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Wednesday, March 13, 2019 4:00Pm Wednesday, March 13, 2019 4:00pm Oklahoma Health Care Authority 4345 N. Lincoln Blvd. Oklahoma City, OK 73105 The University of Oklahoma HealthSciencesCenter CO L L EGEO FP HAR M ACY P HAR M ACY M AN AGEM EN T CO N S U L T AN T S M EM O R AN DU M TO: DrugU tilizationR eview (DU R )BoardM embers FR O M : BethanyHolderread,Pharm.D. S U BJECT : P acketContentsforDU R BoardM eeting– M arch13,2019 DAT E: February28,2019 N ote: T heDU R Boardw illmeetat4:00pm T hemeetingw illbeheldat4345N .LincolnBlvd. Enclosed are the following items related to the March meeting. Material is arranged in order of the agenda. Call to Order Public Comment Forum Action Item – Approval of DUR Board Meeting Minutes – Appendix A Update on Medication Coverage Authorization Unit/Update: Drug Utilization Review of Prenatal Vitamins (PV) – Appendix B Action Item – Vote to Prior Authorize Inbrija™ (Levodopa Inhalation) and Osmolex ER™ [Amantadine Extended- Release (ER)] – Appendix C Action Item – Vote to Prior Authorize Aimovig™ (Erenumab-aooe), Ajovy™ (Fremanezumab-vfrm), and Emgality® (Galcanezumab-gnlm) – Appendix D Action Item – Vote to Prior Authorize Epidiolex® (Cannabidiol), Diacomit® (Stiripentol), and Sympazan™ (Clobazam Oral Film) – Appendix E Action Item – Vote to Prior Authorize Gamifant® (Emapalumab-lzsg) – Appendix F Action Item – Vote to Prior Authorize Firdapse® (Amifampridine) – Appendix G Action Item – Vote to Prior Authorize Retacrit™ (Epoetin Alfa-epbx) – Appendix H Annual Review of Chronic Lymphocytic Leukemia (CLL) Medications and 30-Day Notice to Prior Authorize Copiktra™ (Duvelisib) – Appendix I Annual Review of Lymphoma Medications and 30-Day Notice to Prior Authorize Adcetris® (Brentuximab Vedotin), Beleodaq® (Belinostat), Calquence® (Acalabrutinib), Folotyn® (Pralatrexate), Istodax® (Romidepsin), Poteligeo® (Mogamulizumab-kpkc), Truxima® (Rituximab-abbs), Zevalin® (Ibritumomab Tiuxetan), and Zolinza® (Vorinostat) – Appendix J 30-Day Notice to Prior Authorize Lutathera® (Lutetium Lu 177 Dotatate) and Vitrakvi® (Larotrectinib) – Appendix K ORI-4403 • P.O. BOX 26901 • OKLAHOMA CITY, OKLAHOMA 73126-0901 • (405) 271-9039 • FAX: (405) 271-2615 Action Item – Annual Review of Anticoagulants and Platelet Aggregation Inhibitors – Appendix L Annual Review of Hereditary Angioedema (HAE) Medications and 30-Day Notice to Prior Authorize Takhzyro™ (Lanadelumab-flyo) and to Update the Prior Authorization Criteria for Cinryze® (C1 Esterase Inhibitor), Haegarda® (C1 Esterase Inhibitor), and Kalbitor® (Ecallantide) – Appendix M Annual Review of Multiple Sclerosis (MS) Medications – Appendix N Annual Review of Luxturna™ (Voretigene Neparvovec-rzyl) – Appendix O Annual Review of Osteoporosis Medications – Appendix P Industry News and Updates – Appendix Q U.S. Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) Updates – Appendix R Future Business Adjournment ORI-4403 • P.O. BOX 26901 • OKLAHOMA CITY, OKLAHOMA 73126-0901 • (405) 271-9039 • FAX: (405) 271-2615 Oklahoma Health Care Authority Drug Utilization Review Board (DUR Board) Meeting – March 13, 2019 @ 4:00pm Oklahoma Health Care Authority 4345 N. Lincoln Blvd. Oklahoma City, Oklahoma 73105 AGENDA Discussion and Action on the Following Items: Items to be presented by Dr. Muchmore, Chairman: 1. Call to Order A. Roll Call – Dr. Cothran Items to be presented by Dr. Muchmore, Chairman: 2. Public Comment Forum A. Acknowledgment of Speakers for Public Comment Items to be presented by Dr. Muchmore, Chairman: 3. Action Item – Approval of DUR Board Meeting Minutes – See Appendix A A. February 13, 2019 DUR Minutes – Vote B. February 13, 2019 DUR Recommendations Memorandum C. Correspondence Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 4. Update on Medication Coverage Authorization Unit/Update: Drug Utilization Review of Prenatal Vitamins (PV) – See Appendix B A. Medication Coverage Activity for February 2019 B. Pharmacy Helpdesk Activity for February 2019 C. Update: Drug Utilization Review of Prenatal Vitamins (PV) Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 5. Action Item – Vote to Prior Authorize Inbrija™ (Levodopa Inhalation) and Osmolex ER™ [Amantadine Extended-Release (ER)] – See Appendix C A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Abbott, Dr. Muchmore, Chairman: 6. Action Item – Vote to Prior Authorize Aimovig™ (Erenumab-aooe), Ajovy™ (Fremanezumab- vfrm), and Emgality® (Galcanezumab-gnlm) – See Appendix D A. Introduction B. Cost Comparison C. College of Pharmacy Recommendations Items to be presented by Dr. Adams, Dr. Muchmore, Chairman: 7. Action Item – Vote to Prior Authorize Epidiolex® (Cannabidiol), Diacomit® (Stiripentol), and Sympazan™ (Clobazam Oral Film) – See Appendix E A. Introduction B. Market News and Updates C. College of Pharmacy Recommendations Items to be presented by Dr. Chandler, Dr. Muchmore, Chairman: 8. Action Item – Vote to Prior Authorize Gamifant® (Emapalumab-lzsg) – See Appendix F A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Connell, Dr. Muchmore, Chairman: 9. Action Item – Vote to Prior Authorize Firdapse® (Amifampridine) – See Appendix G A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Nawaz, Dr. Muchmore, Chairman: 10. Action Item – Vote to Prior Authorize Retacrit™ (Epoetin Alfa-epbx) – See Appendix H A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Schmidt, Dr. Borders, Dr. Medina, Dr. Muchmore, Chairman: 11. Annual Review of Chronic Lymphocytic Leukemia (CLL) Medications and 30-Day Notice to Prior Authorize Copiktra™ (Duvelisib) – See Appendix I A. Introduction B. Current Prior Authorization Criteria C. Utilization of CLL Medications D. Prior Authorization of CLL Medications E. Market News and Updates F. Copiktra™ (Duvelisib) Product Summary G. Recommendations H. Utilization Details of CLL Medications Items to be presented by Dr. Schmidt, Dr. Borders, Dr. Medina, Dr. Muchmore, Chairman: 12. Annual Review of Lymphoma Medications and 30-Day Notice to Prior Authorize Adcetris® (Brentuximab Vedotin), Beleodaq® (Belinostat), Calquence® (Acalabrutinib), Folotyn® (Pralatrexate), Istodax® (Romidepsin), Poteligeo® (Mogamulizumab-kpkc ), Truxima® (Rituximab- abbs), Zevalin® (Ibritumomab Tiuxetan), and Zolinza® (Vorinostat) – See Appendix J A. Introduction B. Current Prior Authorization Criteria C. Utilization of Lymphoma Medications D. Prior Authorization of Lymphoma Medications E. Market News and Updates F. Product Summaries G. Recommendations H. Utilization Details of Lymphoma Medications Items to be presented by Dr. Schmidt, Dr. Borders, Dr. Medina, Dr. Muchmore, Chairman: 13. 30-Day Notice to Prior Authorize Lutathera® (Lutetium Lu 177 Dotatate) and Vitrakvi® (Larotrectinib) – See Appendix K A. Introduction B. Market News and Updates C. Product Summaries D. Recommendations Items to be presented by Dr. Nawaz, Dr. Muchmore, Chairman: 14. Action Item – Annual Review of Anticoagulants and Platelet Aggregation Inhibitors – See Appendix L A. Current Prior Authorization Criteria B. Utilization of Anticoagulants and Platelet Aggregation Inhibitors C. Prior Authorization of Anticoagulants and Platelet Aggregation Inhibitors D. Market News and Updates E. College of Pharmacy Recommendations F. Utilization Details of Anticoagulants G. Utilization Details of Platelet Aggregation Inhibitors Items to be presented by Dr. Chandler, Dr. Muchmore, Chairman: 15. Annual Review of Hereditary Angioedema (HAE) Medications and 30-Day Notice to Prior Authorize Takhzyro™ (Lanadelumab-flyo) and to Update the Prior Authorization Criteria for Cinryze® (C1 Esterase Inhibitor), Haegarda® (C1 Esterase Inhibitor), and Kalbitor® (Ecallantide) – See Appendix M A. Current Prior Authorization Criteria B. Utilization of HAE Medications C. Prior Authorization of HAE Medications D. Market News and Updates E. Takhzyro™ (Lanadelumab-flyo) Product Summary F. College of Pharmacy Recommendations G. Utilization Details of HAE Medications Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 16. Annual Review of Multiple Sclerosis (MS) Medications – See Appendix N A. Current Prior Authorization Criteria B. Utilization of MS Medications C. Prior Authorization of MS Medications D. Market News and Updates E. College of Pharmacy Recommendations F. Utilization Details of MS Medications Items to be presented by Dr. Adams, Dr. Muchmore, Chairman: 17. Annual Review of Luxturna™ (Voretigene Neparvovec-rzyl) – See Appendix O A. Introduction B. Current Prior Authorization Criteria C. Utilization of Luxturna™ (Voretigene Neparvovec-rzyl) D. Prior Authorization of Luxturna™ (Voretigene Neparvovec-rzyl) E. Market News and Updates F. College of Pharmacy Recommendations Items to be presented by Dr. Connell, Dr. Muchmore, Chairman: 18. Annual Review of Osteoporosis Medications – See Appendix P A. Current Prior Authorization Criteria B. Utilization of Osteoporosis Medications C. Prior Authorization of Osteoporosis Medications D. Market News and Updates E. College of Pharmacy Recommendations F. Utilization Details of Osteoporosis Medications Non-Presentation; Questions Only: 19. Industry News and Updates – See Appendix Q A. Introduction B. News and Updates Items to be presented by Dr. Cothran, Dr. Muchmore, Chairman: 20. U.S. Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) Updates – See Appendix R Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 21. Future Business* (Upcoming
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