The Prescriber E-Letter October 2015, Volume 7, Issue 1

October 2015, Volume 7, Issue 1

The Prescriber e-Letter October 2015, Volume 7, Issue 1

Neuraminidase inhibitors Topical Corticosteroids (cont.)

® The neuraminidase inhibitors zanamivir (Relenza ) and The prior authorization process for topical corticosteroids ® oseltamivir (Tamiflu ) are approved by the U.S. Food and was implemented on October 26, 2015. The PA status of the Drug Administration (FDA) for the prophylaxis and individual products is outlined below. treatment of influenza and have demonstrated activity against both influenza A and influenza B. These agents interfere with the release of progeny influenza virus from infected cells, PA No PA thereby preventing new rounds of infection. A 2003 meta- Class I. Super Potent analysis of 17 treatment and seven prevention trials Clobetasol propionate cream, Betamethasone augmented gel ® concluded that these drugs reduced the median duration of ointment (Temovate ) Betamethasone dipropionate lotion, ® symptoms by approximately one day and may reduce the Clobetasol propionate foam (Olux ) ointment Clobetasol propionate foam / Betamethasone dipropionate, odds of developing influenza by 70 to 90%. However, recent emollient (Olux-E®) augmented ointment (Diprolene®)# trials and meta-analyses have demonstrated conflicting Clobetasol propionate lotion, Clobetasol propionate/emollient results on the ability of these agents to reduce influenza- shampoo, spray (Clobex®) (Temovate E®) related complications. Therefore, prior authorization will be Halobetasol cream, ointment Clobetasol propionate gel, solution required for quantities greater than one treatment course per (Ultravate®)# Clobetasol propionate shampoo kit season. Diflorasone ointment Fluocinonide 0.1% cream (Vanos®) The prior authorization process for neuraminidase inhibitors Flurandrenolide tape (Cordran®) was implemented on October 26, 2015, and is outlined Halobetasol / lactic acid (Ultravate ® below. All agents require a PA from June 1 to September 30. X ) From October 1 to May 31, a PA will be required for doses Class II. Potent exceeding the quantity limit as noted in the table below. Amcinonide ointment Betamethasone dipropionate cream Zanamivir requires PA for members <5 years of age. Desoximetasone 0.25% cream, Betamethasone dipropionate, ointment, spray, 0.05% gel augmented cream (Diprolene AF®)# Drug PA for Quantity Limits (Topicort®) Betamethasone dipropionate, ® Diflorasone cream/emollient augmented lotion (Diprolene®)# Zanamivir (Relenza ) > 20 inhalations/season ® ® (Apexicon-E ) Fluocinonide cream, gel, ointment, Oseltamivir 30 mg (Tamiflu ) > 20 capsules/season Halcinonide cream, ointment solution Oseltamivir 45 mg and 75 mg > 10 capsules/season (Halog®) Mometasone ointment (Elocon®) (Tamiflu®) Triamcinolone 0.5% ointment Oseltamivir 6 mg/mL > 180 mL/season ® Class III. Upper Mid-Strength Potent suspension (Tamiflu ) Amcinonide cream Amcinonide lotion Betamethasone valerate foam Betamethasone valerate ointment (Luxiq®) Fluocinonide / emollient Topical Corticosteroids Desoximetasone 0.05% cream, Fluticasone ointment ointment (Topicort®) Triamcinolone 0.1% ointment, 0.5% Topical corticosteroids are FDA-approved for the treatment Diflorasone cream (Psorcon®) cream of a variety of dermatological conditions. The topical Class IV. Mid-Strength Potent corticosteroids were subdivided in the former classification Clocortolone cream (Cloderm®) Fluocinolone ointment (Synalar®)# system of four groups: low potency, medium potency, high Fluocinolone ointment kit (Synalar®) Hydrocortisone valerate ointment potency and very high potency. The USA classification Triamcinolone 0.05% ointment Mometasone cream, solution system subdivides topical corticosteroids into seven classes, Triamcinolone spray (Kenalog®) (Elocon®)# with group one being super potent and group seven being Triamcinolone 0.1% cream least potent. MassHealth has determined that more costly topical corticosteroids will require PA, including all brand- name and generic products that are more costly than comparable alternatives.

Topical Corticosteroids (cont.) The Prescriber e-Letter is an update designed to enhance the transparency and efficiency of the MassHealth drug prior-authorization (PA) process and the MassHealth Drug List. Each issue highlights key clinical information and updates to the MassHealth Drug List. The Prescriber E-Letter was prepared by the MassHealth Drug Utilization Review Program and the MassHealth Pharmacy Program. The Prescriber e-Letter October 2015, Volume 7, Issue 1

Class V. Lower Mid-Strength Potent Fluocinolone cream kit (Synalar®) Betamethasone valerate cream Fluocinolone shampoo (Capex®) Desonide lotion, ointment Fluticasone lotion (Cutivate®) Fluocinolone 0.01% cream Hydrocortisone probutate cream Fluocinolone 0.025% cream Hydrocortisone solution Hydrocortisone cream, lotion, (Pandel®) (Synalar®)# ointment Fluticasone cream (Cutivate®)# Combination Products Hydrocortisone butyrate/emollient Betamethasone/calcipotriene Hydrocortisone/pramoxine foam Hydrocortisone butyrate cream, ointment, scalp suspension ointment, solution (Taclonex®) Hydrocortisone valerate cream Neomycin/fluocinolone cream, Prednicarbate cream, ointment cream kit (Dermatop®)# #This designates a brand-name drug with FDA “A”-rated generic equivalents. Triamcinolone 0.1% lotion, 0.025% PA is required for the brand, unless a particular form of that drug (for ointment example, tablet, capsule, or liquid) does not have an FDA “A”-rated generic Class VI. Mild Potent equivalent. Fluocinolone solution kit (Synalar®) Alclometasone cream, ointment Desonide gel (Desonate®) Betamethasone valerate lotion Desonide cream Fluocinolone body oil, scalp oil (Derma-smoothe-FS®)# Fluocinolone solution (Synalar®)# Fluticasone cream, ointment (Cutivate®)# Triamcinolone 0.025% cream, lotion

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