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THOMAS J. VILSACK, GOVERNOR DEPARTMENT OF HUMAN SERVICES SALLY J. PEDERSON, LT. GOVERNOR KEVIN W. CONCANNON, DIRECTOR

Iowa Medicaid Pharmaceutical and Therapeutics (P & T) Committee Meeting

December 8, 2005

Location: Room 116 Time: 9:30 a.m. – 6:00 p.m. State Capitol Des Moines, Iowa

AGENDA

1. Welcome & Introductions a) Committee Members b) Staff 2. Approval of the minutes 3. Public Comment (See attachment 1 for Speaker Disclosure) 4. Update a) Preferred List b) Prior Authorization Criteria 5. Economic Review of the Iowa Medicaid Preferred Drug List, New , New Generic Drugs, and New Dosage Forms (Closed Executive Session)

*Lunch Break 12:15 p.m.-1:00 p.m.*

6. Preferred Drug List (PDL), Newly Released Drugs, Newly Released Generic Drugs and New Dosage Forms discussion and deliberation (Open Session) (See attachments 2, 3 and 4) 7. Final Recommendations by the P & T Committee on the Preferred Drug List **Disclaimer: Executive Sessions may be necessary during the deliberation process**

www.IowaMedicaidPDL.com For more information contact Sandy Pranger at [email protected] or (515) 725-1272

IOWA MEDICAID ENTERPRISE - 100 ARMY POST ROAD - DES MOINES, IA 50315 Attachment 1 State of Iowa Conflict of Interest Disclosure

The Iowa Medicaid Pharmaceutical and Therapeutics (P&T) Committee and persons testifying or presenting to the Iowa Medicaid P&T Committee are asked to disclose any financial or other affiliation with organizations that may have a direct or indirect interest in the business in front of the Committee.

A financial interest may include, but is not limited to, being a shareholder in the organization; being on retainer with the organization; or having research or honoraria paid by the organization.

An affiliation may include holding a position on an advisory committee or some other role or benefit to a supporting organization.

The existence of such relationships does not necessarily constitute a conflict of interest and will not preclude an individual from participating on, or addressing the P&T Committee. This policy is intended to openly identify any potential conflicts so that the P&T Committee members and the public are able to form their own judgments.

Please check the box of the statement that best applies.

Statement of No Conflicts I do not have a current or recent (within the last 12 months) financial arrangement or affiliation with any organization that may have a direct interest in the business before the Iowa Medicaid P&T Committee.

Disclosures I have a financial interest, affiliation or am employed by an organization that may have a direct interest in the business before the Iowa Medicaid P&T Committee

I refuse to state my affiliations

Organization Role/Relationship

_ (print name)

_

Attachment 2

Preferred Drug List Discussion Order

1. Ace and Thiazide Combo’s 2. Ace Inhibitors 3. Ace Inhibitors and CA Channel Blockers 4. Acne Products: Isotretinoin 5. Agents for Fabrys Disease 6. Agents for Gaucher Disease 7. Agents for Pheochromocytoma 8. Alcohol Deterrents 9. ALS Drug 10. Alzheimer – Cholinomimetics 11. Amino Glycosides 12. – Misc. 13. Anaphylaxis Therapy 14. Androgens / Anabolics 15. Angiotensin Receptor Blocker 16. Anorectal – Misc. 17. 18. Anti-Infective Combo’s – Misc. 19. – Isosorbide Nitrate 20. Antiarrhythmics 21. Antiasthmatic – Combos 22. Antiasthmatic – Alpha Proteinase Inhibitor 23. Antiasthmatic – Anti-Cholinergics 24. Antiasthmatic – Anti-Inflammatory Agents 25. Antiasthmatic – Beta- 26. Antiasthmatic – Hydro-Lytic Enzymes 27. Antiasthmatic – Leukotriene Receptor Antagonists 28. Antiasthmatic – Misc. Respiratory Inhalants 29. Antiasthmatic – Mixed Adrenergics 30. Antiasthmatic – Mucolytics 31. Antiasthmatic – Nasal Misc. 32. Antiasthmatic – Nasal Steriods 33. Antiasthmatic – Steriod Inhalants 34. Antiasthmatic – Xanthines 35. – Misc. 36. Anti-Cataplectic Agents 37. 38. 39. 40. Antidotes – Chelating Agents 41. – 5-HT3 Receptor Antagonists/Substance P Neurokinin 42. Antiemetic – Anticholinergic / Dopaminergic 43. – Assorted 44. – Non-Sedating 45. Antihistamines – Non-Sedating / Decongestants 46. Antihistamines – Other 47. Antihypertensive Combos 48. Antihypertensives – Central 49. Antileprotic

50. Antimalarial Agents 51. / Antituberculosis 52. Anti-Parkinsonian Drugs 53. Agents 54. Anti-Psoriatics – Biologicals 55. Anti-Psoriatics – Non-Biologicals 56. Antispasmodics 57. Antispasmodics – Long Acting 58. Antithyroid Therapies 59. Arb’s and 60. Arthritis – Misc. 61. Artificial Saliva / 62. Beta Blockers – Alpha / Beta 63. Beta Blockers – Cardio Selective 64. Beta Blockers – Non-Selective 65. Beta Blockers and Combo’s 66. Beta – Lactams / Clavulanate Combo’s 67. BPH 68. Calcium Channel Blockers – Amlodipines 69. Calcium Channel Blockers – Diltiazems 70. Calcium Channel Blockers – Felodipines 71. Calcium Channel Blockers – Isradipines 72. Calcium Channel Blockers – Nifedipines 73. Calcium Channel Blockers – Nisoldipine 74. Calcium Channel Blockers – Verapamils 75. Carbapenems 76. Cardiac Glycosides 77. Carnitine Replenisher – Agents 78. CCB / Lipid 79. Cephalosporins 80. Chelating Agents 81. Cholesterol – Bile Sequestrants 82. Cholesterol – Fibric Acid Derivatives 83. Cholesterol – HMG COA + Absorb Inhibitors 84. Cholinergic 85. Compounding Materials 86. Contraceptives – Bi-Phasic Combinations 87. Contraceptives – Injectable 88. Contraceptives – Monophasic Combination O/C’s 89. Contraceptives – Patches / Vaginal Products 90. Contraceptives – Progestin Only 91. Contraceptives – Tri-Phasic Combinations 92. Cough / Cold – Antitussive – Narcotic 93. Cough / Cold – Antitussive – Non-Narcotic 94. Cough / Cold – Antitussive – Expectorant 95. Cough / Cold – Antitussive – Expectorant – Decongest – Antihist 96. Cough / Cold – Antitussive – Expectorant – Decongestant 97. Cough / Cold – Decongestant & Anticholinergic 98. Cough / Cold – Decongestant & 99. Cough / Cold – Decongestant w/Expectorant 100. Cough / Cold – Decongestant – Antihistamine w/Expectorant 101. Cough / Cold – Decongestant – Antihistamine – Anticholinergic 102. Cough / Cold – Expectorant Mixtures

103. Cough / Cold – Expectorants 104. Cough / Cold – Narcotic Antitussive – Antihistamine 105. Cough / Cold – Narcotic Antitussive – Decongestant 106. Cough / Cold – Narcotic Antitussive – Decongestant – Antihistamine 107. Cough / Cold – Non-Narc Antitussive – Antihistamine 108. Cough / Cold – Non-Narc Antitussive – Decongestant 109. Cough / Cold – Non-Narc Antitussive – Decongestant – Antihistamine 110. Cough / Cold – Systemic Decongestants 111. Cough / Cold – Topical Decongestants 112. Cox 2 Inhibitors – Highly Selective 113. Cox 2 Inhibitors – Selective 114. Cyto-Megalovirus Agents 115. Dental Products 116. Diabetic – Alphaglucosidase 117. Diabetic – Insulin 118. Diabetic – Insulin Penfills 119. Diabetic – Meglitinides 120. Diabetic – Oral Biguanides 121. Diabetic – Oral Sulfonylureas 122. Diabetic – Other 123. Diabetic – Sulfonyluria / Biguanide 124. Diabetic – Thiazol 125. Diabetic – Thiazol / Biguanide Combo 126. Diagnostic Biologicals 127. Diuretics 128. Dopamine Receptor 129. Ear 130. Electrolytes / Nutritionals 131. Erythropoeisis Stimulating Agents 132. Estrogen Combo’s 133. Estrogens – Patches 134. Estrogens – Tabs 135. Fluoroquinolones 136. GI – Anti-Flatulents / GI Stimulants 137. GI – Antidiarrheal / – Misc. 138. GI – Antiperistaltic Agents 139. GI – Digestive Enzymes 140. GI – H2-Antagonists 141. GI – Inflammatory Bowel Agents 142. GI – Irritable Bowel Syndrome Agents 143. GI – Misc. 144. GI – Misc. Anti-Ulcer 145. GI – Prostaglandins 146. GI – Proton Pump Inhibitor 147. GI – Proton Pump Inhibitor / NSAID Combo 148. GI – Ulcer Anti-Infective 149. – Corticotropin 150. Glucocorticoids – 151. Gout 152. Granulocyte CSF 153. Growth Hormone 154. Hemostatic 155. Hepatitis B Only

156. Hepatitis C Agents 157. Hereditary Tyrosinemia Type 1 (HT-1) Treatment – Agents 158. Herpes Agents 159. Hyperparathyroid Treatment – D Analogs 160. Hyperparathyroid Treatment – Vitamin D Analogs and Calcimimetics 161. Immune Serums 162. Agents 163. Irrigation Solutions 164. K Removing Resins 165. Lincosamides / Oxazolidinones / Leprostatics 166. Macrolides / Erythromycin’s / Ketolides 167. Migraine – Carboxylic Acid Derivatives 168. Migraine – Ergotamine Derivatives 169. Migraine – Misc. 170. Migraine – Selective Serotonin Agonists (5HT) – Injectables 171. Migraine – Selective Serotonin Agonists (5HT) – Tabs 172. Minerals 173. Mouth – Topical Oral 174. Mouth – Steroids 175. Mouth Anti-Infectives 176. Mouth Antiseptics 177. Mucopolysaccharidosis 178. Multiple Sclerosis Agents 179. – Combinations 180. Muscle Relaxants 181. Narcotic – Antagonists 182. Narcotics – Misc. 183. Narcotics – Selected 184. Narcotics – Long Acting 185. Neurologics – Misc. 186. Neuromuscular Blocking Agents 187. Nicardipines 188. Nitro – Ointment / Cap / CR 189. Nitro – Patches 190. Nitro – Sublingual / Spray 191. NSAIDS 192. Op. Adrenergic Agents 193. Op. Antiallergics 194. Op. Antibiotics 195. Op. Antiinflammatory / Steroids Ophth 196. Op. Beta-Blockers 197. Op. Carbonic Anhydrase Inhibitors / Combo 198. Op. Cycloplegics 199. Op. Miotics – Direct Acting 200. Op. Misc. 201. Op. NSAID’s 202. Op. Prostaglandins 203. Op. Quinolones 204. Op. Selective Alpha Adrenergic Agonists 205. Osteoporosis 206. Oxytocics 207. Parkinsons – Anticholinergics 208. Parkinsons – Comt Inhibitors

210. Parkinsons – Selected Dopamin Agonists 211. Peripheral Vasodilators 212. Phosphate Binders 213. Phosphodiesterase Inhibitors 214. Aggr. Inhibitors / Combo’s – Misc. 215. Platelet Aggregation Inhibitors 216. Pressors 217. Progestins 218. Pulmonary Anti-Hypertensives 219. Purine Analog 220. Rheumatoid Arthritis – Biologicals 221. Rheumatoid Arthritis – Non-Biologicals 222. RSV Prophylaxis 223. / – Non-Benzodiazepines 224. Somatostatic Agents 225. Tetracyclines 226. 227. Tissue Plasminogen Activator 228. Topical – Acne Preparations 229. Topical – 230. Topical – Antifungals 231. Topical – Antineoplastics 232. Topical – 233. Topical – Antiseborrheics 234. Topical – Antiseptics / Disinfectants 235. Topical – Antivirals 236. Topical – Astringents / Protectants 237. Topical – Burn Products 238. Topical – Cauterizing Agents 239. Topical – 240. Topical – Emollients 241. Topical – Enzymes / Keratolytics / Urea 242. Topical – Genital Warts 243. Topical – Immunomodulators 244. Topical – Local Anesthetics 245. Topical – Nasal Antibiotics 246. Topical – Scabicides and Pediculicides 247. Topical – Steroid Combinations 248. Topical – Steroid Local Anesthetics 249. Topical – Tretinoids 250. Topical – Wound / Decubitus Care 251. Urea Cycle Disorder – Agens 252. Urological – Misc. 253. Vaginal – Antifungals 254. Vaginal – Antibacterials 255. Vaginal – Contraceptives 256. Vaginal – Estrogens 257. Vaginal – Other 258. Vasopressins 259. 260. Vitamins – Misc. 261. Weight Loss

Attachment 3

Newly Released Drugs On the PDL

1. Actonel with Calcium 2. ACTOplus met 3. Ammonul 4. Balacet 5. BiDil 6. Cubicin 7. Fluarix 8. Fortical 9. Gammagard Liquid 10. Gamunex 11. Lyrica 12. Mycamine 13. Naglazyme 14. Nevanac 15. Omacor 16. Parcopa 17. Rozerem 18. Tygacil 19. Vanos Cream 20. Xibrom

Attachment 4

Newly Released Generic Drugs

1. Cilostazol (Generic Pletal) 2. Clarithromycin (Generic Biaxin) 3. Clarithromycin ER (Generic Biaxin XL) 4. Estradiol TD System .025mg and .075mg (Generic Climara) 5. Fexofenadine (Generic Allegra) 6. Intraconazole (Generic Sporanox) 7. Sertraline (Generic Zoloft) 8. Terconazole Vaginal Cream (Generic Terazol 7)

New Dosage Forms 1. Ambien CR 2. Aricept ODT 3. Focalin XR 4. Megace ES 5. Zmax