OHCA Webinar Wednesday, March 10, 2021 Review Board 4:00pm Please register for the webinar at: https://zoom.us/s/97305655255 After registering, you will receive a confirmation email containing information about joining the webinar. Drug Utilization The University of Oklahoma Health Sciences Center COLLEGE OF PHARMACY PHARMACY MANAGEMENT CONSULTANTS MEMORANDUM TO: Drug Utilization Review (DUR) Board Members FROM: Michyla Adams, Pharm.D. SUBJECT: Packet Contents for DUR Board Meeting – March 10, 2021 DATE: February 22, 2021 NOTE: In response to COVID-19, the March 2021 DUR Board meeting will be held via OHCA webinar at 4:00pm. Please register for the meeting using the following website address: https://zoom.us/s/97305655255 After registering, you will receive a confirmation email containing information about joining the webinar. 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 Quarterly Review of the Medication Therapy Management (MTM) Program – Appendix B Update on Medication Coverage Authorization Unit/Spring 2021 Pipeline Update – Appendix C Action Item – Vote to Prior Authorize Anjeso® (Meloxicam Injection) and Licart™ (Diclofenac Epolamine Topical System) – Appendix D Action Item – Vote to Prior Authorize Oxlumo™ (Lumasiran) – Appendix E Action Item – Vote to Prior Authorize Fintepla® (Fenfluramine) – Appendix F Action Item – Vote to Prior Authorize Teriparatide – Appendix G Action Item – Vote to Prior Authorize Zokinvy™ (Lonafarnib) – Appendix H ORI-4403 • P.O. BOX 26901 • OKLAHOMA CITY, OKLAHOMA 73126-0901 • (405) 271-9039 • FAX: (405) 271-2615 Action Item – Vote to Prior Authorize Nurtec™ ODT (Rimegepant) and Vyepti® (Eptinezumab-jjmr) – Appendix I Action Item – Vote to Prior Authorize Inqovi® (Decitabine/Cedazuridine), Onureg® (Azacitidine), and Riabni™ (Rituximab-arrx) – Appendix J Action Item – Annual Review of Qutenza® (Capsaicin 8% Patch) – Appendix K Annual Review of Lymphoma Medications and 30-Day Notice to Prior Authorize Breyanzi® (Lisocabtagene Maraleucel), Monjuvi® (Tafasitamab- cxix), Romidepsin 27.5mg/5.5mL Vial, Tecartus™ (Brexucabtagene Autoleucel), and Ukoniq™ (Umbralisib) – Appendix L Annual Review of Lutathera® (Lutetium Lu 177 Dotatate) and Vitrakvi® (Larotrectinib) – Appendix M Annual Review of Hemophilia Medications and 30-Day Notice to Prior Authorize Sevenfact® [Coagulation Factor VIIA (Recombinant)-jncw] – Appendix N Annual Review of Multiple Sclerosis Medications and 30-Day Notice to Prior Authorize Bafiertam™ (Monomethyl Fumarate), Kesimpta® (Ofatumumab), and Zeposia® (Ozanimod) – Appendix O Annual Review of Hereditary Angioedema (HAE) Medications and 30-Day Notice to Prior Authorize Orladeyo™ (Berotralstat) – Appendix P Annual Review of Granulocyte Colony-Stimulating Factors (G-CSFs) and 30-Day Notice to Prior Authorize Nyvepria™ (Pegfilgrastim-apgf) – Appendix Q Annual Review of Anti-Emetic Medications and 30-Day Notice to Prior Authorize Barhemsys® (Amisulpride) – Appendix R Annual Review of Growth Hormone Products and 30-Day Notice to Prior Authorize Sogroya® (Somapacitan-beco) – Appendix S U.S. Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) Updates – Appendix T 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 10, 2021 @ 4:00pm Oklahoma Health Care Authority (OHCA) Webinar Please register for the meeting at: https://zoom.us/s/97305655255 After registering, you will receive a confirmation email containing information about joining the webinar. AGENDA Discussion and Action on the Following Items: Items to be presented by Dr. Mitchell, Vice Chairwoman: 1. Call to Order A. Roll Call – Dr. Wilcox DUR Board Members: Telephone Conference Participants Dr. Stephen Anderson – participating via Zoom teleconference Dr. Jennifer de los Angeles – participating via Zoom teleconference Ms. Jennifer Boyett – participating via Zoom teleconference Dr. Markita Broyles – participating via Zoom teleconference Dr. Theresa Garton – participating via Zoom teleconference Dr. Megan Hanner – participating via Zoom teleconference Dr. Lynn Mitchell – participating via Zoom teleconference Dr. John Muchmore – participating via Zoom teleconference Dr. Lee Muñoz – participating via Zoom teleconference Dr. James Osborne – participating via Zoom teleconference Public Access to Meeting via Zoom: Please register for the meeting at: https://zoom.us/s/97305655255 Or join by phone: Dial: +1-253-215-8782 or +1-346-248-7799 Webinar ID: 973 0565 5255 Passcode: 92831084 Public Comment for Meeting: . Speakers who wish to sign up for public comment at the OHCA DUR Board meeting may do so in writing by visiting www.okhca.org/DUR and completing the Speaker Registration Form. Completed Speaker Registration forms should be submitted to [email protected]. Forms must be received after the DUR Board agenda has been posted and no later than 24 hours before the meeting. The DUR Board meeting will allow public comment and time will be limited to 40 minutes total for all speakers during the meeting. Each speaker will be given 5 minutes to speak at the public hearing. If more than 8 speakers properly request to speak, time will be divided evenly. Only 1 speaker per manufacturer will be allowed. Items to be presented by Dr. Mitchell, Vice Chairwoman: 2. Public Comment Forum A. Acknowledgment of Speakers for Public Comment Items to be presented by Dr. Mitchell, Vice Chairwoman: 3. Action Item – Approval of DUR Board Meeting Minutes – See Appendix A A. February 17, 2021 DUR Minutes – Vote B. February 17, 2021 DUR Recommendation Memorandum C. Correspondence Items to be presented by Dr. Smith, Dr. Mitchell, Vice Chairwoman: 4. Quarterly Review of the Medication Therapy Management (MTM) Program – See Appendix B A. Medication Therapy Management Program Update Items to be presented by Dr. Nawaz, Dr. Wilson, Dr. Mitchell, Vice Chairwoman: 5. Update on Medication Coverage Authorization Unit/Spring 2021 Pipeline Update – See Appendix C A. Pharmacy Helpdesk Activity for February 2021 B. Medication Coverage Activity for February 2021 C. Spring 2021 Pipeline Update Items to be presented by Dr. Wilson, Dr. Mitchell, Vice Chairwoman: 6. Action Item – Vote to Prior Authorize Anjeso® (Meloxicam Injection) and Licart™ (Diclofenac Epolamine Topical System) – See Appendix D A. New U.S. Food and Drug Administration (FDA) Approval(s) B. College of Pharmacy Recommendations Items to be presented by Dr. Wilson, Dr. Mitchell, Vice Chairwoman: 7. Action Item – Vote to Prior Authorize Oxlumo™ (Lumasiran) – See Appendix E A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Ha, Dr. Mitchell, Vice Chairwoman: 8. Action Item – Vote to Prior Authorize Fintepla® (Fenfluramine) – See Appendix F A. New U.S. Food and Drug Administration (FDA) Approval(s) B. College of Pharmacy Recommendations Items to be presented by Dr. Daniel, Dr. Mitchell, Vice Chairwoman: 9. Action Item – Vote to Prior Authorize Teriparatide – See Appendix G A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Nawaz, Dr. Mitchell, Vice Chairwoman: 10. Action Item – Vote to Prior Authorize Zokinvy™ (Lonafarnib) – See Appendix H A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Chandler, Dr. Mitchell, Vice Chairwoman: 11. Action Item – Vote to Prior Authorize Nurtec™ ODT (Rimegepant) and Vyepti® (Eptinezumab-jjmr) – See Appendix I A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Borders, Dr. Mitchell, Vice Chairwoman: 12. Action Item – Vote to Prior Authorize Inqovi® (Decitabine/Cedazuridine), Onureg® (Azacitidine), and Riabni™ (Rituximab-arrx) – See Appendix J A. Introduction B. New U.S. Food and Drug Administration (FDA) Approval(s) and Indication(s) C. College of Pharmacy Recommendations Items to be presented by Dr. Wilson, Dr. Mitchell, Vice Chairwoman: 13. Action Item – Annual Review of Qutenza® (Capsaicin 8% Patch) – See Appendix K A. Current Prior Authorization Criteria B. Utilization of Qutenza® (Capsaicin 8% Patch) C. Prior Authorization of Qutenza® (Capsaicin 8% Patch) D. Market News and Updates E. College of Pharmacy Recommendations Items to be presented by Dr. Borders, Dr. Mitchell, Vice Chairwoman: 14. Annual Review of Lymphoma Medications and 30-Day Notice to Prior Authorize Breyanzi® (Lisocabtagene Maraleucel), Monjuvi® (Tafasitamab-cxix), Romidepsin 27.5mg/5.5mL Vial, Tecartus™ (Brexucabtagene Autoleucel), and Ukoniq™ (Umbralisib) – See Appendix L 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. College of Pharmacy Recommendations H. Utilization of Lymphoma Medications Items to be presented by Dr. Borders, Dr. Mitchell, Vice Chairwoman: 15. Annual Review of Lutathera® (Lutetium Lu 177 Dotatate) and Vitrakvi® (Larotrectinib) – See Appendix M A. Introduction B. Current Prior Authorization Criteria C. Utilization of Lutathera® (Lutetium Lu-177 Dotatate) and Vitrakvi® (Larotrectinib) D. Prior Authorization of Lutathera® (Lutetium Lu-177 Dotatate) and Vitrakvi® (Larotrectinib) E. Market News and Updates F. College of Pharmacy Recommendations Items to be presented by