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Oregon Drug Use Review / Pharmacy & Therapeutics Committee © Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program OHA Division of Medical Assistance Programs 500 Summer Street NE, E35; Salem, OR 97301‐1079 Phone 503‐947‐5220 | Fax 503‐947‐1119 Oregon Drug Use Review / Pharmacy & Therapeutics Committee Thursday, August 5th, 2021 1:00 ‐ 5:00 PM Remote Meeting via Zoom Platform MEETING AGENDA NOTE: Any agenda items discussed by the DUR/P&T Committee may result in changes to utilization control recommendations to the OHA. Timing, sequence and inclusion of agenda items presented to the Committee may change at the discretion of the OHA, P&T Committee and staff. The DUR/P&T Committee functions as the Rules Advisory Committee to the Oregon Health Plan for adoption into Oregon Administrative Rules 410‐121‐0030 & 410‐121‐0040 in accordance with Oregon Revised Statute 183.333. I. CALL TO ORDER 1:00 PM A. Roll Call & Introductions R. Citron (OSU) B. Approval of Agenda R. Citron (OSU) C. Conflict of Interest Declaration R. Citron (OSU) D. Approval of Minutes R. Citron (OSU) E. Department Update T. Douglass (OHA) F. Legislative Update T. Douglass (OHA) 1:20 PM II. CONSENT AGENDA TOPICS S. Ramirez (Chair) A. CMS Annual Report B. Quarterly Utilization Reports C. Oncology Prior Authorization Updates 1. Public Comment III. DUR ACTIVITIES 1:25 PM A. ProDUR Report L. Starkweather (Gainwell) B. RetroDUR Report D. Engen (OSU) C. Oregon State Drug Review K. Sentena (OSU) 1. Antidepressant Review 2. Bipolar Disorder: Resources for Primary Care Providers IV. PREFERRED DRUG LIST NEW BUSINESS 1:45 PM A. SGLT‐2 Inhibitors Class Update K. Sentena (OSU) 1. Class Update/Prior Authorization Criteria 2. Public Comment 3. Discussion of Clinical Recommendations to OHA 2:00 PM B. Amondys 45™ (casmisersen) New Drug Evaluation S. Servid (OSU) 1. New Drug Evaluation/Prior Authorization Criteria 2. Public Comment 3. Discussion of Clinical Recommendations to OHA 1 2:15 PM C. Benlysta® (belimumab) Prior Authorization Update D. Moretz (OSU) 1. Prior Authorization Update 2. Public Comment 3. Discussion of Clinical Recommendations to OHA 2:30 PM D. Other Dyslipidemia Drugs Class Update and New Drug M. Herink (OSU) Evaluation 1. Class Update/Prior Authorization Criteria 2. Evkeeza™ (evinacumab‐dgnb) New Drug Evaluation 3. Publict Commen 4. Discussion of Clinical Recommendations to OHA 2:50 PM E. Overactive Bladder Class Update and New Drug K. Sentena (OSU) Evaluation 1. Class Update 2. Gemtesa® (vibegron) New Drug Evaluation 3. Public Comment 4. Discussion of Clinical Recommendations to OHA 3:05 PM BREAK 3:20 PM F. Asthma Biologics DERP Summary D. Moretz (OSU) 1. DERP Summary/Prior Authorization Criteria 2. Public Comment 3. Discussion of Clinical Recommendations to OHA 3:40 PM G. Phosphate Binders Literature Scan D. Moretz (OSU) 1. Literature Scan/Prior Authorization Criteria 2. Public Comment 3. Discussion of Clinical Recommendations to OHA 3:50 PM H. HIV Class Update and New Drug Evaluation 1. DERP Report and Class Update S. Fletcher (OSU) 2. Cabenuva™ (cabotegravir/rilpivirine) and A. Gibler (OSU) Vocabria™ (cabotegravir) New Drug Evaluations 3. Public Comment 4. Discussion of Clinical Recommendations to OHA 4:20 PM V. EXECUTIVE SESSION 4:50 PM VI. RECONVENE for PUBLIC RECOMMENDATIONS VII. ADJOURN 2 Drug Use Research & Management Program OHA Health Systems Division 500 Summer Street NE, E35; Salem, OR 97301-1079 Phone 503-947-5220 | Fax 503-947-1119 Oregon Drug Use Review / Pharmacy & Therapeutics Committee Name Title Profession Location Term Expiration Mark Helm, MD, MBA, FAAP Physician Pediatrician Salem December 2021 Russell Huffman, DNP, PMHNP Public Mental Health Nurse Practitioner Salem December 2021 Jim Rickards, MD, MBA Physician Radiologist / Medical Director McMinnville December 2021 Cathy Zehrung, RPh Pharmacist Pharmacy Manager Silverton December 2021 Patrick DeMartino, MD Physician Pediatrician Portland December 2022 Cat Livingston, MD, MPH Physician Medical Director, Health Share Portland December 2022 Stacy Ramirez, PharmD Pharmacist Ambulatory Care Pharmacist Corvallis December 2022 Tim Langford, PharmD, BCPS, Pharmacist Pharmacy Director, Klamath Tribes Klamath December 2023 USPHS Falls Caryn Mickelson, PharmD Pharmacist Pharmacy Director, Coquille Indian Coos Bay December 2023 Tribe Robin Moody, MPH Public Executive Director, Oregon Health Portland December 2023 Forum William Origer, MD, FAAFP Physician Residency Faculty Albany December 2023 Oregon Pharmacy and Therapeutics Committee Appointments Last updated 1/1/2021 3 Drug Use Research & Management Program OHA Health Systems Division 500 Summer Street NE, E35; Salem, OR 97301‐1079 Phone 503‐947‐5220 | Fax 503‐947‐1119 Oregon Drug Use Review / Pharmacy & Therapeutics Committee Thursday, June 3, 2021 1:00 - 5:00 PM Via Zoom webinar MEETING MINUTES NOTE: Any agenda items discussed by the DUR/P&T Committee may result in changes to utilization control recommendations to the OHA. Timing, sequence and inclusion of agenda items presented to the Committee may change at the discretion of the OHA, P&T Committee and staff. The DUR/P&T Committee functions as the Rules Advisory Committee to the Oregon Health Plan for adoption into Oregon Administrative Rules 410- 121-0030 & 410-121-0040 in accordance with Oregon Revised Statute 183.333 Members Present: Stacy Ramirez, PharmD; William Origer, MD, FAAFP; Mark Helm, MD, MBA, FAAP; Russell Huffman, DNP, PMHNP; Patrick DeMartino, MD; Cat Livingston, MD, MPH; Tim Langford, PharmD, BCPS, USPHS; Robin Moody, MPH; Caryn Mickelson, PharmD, Cathy Zehrung, PharmD Staff Present: Jennifer Bowen, Admin; Roger Citron, RPh; David Engen, PharmD; Sara Fletcher, PharmD; Richard Holsapple, RPh; Deanna Moretz, PharmD; Sarah Servid, PharmD; Megan Herink, PharmD; Dee Weston, JD; Brandon Wells; Amanda Parrish, LCSW; Kyle Hamilton. Audience: Andrea Willcuts, Takeda; Andrew Yu, Novartis; Bill McDougall, Biogen; Brandie Feger, Advanced Health; Brandon Yip, Sanofi-Genzyme; Carrie Johnson, PharmD, Amgen; Chi Kohlhoff, Viela Bio; Chris Yates, Merck; Craig Sexton, GSK; Cyreatha Bryant, RPh, Gainwell Technologies; Dennis Schaffner, Sanofi-Genzyme; Gregg Rasmussen, Vertex Pharmaceuticals; Jason Tessmer, Novo Nordisk; Jennifer Shear, PharmD, Teva; Joel Rios, Gainwell Technologies; Kalpesh Patel, Gainwell Technologies; Kara Tyler, Kite Pharma; Katie Scheelar, Moda/EOCCO; Lindsey Walter, Novartis; Lisa Allen, Vertex Pharmaceuticals; Lisa Dunn, Amgen; Lynda Finch, PhD, Biogen; Margaret Olmon, PharmD, AbbVie; Mark Kantor, AllCare CCO; Matt Worthy, OHSU; Timothy McFerrin, Alkermes; Melissa Snider, Gilead Sciences; Michael Foster, BMS; Mike Donabedian, Sarepta Therapeutics; Nancy Mahler, Oncopeptides; Rebecca Rubin, BioCryst; Rick Frees, Vertex; Robert Pearce, Teva; Shirley Quach, Novartis; Sophia Yun, Janssen; Steve Hall, Genentech; Tina Shriner, AbbVie; Wendy Bibeau, BMS. (*) Provided verbal testimony Written testimony: Posted to OSU Website 4 Drug Use Research & Management Program OHA Health Systems Division 500 Summer Street NE, E35; Salem, OR 97301‐1079 Phone 503‐947‐5220 | Fax 503‐947‐1119 I. CALL TO ORDER A. Roll Call & Introductions a. Called to order at approx. 1:08 p.m., introductions by staff and committee. B. Approval of Agenda C. Conflict of Interest Declaration D. Approval of April 2021 Minutes presented by Mr. Citron ACTION: Motion to approve, 2nd, all in favor E. Department Update F. Legislative Update II. CONSENT AGENDA TOPICS A. Quarterly Utilization Reports B. Colony Stimulating Factors Literature Scan C. Oncology Prior Authorization Updates D. Orphan Drug Policy Updates ACTION: Motion to approve, 2nd, all in favor III. DUR ACTIVITIES A. ProDUR Report: Rich Holsapple, RPh B. RetroDUR Report: Dave Engen, PharmD C. Oregon State Drug Review: Kathy Sentena, PharmD a. Covid‐19 Viral Testing b. 2019‐2020 Food and Drug Administration Drug Safety Communications Update c. Coronavirus Disease‐2019 Vaccine Update IV. DUR OLD BUSINESS A. Antipsychotics in Young Children Safety Edit: Sarah Servid, PharmD Recommendations: a. Implement a safety edit to ensure appropriate use of antipsychotics in children 5 years of age or less b. Implement a retrospective provider outreach program ACTION: Motion to approve, 2nd, all in favor 5 Drug Use Research & Management Program OHA Health Systems Division 500 Summer Street NE, E35; Salem, OR 97301‐1079 Phone 503‐947‐5220 | Fax 503‐947‐1119 V. PREFERRED DRUG LIST NEW BUSINESS A. Growth Hormone ADR & Prior Authorization (PA) Update: Dave Engen, PharmD Recommendation: a. Add somapacitan‐beco to Growth Hormone PDL class, designate non‐preferred, and restrict use for OHP‐covered conditions b. Update to PA criteria to align with HERC coverage guidance and FDA‐approved indications ACTION: Motion to approve, 2nd, all in favor B. Hereditary Angioedema Class Update (NDE): Sarah Servid, PharmD Recommendation: a. Update PA criteria to include berotralstat b. No changes to the PDL based on clinical evidence c. Evaluate costs in executive session ACTION: Motion to approve, 2nd, all in favor C. Multiple Sclerosis Drug Class Update & New Drug Evaluation for Kesimpta (Ofatumumab) and Ponvory (Ponesimod) (NDE): Deanna Moretz, PharmD Recommendations: a. Update PA criteria to apply to ofatumumab for both PAD and POS pharmacy claims b. Add ponesimod tablets to the Oral MS Drug PA criteria and update as proposed c. Evaluate costs in executive session Public Comment: Wendy Bibeau, BMS; Lynda Finch, Biogen; Steve Hall, Genentech; Shirley Quach, Novartis ACTION: Motion to approve, 2nd, all
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