljanz Follow-Up Review High-Level Analysis of Human Immunodeficiency Virus Agents Class Reviews Clinical Updates Utilization Trends Review Drug Information Review Drug Update Newsletter Horizon Watch Report FUTURE AGENDA ITEMS REVIEW OF DURB RECOMMENDATIONS ADJOURNMENT OF MEETING Patent Expiration Report Clinical Compass Newsletter Chair Chair Chair 3
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5 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 MEMBERS PRESENT Laurel E. Ashworth, Pharm.D., Chair Joseph R. Bona, M.D., MBA, Vice-Chair Karen L. Carter, M.D. Ann R. Damon, Pharm.D. Carl Ellis, R.Ph. Deborah W. Fincher, M.S., R.Ph. Thomas B. Gore, M.D. John Greeson, M.D., MBA Rondell C. Jaggers, Pharm.D. Edwina L. Jones, Pharm.D. Robyn Lorys, Pharm.D. J. Russell May, Pharm.D. Osgood (Drew) A. Miller, R.Ph. Donald A. Paul, M.D. Matthew Perri, III, R.Ph., Ph.D. Sandra L. White, M.D., MBA, FACR Mary Virginia "Ginny" Yates, Pharm.D. MEMBERS ABSENT Paul D. Boyce, M.D. Melissa D. Carter, J.D, Staff Linda Wiant, Pharm.D., Pharmacy Director, Pharmacy Services Turkesia Robertson-Jones, Pharm.D., Pharmacy Operations Manager, Pharmacy Services Gilletta Gray, R.Ph., Clinical Manager, Pharmacy Services Lori Garner, MHS, MBA, R.Ph., Pharmacist, Pharmacy Services Rose Marie Duncan, MBA, Program Associate, Pharmacy Services Matthew Leigh, Pharm.D. Candidate NorthStar HealthCare Consulting Tara R. Cockerham, Pharm.D., Clinical Programs Director Elizabeth Flores, Pharm.D., Clinical Pharmacist Catamaran Susan McCreight, Sr. Director, Public Sector Account Management Mark Hall, MBA, PMP, Account Manager Talmahjia Tami Sweat, Pharm.D., Clinical Systems Product Manager Christopher Hamilton, R.Ph., Clinical Consultant, Account Management 5
6 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Goold Health Services Steve Liles, Pharm.D., Sr. Director, Pharmacy Services Doug Martin, Pharm.D., Pharmacy Project Manager University of Georgia Pharmacy School Erin Masarello, Pharm.D. Candidate Leigh Perri, Pharm.D. Candidate Call to Order The Drug Utilization Review Board (DURB/DUR Board/Board) held its first meeting for the calendar year on March 19, The Chair, Laurel E. Ashworth, Pharm.D., called the meeting to order at 9:01am. Comments from the Department Linda Wiant, Pharm.D., Pharmacy Director, Pharmacy Services, commented on the following items: 1. Pharmacy Students UGA students, Erin Massarello and Leigh Ann Perri, and Mercer student, Matthew Leigh, were welcomed. 2. Resignations Arvind Gupta, M.D., has resigned from the DUR Board. Appreciation for his service to the Board was expressed. 3. DUR Board The Department is seeking nominations for the DUR Board. Nominations can be ed to DCH. 4. Medicaid Snapshot: Year in Review A presentation was given to provide an overview of Medicaid expenditures/growth, pharmacy expenditures, specialty drug trending, DUR initiatives and DURB recommendations (see Attachment A). Minutes from the Previous Meeting Dr. Ashworth asked for comments regarding the minutes from the December 11, 2012 meeting. There were no corrections. A motion was made, seconded, and carried to approve the minutes as written. Manufacturers Forum Tara Cockerham, Pharm.D., reviewed information regarding the Manufacturers Forum that was provided in the Manufacturer Information section in the DUR Board binder. A total of twentytwo (22) manufacturers participated and provided information regarding the following drugs discussed at the March 2013 DURB meeting: Manufacturers AbbVie Bausch & Lomb Pfizer Sunovion Amgen Sanofi Vertex GlaxoSmithKline Biogen Humira Besivance, Lotemax Gel Lyrica, Genotropin, Pristiq Latuda, Zetonna Enbrel Sklice Incivek Advair, Flovent Avonex 6 Drugs
7 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Manufacturers Novartis Janssen AstraZeneca United Therapeutics Merck Teva UCB Bristol-Myers Squibb Novo Nordisk Forest Otsuka Actelion Ferring Drugs Exelon Patch, Fanapt, Gilenya Xarelto, Invega Sustenna Brilinta Adcirca, Tyvaso Cosopt PF, Januvia, Victrelis ProAir HFA, Qnasl Neupro, Cimzia Bydureon Norditropin Daliresp Abilify Tracleer Prepopik Questions and comments were made on the following: Manufacturer restrictions on data provided, pharmacoeconomic data; budget-impact models. The next forum will be held on Thursday, May 2, 2013 from 9am-5pm at the NorthStar Healthcare Consulting office: 1121 Alderman Drive, Suite 112, Alpharetta, GA New Drug Reviews Clinical information for the following new drugs, in the market six months or more, was presented for discussion and recommendations. The complete detailed drug summary is in the New Drugs for Review section of the DUR Board binder. Therapeutic Class Drugs Presenter Antiparkinson Neupro Tara Cockerham, Pharm.D. Bowel Preparation Prepopik Tara Cockerham, Pharm.D. Topical Scabicide and Pediculicide Sklice Tara Cockerham, Pharm.D. Antineoplastics Xtandi Tara Cockerham, Pharm.D. The Board discussed the drug information, provided comments, and raised questions on the following: Sklice pregnancy testing to rule out pregnancy; exclusion of pregnant patients in the clinical trial; local resistant patterns Therapeutic Class Review Clinical information for the following therapeutic class was presented for discussion by Dr. Tara Cockerham. The complete detailed therapeutic class review was provided in the Therapeutic Class Review section of the DUR Board binder. Therapeutic Class Name Oral Nonsteroidal Antiinflammatory Drugs (NSAIDs) 7
8 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Comments were provided on usage in older patients and in Coronary Artery Disease (CAD) patients. The Department noted there were no current issues from providers that have come up with this drug class. Supplemental Rebate Drugs New Clinical Information Review Clinical updates to the Supplemental Rebate categories were listed in the Supplemental Rebate section of the DURB binder. The following therapeutic categories had updates: Drug Class/Name Anticonvulsants Second Generation Antiinfectives - Miscellaneous Beta Adrenergics Short-Acting Inhalers Gastrointestinal Digestive Enzymes Insulin Nasal Steroids Nonsteroidal Antiinflammatory Agents Ophthalmic Quinolones Osteoporosis Agents Platelet Aggregate Inhibitors/Combinations - Miscellaneous Pulmonary Antihypertensives Topical Corticosteroids Topical Scabicides and Pediculicides Adrenergic Combinations Alzheimer - Cholinomimetics Androgen/Anabolics Angiotensin II Receptor Antagonist (ARBs) and Combinations Anticoagulants Antidepressants Selective Norepinephrine Reuptake Inhibitors Antiemetic Drugs Antihemophilic Products Antihistamines - Nasal Antihistamines Non-Sedating Antihyperkinesis Agents Antimanic Agents Antineoplastics and Adjunct Therapies Antiparkinson Agents Asthma & Bronchodilator Agents Atypical Antipsychotics Cardiac Other Cephalosporins Cholesterol Bile Acid Sequestrants Diabetic Dipeptidyl Peptidase IV (DPP-IV) Inhibitors Diabetic Non-Insulin Injectables 8
9 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Drug Class/Name - continued Direct Renin Inhibitors and Combinations Gastrointestinal Inflammatory Bowel Agents Gastrointestinal Proton Pump Inhibitors Growth Hormones Hematopoietic Agents Hepatitis C Lipid Niacin Lipid-Other Migraine Selective Serotonin Agents Multiple Sclerosis (MS) Agents Ophthalmic Antiallergic Ophthalmic Antiinflammatory/Steroid Agents Ophthalmic Beta Blockers Ophthalmic Nonsteroidal Antiinflammatory Agents Ophthalmic Prostaglandins Opioid Agonists Opioid Partial Agonists Progestins Prostatic Hypertrophy Agents Topical Immunomodulators Triglyceride Lowering Agents Tumor Necrosis Factor (TNF) Agents There were no comments or questions from the Board. DCH Decisions DCH Decisions from the December 2012 DUR Board meeting were provided in the DCH Decision section of the DUR Board binder. Utilization Trend Review Utilization trends for Georgia Medicaid Fee-for-Service were provided in detail in the Utilization Trends section of the DUR Board binder. Drug Information Information from the following was provided in detail in the Drug Information section of the DUR Board binder used for this meeting: Drug Update Newsletter Horizon Watch Report Patent Expiration Report Clinical Compass Newsletter Future Agenda Items The following future agenda items were noted: Utilization Review Activities 9
10 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Consumer Comments Session Dr. Bona conducted the Consumer Comments Session. Consumer comments were presented to the Board from the following: Camden Pace, Consumer consider open access for all atypical antipsychotics Dr. Tara Cockerham read a consumer comment (received after last meeting) from the Georgia AIDS Coalition, Cathalene Teahan, RN, MSN Disclosure forms were completed by Camden Pace and Cathalene Teahan and were reviewed by the Department. Upcoming Meetings The following upcoming meetings were published in the DURB binder: Drug Utilization Review Board 2 Peachtree Street NW 5 th Floor Board Room Atlanta, Georgia Thursday, June 6, 2013 Thursday, September 19, 2013 Tuesday, December 10, 2013 Manufacturers Forum NorthStar Healthcare Consulting 1121 Alderman Drive Suite 112 Alpharetta, Georgia Thursday, May 2, 2013 Thursday, August 1, 2013 Thursday, November 7, 2013 Disclosure Forms Disclosure forms were received and reviewed by the Department for completeness for all Board members attending the meeting. Dr. Donald Paul disclosed program support from a manufacturer and abstained from voting for products or classes of medications from this manufacturer. Adjournment of Open Session The DUR Board voted to close the open meeting pursuant to the Open Meeting Act of Georgia Section and pursuant to Federal Law Section 1396R-8B3D. The individuals recorded in attendance from the Department of Community Health, Goold Health Services, NorthStar HealthCare Consulting, Catamaran and University of Georgia and Mercer pharmacy students attended the closed session with the Board members. A motion was made by Rusty May, Pharm.D., and seconded by Karen Carter, M.D., to adjourn the open session and approve the closed session. There was a unanimous vote approving the closed session. The Chairman, 10
11 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Dr. Laurel Ashworth, adjourned the open session at approximately 10:47 am, at which time members took a break then reconvened for the executive (closed) session. Executive Session The executive session was held from 11:04am to 1:15pm. Board s Recommendations to the Department After all clinical and financial evaluations and discussions, the DUR Board reconvene ed in the open session, voted, and presented the Department with the following recommendations for changes to the Preferred Drug List (PDL). All motions and votes are noted in Attachment B. New Drug Reviews Antiparkinson Agent The DUR Board recommended Non-Preferred status with Prior Authorization for Neupro. Gastrointestinal Bowel Evacuation Preparation The DUR Board recommended Non-Preferred status with Prior Authorization for Prepopik. Topical Scabicides and Pediculicides The DUR Board recommended Non-Preferred status with Prior Authorization for Sklice. Antineoplastics The DUR Board recommended Preferred status with Prior Authorization for Xtandi. Analgesics - Miscellaneous Supplemental Rebate Class Reviews The DUR Board recommended Non-Preferred status with Prior Authorization for Butalbital-Aspirin-Caffeine Capsule, Butalbital-Acetaminophen-Caffeine Capsule, Bupap, Zebutal, Dolgic Plus and Phrenilin Forte. Anticonvulsants The DUR Board recommended Non-Preferred status with Prior Authorization for Banzel, Vimpat and Lamotrigine Chewable Tablet. Antiinfective - Miscellaneous The DUR Board recommended Non-Preferred status with Prior Authorization for Metronidazole 375mg Capsule. 11
12 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Beta Adrenergics Short-Acting Inhalers The DUR Board recommended Non-Preferred status with Prior Authorization for Ventolin HFA and ProAir HFA. Gastrointestinal Digestive Enzymes The DUR Board recommended Non-Preferred status with Prior Authorization for Ultresa and Zenpep Gastrointestinal - Laxatives The DUR Board recommended Non-Preferred status with Prior Authorization for Kristalose. Hyperparathyroid Treatment Vitamin D Analogs and Calcimimetics The DUR Board recommended Non-Preferred status with Prior Authorization and Grandfathering for Zemplar. Insulins The DUR Board recommended Preferred status for Humulin R Vial, Humulin N Vial and Levemir Vial, and Preferred status with Prior Authorization for Levemir Flexpen. Non-Steroidal Antiinflammatory Agents The DUR Board recommended Non-Preferred status with Prior Authorization for Diclofenac Sodium Extended-Release Tablet, Etodolac Extended-Release Tablet, Fenoprofen Calcium Tablet, Indomethacin Extended-Release Capsule, Ketoprofen Capsule, Ketoprofen Extended-Release Capsule, Meclofenamate Sodium Capsule, Naproxen Delayed-Release Tablet, Oxaprozin Tablet and Tolmetin Sodium Capsule and Tablet. Ophthalmic Quinolones The DUR Board recommended Non-Preferred status with Prior Authorization for Besivance and Ofloxacin. Ophthalmic Selective Alpha Adrenergic Agonists The DUR Board recommended Non-Preferred status with Prior Authorization for Alphagan P 0.1%. Opioid Combinations The DUR Board recommended Preferred status for Ibudone 10mg-200mg Tablet and Non-Preferred status with Prior Authorization for Hydrocodone-Ibuprofen 5mg- 12
13 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, mg and 7.5mg-200mg Tablets. Phosphate Binders The DUR Board recommended Non-Preferred status with Prior Authorization for Renvela 800mg Tablet. Platelet Aggregate Inhibitors and Combinations The DUR Board recommended Preferred status for Brilinta. The DUR Board also requested the Department monitor and report on utilization of Brilinta in 6 months. Pulmonary Antihypertensives The DUR Board recommended Preferred status with Prior Authorization for Revatio. Steroid Inhalants The DUR Board recommended Preferred status for Pulmicort Flexhaler. Topical Acne Preparations The DUR Board recommended Preferred status for Klaron Suspension, Tazorac Cream and Gel and Ziana, Preferred status with Prior Authorization for Azelex and Non- Preferred status with Prior Authorization for Benzaclin, Benzamycin Pak, Clindagel, Clindamycin Phosphate Swab, Ery and Erythromycin Swabs, Metrogel Pump, Metronidazole Cream and Lotion and Sulfacetamide Sodium Suspension. Topical Corticosteroids-Low Potency The DUR Board recommended Preferred status for Fluocinolone Acetonide Oil and Non-Preferred status with Prior Authorization for Derma-Smoothe FS, U-Cort and Desonide Lotion. Topical Corticosteroids-Medium Potency The DUR Board recommended Preferred status for Kenalog Aerosol and Non- Preferred status with Prior Authorization for Amcinonide Cream; Betamethasone Valerate Lotion; Fluocinolone Acetonide Cream, Ointment and Solution; Fluticasone Proprionate Cream and Ointment; Hydrocortisone Butyrate Cream; Mometasone Furoate Cream, Ointment and Solution and Triamcinolone Acetonide Lotion. Topical Corticosteroids-High Potency The DUR Board recommended Non-Preferred status with Prior Authorization for Amcinonide Ointment; Apexicon E Cream; Betamethasone Dipropionate Gel and Ointment; Betamethasone Dipropionate (Augmented) Cream, Lotion and Ointment; Clobetasol Propionate Foam; Desoximetasone Cream, Gel and Ointment and Diflorasone Diacetate 13
14 Department of Community Health Drug Utilization Review Board (DURB) MINUTES Tuesday, March 19, 2013 Cream and Ointment. Topical Scabicides and Pediculicides The DUR Board recommended Non-Preferred status with Prior Authorization for Natroba. Conclusion At the conclusion of the executive session, the open session reconvened at 1:29pm and audience participants were invited back into the board room to hear the Board s recommendations submitted to the Department. Dr. Ashworth and Dr. Bona presided over the voting and presented the recommendations from the Board to the Department. With no other business for discussion, Chair Ashworth adjourned the meeting at 2:24pm. THESE MINUTES ARE HEREBY APPROVED AND ADOPTED, THIS THE DAY OF, Laurel Ashworth, Pharm.D., Chair 14
15 Georgia Department of Community Health Attachment A Medicaid Snapshot: The Year in Review Attachment A Presentation to: Medicaid Drug Utilization Review Board Presented by: Linda Wiant, Pharmacy Director Georgia Department of Community Health 15 March 19,
16 Georgia Department of Community Health Mission The Georgia Department of Community Health We will provide Georgians with access to affordable, quality health care through effective planning, purchasing and oversight. We are dedicated to A Healthy Georgia. Georgia Department of Community Health 16 1
17 Georgia Department of Community Health Medicaid Title Expenditures or Chapter and Slide Growth (use as needed; feel free to delete) Georgia Department of Community Health 17 2
18 Medicaid Growth Trends National View Enrollees (millions) % of Population 2% 12.5% 17.47% 26.1% Total Cost (billions) <$1 $206 $401 $871 % of GDP <1/2% 21% 2.1% 27% 2.7% 37% 3.7% Georgia Department of Community Health 18 3
19 Enrollment and Expenditures by Group Georgia Department of Community Health 19 4
20 Enrollment and Expenditures by Group Georgia Department of Community Health 20 5
21 Medicaid Growth Trends Georgia View Georgia Department of Community Health 21 6
22 GA Medicaid and PeachCare for Kids Total FY2012 Expenditures (includes State, Federal and other Fund Sources): Medicaid: $8,134,503,878 PeachCare for Kids: $ 328,621,859 Average Spend per Day - $31.4 million per work day Claims Paid per Day 201,604 per work day 59% of total Georgia Births are paid for by Medicaid 19.0% 18.0% Medicaid and PeachCare represents 17% of the state funds budget (excluding motor 17.0% 16.0% 15.0% 14.3% 14.5% fuel and lottery) 14.0% 15.3% 18.2% 16.7% 17.2% 17.0% 13.0% 12.0% 11.0% Georgia Department of Community Health 10.0%
23 Georgia Department of Community Health Medicaid Growth Trends Georgia View Fee For Service Pharmacy Expenditures Enrollees 947,054 1,456,520 1,818,829 % of State Population 11.56% 15.03% 14.92% State Funds (millions) $1,393 $1,875 $ 3,889 % of State Revenue 10.2% 12.4% 16.5% Georgia Department of Community Health 23 8
24 GA Medicaid FFS Prescription Spending 9,000, ,000,000 4% increase in FFS population (440,569) 12.1% increase in expenditures 17.7 % increase in Rxs paid 2007: $466,554, : $530,384, ,000,000 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 Rx Count PMPM (Rx) PMPM ($) PUPM (Rx) PUPM ($) $ $ $ $ $540,000, $520,000, $500,000, $480,000, $460,000, $440,000, $420,000, Amount Paid Georgia Department of Community Health 24 9
25 Fee For Service Drivers 2008 Totals 2012 Totals Avg Cost Count of Amount Avg Cost Count of Rank Drug Grouping Description Rx Count Amount Paid per Rx Members Drug Grouping Description Rx Count Paid per Rx Members 1 ANALGESICS - OPIOID* 498,582 $12,526,412 $ ,429 ANALGESICS - OPIOID* 627,917 $15,126,768 $ ,061 2 ANTICONVULSANTS* 432,456 $52,446,941 $ ,456 ANTICONVULSANTS* 563,599 $34,669,181 $ ,289 3 ANTIHYPERTENSIVES* 376,999 $11,980,642 $ ,159 ANTIDEPRESSANTS* 470,793 $9,826,781 $ ,845 4 ANTIDEPRESSANTS* 372,617 $14,221,955 $ ,071 ANTIHYPERTENSIVES* 458,953 $10,655,832 $ ,468 5 ANTIASTHMATIC AND BRONCHODILATOR AGENTS* 353,980 $31,928,892 $ ,348 ANTIASTHMATIC AND BRONCHODILATOR AGENTS* 449,568 $53,515,653 $ ,895 6 ANTIPSYCHOTICS/ANTIMANIC AGENTS* 321,096 $83,952,701 $ ,947 ANTIANXIETY AGENTS* 372, $3,438, $ ,389 7 ANTIANXIETY AGENTS* 295,218 $2,648,610 $ ,472 ANTIPSYCHOTICS/ANTIMANIC AGENTS* 342,330 $68,699,102 $ ,134 8 ANTIDIABETICS* 267,035 $19,662,297 $ ,010 ANTIHISTAMINES* 302,027 $2,587,476 $ ,196 9 ULCER DRUGS* 242,806 $12,094,734 $ ,409 ULCER DRUGS* 292,202 $5,263,348 $ , ANTIHISTAMINES* 208,746 $2,170,148 $ ,778 ANTIDIABETICS* 290,506 $26,930,264 $ , Totals 2012 Totals Rank Drug Group Description Amount Paid Rx Count Avg Cost per Rx Count of Members Drug Group Description Amount Paid Rx Count Avg Cost per Rx Count of Members 1 ANTIPSYCHOTICS/ANTIMANIC AGENTS* $83,952, ,096 $ ,947 ANTIPSYCHOTICS/ANTIMANIC AGENTS* $68,699, ,330 $ ,134 2 ANTICONVULSANTS* $52,446, ,456 $ ,456 ANTIVIRALS* $61,394,489 88,517 $ ,993 3 ANTIVIRALS* $34,488,452 66,820 $ ,631 ANTIASTHMATIC AND BRONCHODILATOR AGENTS* $53,515, ,568 $ ,895 4 ANTIASTHMATIC AND BRONCHODILATOR AGENTS* $31,928, ,980 $ ,348 ANTICONVULSANTS* $34,669, ,599 $ ,289 5 HEMATOLOGICAL AGENTS - MISC. * $23,686,734 46,051 $ ,182 HEMATOLOGICAL AGENTS - MISC. * $32,904,820 50,189 $ ,383 6 ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREX $20,459, ,188 $ ,656 ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREX $31,240, ,222 $ ,653 7 ANTIDIABETICS* $19,662, ,035 $ ,010 ANTIDIABETICS* $26,930, ,506 $ ,827 8 ANTIDEPRESSANTS* $14,221, ,617 $ ,071 ANALGESICS - OPIOID* $15,126, ,917 $ ,061 9 ANALGESICS - OPIOID* $12,526, ,582 $ ,429 ENDOCRINE AND METABOLIC AGENTS - MISC.* $14,944,056 37,624 $ , ULCER DRUGS* $12,094, ,806 $ ,409 ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES $11,501,785 24,449 $ ,482 Georgia Department of Community Health 25 10
26 Fee For Service Drivers: Specialty Drug Spending 2012 Specialty: + 16% Nonspecialty: % Total: +4.61% Georgia Department of Community Health 26 11
27 DUR Initiatives Georgia Department of Community Health 27 12
28 DUR Initiatives (Continued) Georgia Department of Community Health 28 13
29 DUR Board Recommendations Opioid Restrictions: 9/1/12: >6 Rxs/month 4/1/13: 5 Rxs/month Suboxone: 4/1/13: PA required for concomitant opioid therapy Georgia Department of Community Health 29 14
30 Drug Utilization Review Board Motions Votes March 19, 2013 New Drug Antiparkinson Agents Motion: Neupro NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Attachment B Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 30
31 Drug Utilization Review Board Motions Votes March 19, 2013 New Drug GI - Bowel Evacuant Preparations Motion: Prepokik NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 31
32 Drug Utilization Review Board Motions Votes March 19, 2013 New Drug Topical - Scabicides & Pediculicides Motion: Sklice NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 32
33 Drug Utilization Review Board Motions Votes March 19, 2013 New Drug Antineoplastics & Adjunctive Motion: Xtandi P/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 33
34 Drug Utilization Review Board Motions Votes March 19, 2013 ANALGESICS - MISCELLANEOUS Drug PDL Status Drug PDL Status Butalbital Aspirin Caffeine Capsule NP/PA Dolgic Plus NP/PA Motion: Butalbital Acetaminophen Caffeine Capsule NP/PA Phrenilin Forte. NP/PA Bupap NP/PA Zebutal NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 34
35 ANTICONVULSANTS Motion: Drug Banzel Lamotrigine Chewable Tablet Drug Utilization Review Board Motions Votes March 19, 2013 PDL Status NP/PA NP/PA Vimpat NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 35
36 ANTIINFECTIVE - MISCELLANEOUS Motion: Drug Metronidazole 375 mg Capsule Drug Utilization Review Board Motions Votes March 19, 2013 PDL Status NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 36
37 BETA ADRENERGICS SHORT ACTING INHALERS Motion: Drug ProAir HFA Drug Utilization Review Board Motions Votes March 19, 2013 PDL Status NP/PA Ventolin HFA NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 37
38 GASTROINTESTINAL - DIGESTIVE ENZYMES Motion: Drug Ultresa Drug Utilization Review Board Motions Votes March 19, 2013 PDL Status NP/PA Zenpep NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 38
39 GASTROINTESTINAL - LAXATIVES Drug Utilization Review Board Motions Votes March 19, 2013 Drug PDL Status Motion: Kristalose NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 39
40 HYPERPARATHYROID TREATMENT - VITAMIN D ANALOGS AND CALCIMIMETICS Drug Utilization Review Board Motions Votes March 19, 2013 Drug PDL Status Motion: NP/PA Zemplar Grandfathering Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 40
41 INSULIN Motion: Drug Humulin R Vial Humulin N Vial Levemir Flexpen Drug Utilization Review Board Motions Votes March 19, 2013 PDL Status P P P/PA Levemir Vial P Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 41
42 Drug Utilization Review Board Motions Votes March 19, 2013 NASAL STEROIDS Motion: No Changes Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 42
43 Drug Utilization Review Board Motions Votes March 19, 2013 NON-STEROIDAL ANTIINFLAMMATORY AGENTS Drug PDL Status Drug PDL Status Diclofenac Sodium Extended Release Tablet NP/PA Ketoprofen Extended Release Capsule NP/PA Motion: Etodolac Extended Release Tablet NP/PA Meclofenamate Sodium Capsule NP/PA Fenoprofen Calcium Tablet NP/PA Naproxen Delayed Release Tablet NP/PA Indomethacin Extended Release Capsule NP/PA Oxaprozin Tablet NP/PA Ketoprofen Capsule NP/PA Tolmetin Sodium Capsule and Tablet NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 43
44 OPHTHALMIC QUINOLONES Drug Utilization Review Board Motions Votes March 19, 2013 Drug PDL Status Motion: Besivance NP/PA Ofloxacin NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 44
45 Drug Utilization Review Board Motions Votes March 19, 2013 OPHTHALMIC SELECTIVE ALPHA ADRENERGIC AGONISTS Drug PDL Status Motion: Alphagan P 0.1% NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 45
46 OPIOID - COMBINATIONS Drug Utilization Review Board Motions Votes March 19, 2013 Drug PDL Status Hydrocodone Ibuprofen 5mg 200mg Motion: Tablet NP/PA Hydrocodone Ibuprofen 7.5mg 200mg Tablet NP/PA Ibudone 10mg 200mg Tablet P Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 46
47 Drug Utilization Review Board Motions Votes March 19, 2013 OSTEOPOROSIS AGENTS Motion: No Changes Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 47
48 Drug Utilization Review Board Motions Votes March 19, 2013 PHOSPHATE BINDERS Drug PDL Status Motion: Renvela 800mg Tablet NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 48
49 Drug Utilization Review Board Motions Votes March 19, 2013 PLATELET AGGREGATE INHIBITORS/COMBINATIONS - MISCELLANEOUS Drug PDL Status Motion: Brilinta P Monitor and report on utilization of Brilinta in 6 months. Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 49
50 Drug Utilization Review Board Motions Votes March 19, 2013 PULMONARY ANTI-HYPERTENSIVES Drug PDL Status Motion: Revatio P/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 50
51 Drug Utilization Review Board Motions Votes March 19, 2013 STEROID INHALANTS Drug PDL Status Motion: Pulmicort Flexhaler P Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D. TOTAL Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. 51
52 Drug Utilization Review Board Motions Votes March 19, 2013 TOPICAL - ACNE PREPARATIONS Drug PDL Status Drug PDL Status Azelex P/PA Klaron Suspension P Benzaclin NP/PA Metrogel Pump NP/PA Motion: Benzamycin Pak NP/PA Metronidazole Cream and Lotion NP/PA Clindagel NP/PA Sulfacetamide Sodium Suspension NP/PA Clindamycin Phosphate Swab NP/PA Tazorac Cream and Gel P Ery Swab NP/PA Ziana P Erythromycin Swab NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 52
53 Drug Utilization Review Board Motions Votes March 19, 2013 TOPICAL - CORTICOSTEROIDS - LOW Motion: Drug PDL Status Drug PDL Status Derma Smoothe FS NP/PA Fluocinolone Acetonide Oil P Desonide Lotion NP/PA U Cort NP/PA Board Members - Present Motion Seconded (Strike out, when absent) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Ashworth, Laurel E. Pharm.D. - Chair N/A N/A N/A N/A N/A N/A 2 Bona, Joseph R. M.D. - Co-Chair 3 Carter, Karen L., M.D. 4 Damon, Ann R., Pharm.D. 5 Ellis, Carl, R.Ph. 6 Fincher, Deborah W., M.S., R.Ph. 7 Gore, Thomas B., M.D. 8 Greeson, John D., M.D., MBA 9 Jaggers, Rondell C., Pharm.D. 10 Jones, Edwina L., Pharm.D., MBA 11 Lorys, Robyn Pharm.D. 12 May, J. Russell, Pharm.D. 13 Miller, Osgood (Drew) A. R.Ph. 14 Paul, Donald A., M.D. 15 Perri, III, Matthew, R,Ph., Ph.D. 16 White, Sandra L., M.D., MBA, FACR 17 Yates, Mary Virginia "Ginny", Pharm.D Board Members - Absent Motion Seconded (Highlight, when present) Maker ( ) By ( ) YES ( ) NO ( ) ABSTAIN ( ) RECUSE ( ) 1 Boyce, Paul D., M.D. 2 Carter, Melissa D., J.D. TOTAL 53
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