Voting Members Present

Enterprise P&T Meeting Committee Meeting Minutes

April 30, 2018

 David Batluck, DO Gus Geraci, MD Chris Meny, RPh Andrew Peterson, PharmD Rodney Wise, MD

Donald Beam, MD Glenn Hamilton, MD Jay Messeroff, RPh David Petkash, MD

William Burnham, MD Fred Hill, MD Kendra Michael, M Jeanine Plante, PharmD

Kirt Caton, MD Jeffrey Kreitman, PharmD Betty Muller, MD Kirby Smith, MD

Don Cooper, RPh Markus Kruesi, MD Lavdena Orr, MD Wayne Weart, PharmD

Rogers Elebra, PharmD Susan McAllister, MD Eric Peters, PharmD Rani Whitfield. MD

 

Excused Voting Members  

John Floyd Brinley, MD Lily Higgins, MD Melissa Rooney, RN Jen Devinney, PharmD Parul Mistry, MD Rajiv Vyas, MD

 

Invited Guests Present  

Linda Albandoz, NCPhT - PRx April Holly - LDH Kelly Martin, PharmD Paul Larry, DMD Corp Dental Director

Kathleen Clement, Administrative- PRx Matt Hassel, Administrative- PRx Lauren Megargell, PharmD-PRx Mariel Shull, PharmD-PRx

Mike Colvin, PharmD Jamila Jorden, PharmD - PRx Tim Melancon, Sparks Therapeutics Devon Trumbower, PharmD-PRx Tracy Davis, PharmD -DC Paul Knecht, PharmD Holly Moreau, Prestige Calla Vodoor – PharmD Patrick DeHoratius, PharmD - PRx Lanaye Lawyer, MD Michelle Murphy, PharmD Pharmacy Director Melwyn Wendt, PharmD Fury Fecondo, PharmD Shalis. Lightner, Pharmacy Manager Herbert Peeples, PharmD

25

 

Issue

Discussion

Conclusion/ Results 

 Vote 

Action/ Person Responsible 

 1. Call to Order

The meeting was called to order at 6:00 PM EST.  Dr. Burnham welcomed all new of our external and internal participants.

Informational Only

Dr. William Burnham

2. Conflict of Interest Disclosures

Dr. Burnham if anyone has a conflict of interest to disclose that would recuse them from voting on any agenda item.

Informational Only

Dr. William Burnham

3. ACLA Common PDL Attestation

  Informational Only

Kelly Martin

 4. Review of last P&T Minutes

Kelly Martin asked if there were any corrections or updates to the minutes from January 29, 2018.  Attendee Correction: Mel Wendt from LDH instead of Doug Wendt from Merck

Informational Only

Kelly Martin

 5. Proxy Minutes

 Proxy email sent 2/20/2018 Informational

Only Kelly Martin

 SHSC – SA Opioid PA Criteria        SHSC – LA Opioid PA Criteria

 Recommendation to add the following line items: 1. Greater than 1 opioid prescription per 30 days is medically necessary. 2. The diagnosis is for pain uncontrolled by non-opioid medications.    Recommendation to approve the newly developedLA Opioid Criteria

Informational Only

Kelly Martin

26

 

Issue

Discussion

Conclusion/ Results 

 Vote

Action/ Person Responsible

6. Old Business  

 Inhaled Corticosteroids (ICS)

PerformRx makes the following recommendation:Remove Dulera from the formulary for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA. a. Members 9 years of age or older currently on this product will be converted to either Breo Ellipta or generic Airduo Respiclick. b. Members 8 years of age or younger will be allowed to obtain Dulera without the need of a prior authorization Make no other changes to the formulary status of any other products within this class.

Committee approved as recommended

25-0

 GLP-1 Agonists

 PerformRx makes the following recommendation: Add Ozempic to the formulary for KF/AHC/AHN/CHC, AHDC and SHSC with a step therapy requirement of a prior trial of a metformin product. Remove Victoza from the formulary for KF/AHC/AHN/CHC, AHDC and SHSC. No indefinite grandfathering, with members currently on Victoza converted to either Trulicity or Ozempic. Add Ozempic to the formulary for ACLA without any step therapy requirement. Make no other changes to the formulary status of any other product in this class.

Add Ozempic KF/AHC/AHN/ CHC, AHDC and SHSC formularywith step therapy.  Add to ACLA formulary with no step therapy

25-0 PerformRx will update the criteria and formulary/PDL with any changes

27

 

Issue

Discussion

Conclusion/ Results 

 Vote 

Action/ Person Responsible 

SHSC- Banzel PerformRx makes the following recommendation: Retire the criteria and making Banzel formulary/preferred with step therapy with another formulary/preferred anticonvulsant medication, age limit of greater than 1year old and ICD-10 codes (listed below) to process at the point of sale for SHSC.  ICD_10 Code –Code Description o G40.811 – Lennox-Gastaut syndrome, not intractable, with status epilepticus o G40.812- Lennox-Gastaut syndrome, not intractable, without status epilepticus o G40.813- Lennox-Gastaut syndrome, intractable, with status epilepticus o G40.814- Lennox-Gastaut syndrome, intractable, without status epilepticus

Committee approved as recommended 25-0

PerformRx will update the criteria and formulary/PDL with any changes

 SHSC - Dostinex

PerformRx makes the following recommendation: Retire the criteria and making Dostinex formulary/preferred with step therapy with bromocriptine along with an ICD-10 code (see below) processed at the point of sale for SHSC. ICD_10 Code –Code Description o E22.1- Hyperprolactinemia

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

28

 

Issue

Discussion

Conclusion/ Results 

 Vote 

Action/ Person Responsible 

 CNS Stimulants Age Limit PA Criteria (ACLA)

PerformRx makes the following recommendation: Approve the updated criteria for ACLA to clearly define what Metadate ER tablets products are preferred. In addition, adding missing products from the Non- Preferred section.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Cystic Fibrosis Oral Agents PA Criteria

 PerformRx makes the following recommendation: Approve the oral cystic fibrosis criteria with the addition of Symdeko for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Lemtrada

 PerformRx makes the following recommendation: Approve the updated prior authorization criteria forKF/AHC/AHN/CHC, AHDC, SHSC, and ACLA with the removal of ECG requirement as it is no longer recommended in labeling. Approve the criteria for BCC with the following change: included all formulary products as prerequisite option.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Opioid PA Criteria- SHSC

 PerformRx makes the following recommendation: Add prior authorization criteria to limit member to one long-acting opioid fill per 30 days.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Hepatitis C PA Criteria- AHDC

 PerformRx makes the following recommendation: Change fibrosis score coverage from F2-F4 and now allow F0-F4 fibrosis coverage

Informational Only

PerformRx will update the criteria and formulary/PDL with any changes

29

 

Issue

Discussion

Conclusion/ Results 

 Vote 

Action/ Person Responsible 

 Hepatitis C PA Criteria- AHDC

 PerformRx makes the following recommendation: Change fibrosis score coverage from F2-F4 and now allow F0-F4 fibrosis coverage

Informational Only

PerformRx will update the criteria and formulary/PDL with any changes

 Tysabri

PerformRx makes the following recommendation: Approve the criteria for BCC with the following change: addition of all formulary products as possible pre-requisite options.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

7. New Business  

 Opioid containing cough/cold medication age limits

PerformRx makes the following recommendation: Add the age limits listed below to KF/AHC/CHC, AHN, AHDC, SHSC and ACLA & BCC a. Codeine products in combination with antihistamines or decongestants (i.e. promethazine with codeine, guaifenesin with codeine etc.)- change the age limit from 12 years of age, to only allowing these products to pay in members 18 years of age and older. b. Hydrocodone products in combination with antihistamines or decongestants (i.e. Tussionex)- Add an age limit only allowing it to pay in members 18 and older products.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Guanylate Cyclase-C Receptor Agonists Criteria- BCC

 PerformRx makes the following recommendation: Approve this newly-created criteria for BCC to more effectively manage requests for this drug class.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

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Issue

Discussion

Conclusion/ Results 

 

Vote Action/ Person Responsible

 Lidoderm PA Criteria - BCC

 PerformRx makes the following recommendation: Approve this newly developed criteria for BCC

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Weight Loss Medications SHSC – Informational Only

 PerformRx makes the following recommendation: Approve the updated criteria to ensure compliance with state requirements that only 2 products (Alli &Xenical) are eligible for coverage.

Informational Only

PerformRx will update the criteria and formulary/PDL with any changes.

8. Drug Reviews Therapeutic Classes:

.

 Oral Antihistamine Agents

PerformRx makes the following recommendation: Removing promethazine vials from the formulary for KF/AHC/AHN/CHC, AHDC, SHSC and ACLARemoving clemastine from the formulary for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA Remove carbinoxamine 4mg tablets from the formulary for SHSC Add chlorpheniramine 4mg tablets to the formularyfor AHDC, ACLA and SHSC Add diphenhydramine 25mg tablets and capsules to the formulary for ACLA. 

Committee approved as recommended 

25-0  PerformRx will update the criteria and formulary/PDL with any changes. 

 Selective serotonin Reuptake Inhibitors

PerformRx makes the following recommendation: Add generic Prozac 40mg capsule to the formulary for SHSC Remove Lexapro solution from formulary with indefinite grandfathering for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA Remove Celexa solution from formulary with indefinite grandfathering for KF/AHC/AHN/CHC, AHDC, and SHSC Remove Paxil CR from the formulary with indefinite grandfathering for AHDC, SHSC and ACLA

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

31

 

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

 Contraceptive Devices Condoms/Diaphrams 

 PerformRx makes the following recommendation: Make no changes to the formulary status of the products within this class.

Committee approved as recommended 

25-0  No Changes 

 Gaucher Disease with PA Criteria

PerformRx makes the following recommendation: Approve the updated Gaucher’s Disease Treatment Agents Prior Authorization Criteria for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA. Make no changes to the formulary status of the products within this class.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

Short Acting Insulins PerformRx makes the following recommendation: Add Admelog and Admelog Solostar to the formulary for KF/AHC/AHN /CHC, AHDC, SHSC, ACLA and BCC with a quantity limit of 30mls per 30 days for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA. Admelog vial will be added to the formulary with a quantity limit of 60 ml/30 days and Admelog Solostar will be added to the formulary with a quantity limit of 30 ml/30 days for BCC. Remove Humalog vials/Kwikpen/cartridge, Apidra and Apidra Solostar from the formulary for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA. Convert members on Humalog vials / Kwikpen /cartridge, Apidra or Apidra Solostar to either Admelog or Admelog Solostar. No indefinite grandfathering for these members. Remove Novolog Flexpen and Novolog from the formulary for SHSC and ACLA. Convert members to either Admelog or Admelog Solostar. No indefinite grandfathering for members on Novolog Flexpen or Novolog. Make no other changes to the formulary status of any other product within this class.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

32

 

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

 SGLT-2 Inhibitors

PerformRx makes the following recommendation: Add Steglatro and Segluromet to the formulary for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA with step therapy requirements. Members must have a previous trial of a metformin product in their history before Steglatro and Segluromet will pay at the point of sale. Add Steglatro and Segluromet to the formulary with prior authorization for BCC. Make no other changes to the formulary status of any other products within this class.

Committee approved, requested we speak to prior authorization team if Jardiance product line is asked for CVD, it is approved and the Steglatro product line is not required first.

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

Single Product Reviews:  

 Entresto

PerformRx makes the following recommendation: Add Entresto to the formulary for KF/AC/AHN/CHC, AHDC, SHSC and ACLA Retire the drug specific prior authorization criteria.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Bidil

PerformRx makes the following recommendation: Add Bidil to the formulary for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Ridaura

 PerformRx makes the following recommendation: Make no changes to the formulary status of Ridauraat this time

Committee approved as recommended

25-0 No Changes

33

  

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

 Luxturna

PerformRx makes the following recommendation: Make no changes to the formulary status of Luxturna at this time.

Committee approved as recommended

25-0 No Changes

 Provenge

PerformRx makes the following recommendation: Make no changes to the formulary status of Provenge at this time

Committee approved as recommended

25-0 No Changes

 Symfi Lo

PerformRx makes the following recommendation: Add Symfi and Symfi Lo to the formulary for KF/AHC/AHN/CHC and SHSC.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

New Products Reviews

PerformRx makes the following recommendation: Add to the formulary for KF/AHC/AHN/CHC, AHDC. Already on formulary for SHSC and ACLA Eliquis Zenpep  Add to the formulary for KF/AHC/AHN/CHC and SHSC Already added to the formulary for ACLA Symfi Lo  Add to the formulary with step therapy for ACLA Segluromet Steglatro Add to the formulary for ACLA Ozempic  Add to the formulary with step therapy for KF/AHC/AHN/CHC, AHDC and SHSC Ozempic Segluromet Steglatro

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

34

 

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

New Products Reviews… continued

Remain Non-Formulary for KF/AHC/AHN/CHC, AHDC and SHSC. Add to formulary for ACLA Trogarzo  

Remain Non-Formulary for KF/AHC/AHN/CHC, AHDC and SHSC. Already on formulary for ACLA Biktarvy  

Remain Non-Formulary & use drug specific PA Criteria for KF/AHC/AHN/CHC, AHDC. Already on formulary with ST For SHSC and ACLA Daliresp  

Remain Non-Formulary & use drug specific PA Criteria, already on formulary for ACLA Makena Quick- Shot AutoInjector Remain Non-Formulary & use drug specific PA Criteria Alunbrig Bosulif Endari Erleada Imbruvica Lyrica CR Opdivo Sublocade Symdeko Trisenox Remain Non-Formulary Adzenys ER Bonjesta Clenpiq Clinimix DicloPR DiThol Fibryga Firvanq Giapreza Heplisav-B Impoyz

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

35

 

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

New Products Reviews… continued

Remain Non-Formulary Lonhala Lutathera Luxturna Nipride RTU Noctiva Odactra Prolastin-C Sinuva Steglujan Solosec Tisseel Xigduo XR

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

9. Prior Authorization Criteria Review Specialty Drugs - Existing:

 Acthar

PerformRx makes the following recommendation: Maintain the current criteria for KF/AHC/ AHN/CHC, AHDC, SHSC and ACLA with no changes.

Committee approved as recommended

25-0 No Changes

 Ampyra

 PerformRx makes the following recommendation: Maintain the current criteria for KF/AHC/AHN /CHC, AHDC, SHSC and ACLA with no changes. 

Committee approved as recommended 

25-0  No Changes 

 Epogen

 PerformRx makes the following recommendation: Maintain the current criteria for KF/AHC/AHN/ CHC, AHDC, SHSC and ACLA. 

Committee approved as recommended 

25-0  No Changes 

 Erythropoiesis Stimulating Agents

PerformRx makes the following recommendations: Maintain the current criteria for KF/AHC/AHN/ CHC, AHDC, SHSC and ACLA with no changes

Committee approved as recommended

25-0 No Changes

36

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

9. Prior Authorization Criteria Review Specialty Drugs - Existing:

 

 Hep C- ACLA only

PerformRx makes the following changes: Approve the prior authorization criteria for ACLA with the following changes: Removed Fibroscan and added FibroSure/FibroTest as a means of determining fibrosis level, removed drug testing and specific timeframe for sobriety, changed to attestation that patient is not actively abusing, removed provider restriction to be in compliance with directive from state.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Kuvan

PerformRx makes the following changes: Approve the criteria with the removal of Phe restricted diet in the reauthorization sections and adding clarification on the Phe level results requiredfor reauthorization for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Oncology without specific criteria

PerformRx makes the following changes: Maintain the current criteria for KF/AHC/AHN/ CHC, AHDC, SHSC, ACLA and BCC with no changes.

Committee approved as recommended

25-0 No Changes

 Rituxan

PerformRx makes the following changes: Approve the updated prior authorization criteria forKF/AHC/AHN/CHC, AHDC, SHSC and ACLA with the following changes: o The addition of Rituxan Hycela o The removal of a glucocorticoid and azathioprine as prerequisite therapy for GPA or MPA and the addition of a nephrologist as an accepted prescriber for these indications.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Soliris

PerformRx makes the following recommendation: Approve this updated prior authorization criteria forKF/AHC/AHN/CHC, AHDC, SHSC and ACLA with the addition of the new indication of Myasthenia Gravis and specific criteria and updating general criteria for all other FDA labeled indications

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

37

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible9. Prior Authorization Criteria Review Specialty Drugs - Existing:

 Long acting injectable antipsychotics

PerformRx makes the following changes: Approve the updated prior authorization criteria forKF/AHC/AHN/CHC, AHDC, SHSC and ACLA with the following changes: removed requirement that member has noncompliance issues and has failed adherence measures to improve.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

Specialty Drugs New:  

 Amyotrophic Lateral Sclerosis Agents\

PerformRx makes the following recommendation: Approve this newly-created criteria for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA to ensure appropriate approval of these agents.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

Non-Specialty - Existing:  

 Buprenorphine products

 PerformRx makes the following recommendation: Approve the criteria for BCC with no changes.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Non-Formulary PA Criteria

PerformRx makes the following recommendation: Change the reviewer note to refer to the Brand name medication criteria as the Medwatch criteria is now retired for ACLA and adapting for AHDC. Change the reviewer note to refer to the Brand name medication criteria as the Medwatch criteria is now retired for Keystone First, AmeriHealth Caritas, AmeriHealth Northeast and Community Health Choices, BCC and retiring for AmeriHealth DC. Change the reviewer note to refer to the Brand name medication criteria as the Medwatch criteria is now retired for SHSC

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

38

Issue Discussion Conclusion/ Results  Vote Action/ Person ResponsibleNon-Specialty - Existing:  Opioid Containing Products

PerformRx makes the following recommendation: Approve the criteria with changes associated with state mandated edits and to help facilitate in the review process for KF/AHC/AHN/CHC. Approve the criteria with minor updates for AHDC

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

Opioid Dependence Agents

PerformRx makes the following recommendation: Approve the criteria with changes associated with state mandated edits and to help facilitate in the review process for KF/AHC/AHN/CHC

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes.

 Lidoderm

PerformRx makes the following recommendation: Approve the Lidoderm prior authorization criteria without any changes for KF/AHC/AHN/CHC, AHDC, ACLA and SHSC.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Mepron

PerformRx makes the following recommendation: Approve the Mepron prior authorization criteria without any changes for KF/AHC/AHN/CHC, AHDC, SHSC and ACLA.

Committee approved as recommended

25-0  PerformRx will update the criteria and formulary/PDL with any changes

 Multaq

PerformRx makes the following recommendation: Approve the Multaq prior authorization criteria with the appropriate changes for KF/AHC/AHN/CHC, AHDC, BCC, ACLA and SHSC. PerformRx recommends adding criteria for which members a negative pregnancy test is/is not warranted.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Serotonin Receptor Agonists (Triptans)

PerformRx makes the following recommendation: Approve the Serotonin Receptor Agonists (Triptans) prior authorization criteria with the appropriate changes (the removal of Zecuity which is no longer available) for KF/AHC/AHN/CHC, AHDC, and SHSC. Approve the Serotonin Receptor Agonists (Triptans) prior authorization criteria with the appropriate changes (the removal of Zecuity which is no longer available) for ACLA.

Committee approved as recommended

25-0 PerformRx will update the criteria and

formulary/PDL with any changes

39

Issue Discussion Conclusion/ Results  Vote Action/ Person ResponsibleNon-Specialty - Existing:  Zyvox

PerformRx makes the following recommendation: Maintain the current criteria for KF/AHC/AHN CHC, AHDC, ACLA and SHSC with no changes.

Committee approved as recommended

25-0 No Changes

 Lyrica and Lyrica CR

PerformRx makes the following recommendation: Approve the Lyrica prior authorization criteria with the addition of the newly approved Lyrica CR and placement of this product with its FDA approved indication of use for KF/AHC/AHN/CHC, AHDC, and SHSC. Approve the Lyrica prior authorization criteria with the addition of the newly approved Lyrica CR and placement of this product with its FDA approved indication of use for ACLA.

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

Pediculicides

PerformRx makes the following recommendation: Approve the Pediculicides prior authorization criteria without any changes for KF/AHC/AHN /CHC, AHDC, ACLA and SHSC.

Committee approved as recommended. Sklice is preferred for KF/AHC/AHN/ CHC with no ST requirement

25-0 PerformRx will update the criteria and formulary/PDL with any changes

 Skeletal Muscle Relaxants

PerformRx makes the following recommendation: Maintain the current criteria for SHSC and ACLA with no changes

Committee approved as recommended

25-0 No Changes

 Qualaquin

PerformRx makes the following recommendation: Maintain the current criteria for SHSC, ACLA, and BCC with no changes.

Committee approved as recommended

25-0 No Changes

 Sporanox

PerformRx makes the following recommendation: Maintain the current criteria for ACLA and SHSC with no changes.

Committee approved as recommended

25-0 No Changes

   

40

Issue Discussion Conclusion/ Results  Vote Action/ Person Responsible

Non-Specialty - New:  

 Formulary Medications with Diagnosis Code Requirement

PerformRx makes the following recommendation: Approve the criteria Diagnosis Code Requirement for KF/AHC/AHN/CHC, AHDC and SHSC

Committee approved as recommended

25-0 PerformRx will update the criteria and formulary/PDL with any changes

10. DTM Program Description

Overview of DTM program Description provided.

Informational Only PerformRx

11. Recalls

Zinbryta Voluntary Market Removal

 SHSC 2 members notified BCC 2 members notified ACLA 0 members notified Prestige 1 member notified There were no other Non-lot level recalls to address

Informational

Shalis Lightner

Jeff Kreitman

12. Adjournment

 The meeting adjourned at 7:47 PM EST 

N/A

The next meeting August 6, 2018from 6:00 PM‐ 8:00 PM. 

       

Dr. William Burnham, MD - Chair Date

41