Dur board members present mhd staff present



Download 89.47 Kb.
Date conversion08.07.2018
Size89.47 Kb.
DRUG UTILIZATION REVIEW BOARD

January 20, 2016

Department of Natural Resources, LaCharrette/Nightengale Conference Rm, Jefferson City MO



DUR BOARD MEMBERS PRESENT

MHD STAFF PRESENT

Susan Abdel-Rahman, Pharm D

Mark Roaseau, R.Ph, Clinical Pharmacist

Stacy Mangum, Pharm D

Stephen Calloway, R. Ph

Charlene Heyde, RPh

Jenna McTeer, RN

Randy Beckner, Pharm D

Andrew Haslag, Fiscal Manager

Sandra Bollinger, PharmD

Angela Wilson, Manager Band I

Ginger Nicol

Lisa Smith, DUR Coordinator




Megan Goldthrite, Administrative Assistant




Elizabeth Short,










DUR BOARD MEMBERS ABSENT

CONTRACTED STAFF PRESENT

Kirk Nelson, MD

Josh Moore, Clinical Pharmacist, Xerox

Jennifer Passanise, ANCC-BC, FNP

Katie Wilbers, Clinical Pharmacist, Xerox

Glenn Talboy

Luke Boehmer, Xerox

Kenneth Haller, MD

1 Student





















OTHERS IN ATTENDANCE

Geri Roling, Wipro

Phil King, Pfizer




John Kirby, Sanofi

Linda Krueger, Acadia




Chet Steckler, Perdue







Tim Ludlam, Allergan







Berend Koops, Merck







Todd Herman, Merck







Terry McCurren Otsuka America







Rob Hansen, Pfizer







Eric Gardner, Vertex







*Many names on the sign in sheet were illegible. Sign in sheet on file for review.


Welcome, Introductions and Opening Remarks

Susan Abdel-Rahman, Pharm D, called the meeting to order. A quorum was established. Stephen Calloway, R.Ph facilitated the meeting on behalf of the MO HealthNet Division (MHD).

Minutes Approval

Vote on the October 2015 meeting minutes were postponed until the April 2016 meeting.

Pharmacy Program/Budget Update

Stephen Calloway presented a brief powerpoint with support by Andrew Haslag. The presentation contained graphs representing an expenditure amount per member for all eligible participants, disabled participants, elderly participants, and other; a pie chart of participants; and expenditures by participants. Information on the Blind Pension was also presented, with support from Angela Wilson and Lisa Smith. Generic dispensing rates were shared with the Committee. Information on the Blind Pension was also presented, with support from Angela Wilson. Mr. Calloway also mentioned that MO HealthNet is working to implement expansion of Medicaid Managed Care and Telehealth, while continuing to manage expenses. Mark Roaseau spoke about what is going on with ICD-10 and October 1st official start date.

Review of Prior Authorization Meeting

Copies of the agenda and draft minutes, including public hearing, from the December 17, 2015 Drug Prior Authorization Committee Meeting were not included (they will be sent electronically prior to the April 2016 DUR meeting.

Implementation Schedule

An updated copy of the Proposed Implementation Schedule for Edits, including PDL classes was included in the Members’ meeting packet and provided as a handout to all attending. The schedule included the therapeutic classes will be implemented April 2016. PDL decisions from September/October will be implemented January 2016. Schedules may be found on the MHD web page at http://dss.missouri.gov/mhd/cs/pharmacy/impsched.pdf

New Drug Review

Stephen Calloway reviewed the new drug products that were identified for the quarter July, August, and September 2015, and the recommended status within the clinical program..

Discussion A listing of products recommended for open access, clinical edit, preferred drug list (PDL) product, or continued prior authorization was provided in the Members’ meeting packet for discussion and action. This listing was also provided as a handout to all attending.

Public Hearing – No public hearing on these drugs.

Decision – Members voted to accept the new drug recommendations as presented. (See Roll Call Vote)



Old Business

Stephen Calloway informed the Board that the approved Preferred Drug List (PDL) from September/October will be implemented in January 2016. Stephen Calloway also advised there was a follow up discussion on DMARDS, they will be revisited in the March 2016 meeting.



Clinical Edit




Evzio

Discussion – Mr. Calloway stated there were changes or modifications recommended, clinical edit

Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)



Vyvanse

Discussion – Mr. Calloway stated that this edit included Vyvanese for ADHD medications, and Mr. Calloway went over indications for the drug.

Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)



Corlanor

Discussion – Mr. Calloway stated there had been a discussion regarding off label usage of the drug

Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)



Entresto

Discussion – Mr. Calloway went over indications for the drug.

Decision – This edit was accepted and added to the block vote. (See Roll Call Votes)



Preferred Drug List (PDL) Annual Review

Products and classes under review this quarter have existing contracts through March 31, 2016. Recommended changes to the edits were bolded for easy identification.

Alzheimer’s Agents


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Antiemetic Agents


Discussion – Mr. Calloway stated there are no changes recommended for this class.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)




Cox-II Inhibitor Agents


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Fibromyalgia & Neuropathic Pain Agents


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Long-Acting Narcotics


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Non-Ergot Dopamine Receptor Agonists

Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



NSAID Agents


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Opiate Dependence Agents


Discussion – Mr. Calloway stated there are no changes recommended for this class.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Sedative Hypnotic Agents


Discussion – Mr. Calloway stated there are no changes recommended for this class.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Skeletal Muscle Relaxants


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Serotonin Receptor Agonists (Triptans)


Discussion – Mr. Calloway reviewed the criteria document, reviewing preferred and non-preferred agents.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)



Tramadol-Like Agents

Discussion – Mr. Calloway stated there are no changes recommended for this class.

Decision – This PDL recommendation was accepted and added to the block vote. (See Roll Call Votes)




Xerox Update

Luke Boehmer, PharmD reviewed clinical edits, utilization data and trends for DMARDS. Also, spoke about the different reasons for denials. Then he spoke about the Opiate Dependence Agents.

Preferred Drug List Discussion/Therapeutic Classes

A handout of therapeutic categories to be reviewed for inclusion on the Preferred Drug List for the next phase and meeting was included in the meeting packet. This handout was also provided to all attendees and will be posted to the Division's web page.

Top 25 Drugs by Cost

Dr. Boehmer reviewed the Top 25 Drugs Summary Reports for the 4th quarter of 2014. Two versions were presented: one report ranked drug spend by dollars and the other by utilization/claims.


Call Center Statistics

A handout detailing pharmacy help desk call center activity was provided for all attending. Cyber Access Active User Counts and Logging Information reports detailing activity were shared. Dr. Boehmer reviewed how many sites/physical locations are trained and have access to CyberAccess. Reports also detailed the number and type of prescribers and active users on CyberAccess.

Adjourn

The DUR Board went into Executive Session for the sole purpose of discussing individual participant specific medical information. At the conclusion of these discussions the group adjourned entertaining no further business, actions or motions. (See attached roll call vote). The next meeting is scheduled for

April 20, 2016.




Roll Call Votes – January 20, 2016


MEMBER

MEETING MINUTES

ALL RECOMMENDATIONS BLOCK VOTE

CLOSED SESSION

ADJOURN

Susan AbdelRahman




Y

Y




Charlene Heyde




Y

Y




Sandra Bollinger




Y

YM




Kenneth Haller




A

A




Glenn Talboy




A

A




Jennifer Passanise




A

A




Stacy Mangum




Y

A




Kirk Nelson




A

A




Ginger Nicol




Y

Y




Randy Beckner




Y (Abstained from Antimetic Agents, Non Ergot Dopamine Receptor Agonists, and 5HT)

Y






EXECUTIVE SESSION

January 20, 2015

DUR BOARD MEMBERS PRESENT

MHD STAFF PRESENT

Susan Abdel-Rahman, Pharm D

Mark Roaseau, R.Ph, Clinical Pharmacist

Stacy Mangum, Pharm D

Stephen Calloway, R. Ph

Charlene Heyde, RPh

Jenna McTeer, RN

Randy Beckner, Pharm D

Andrew Haslag, Fiscal Manager

Sandra Bollinger, PharmD

Angela Wilson, Manager Band I

Ginger Nicol

Lisa Smith, DUR Coordinator




Megan Goldthrite, Administrative Assistant




Elizabeth Short



DUR BOARD MEMBERS ABSENT

CONTRACTED STAFF PRESENT

Kirk Nelson, MD

Josh Moore, Clinical Pharmacist, Xerox

Jennifer Passanise, ANCC-BC, FNP

Katie Wilbers, Clinical Pharmacist, Xerox

Glenn Talboy

Luke Boehmer, Xerox

Kenneth Haller, MD

1 Student




Minutes Review

Minutes of the October Executive Session were approved as submitted.

Case Reviews

Jenna McTeer, RN reviewed 2 case.

Adjourn

Executive session adjourned.


The database is protected by copyright ©dentisty.org 2016
send message

    Main page