Wednesday, February 14, 2018 4:00pm Oklahoma Health Care Authority 4345 N. Lincoln Blvd. Oklahoma City, OK 73105 The University of Oklahoma Health Sciences Center COLLEGE OF PHARMACY PHARMACY MANAGEMENT CONSULTANTS MEMORANDUM TO: Drug Utilization Review (DUR) Board Members FROM: Bethany Holderread, Pharm.D. SUBJECT: Packet Contents for Board Meeting – February 14th, 2018 DATE: January 26, 2018 NOTE: The DUR Board will meet at 4:00 p.m. The meeting will be held at 4345 N. Lincoln Blvd. Enclosed are the following items related to the February 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/Chronic Medication Adherence Program Update – Appendix B Action Item – Vote to Prior Authorize Zerviate™ (Cetirizine Ophthalmic Solution) – Appendix C Action Item – Vote to Prior Authorize ArmonAir™ RespiClick® (Fluticasone Propionate), Trelegy™ Ellipta® (Fluticasone Furoate/Umeclidinium/Vilanterol), QVAR® RediHaler™ (Beclomethasone Dipropionate), AirDuo™ RespiClick® (Fluticasone Propionate/Salmeterol), and Fasenra™ (Benralizumab) and to Update Nucala® (Mepolizumab) and Xolair® (Omalizumab) Criteria – Appendix D Action Item – Vote to Prior Authorize Emflaza® (Deflazacort) – Appendix E Action Item – Vote to Prior Authorize Zilretta™ (Triamcinolone Acetonide Extended-Release Injectable Suspension) – Appendix F Action Item – Vote to Prior Authorize Varubi® IV (Rolapitant) and Cinvanti™ (Aprepitant) – Appendix G Action Item – Annual Review of Seizure Medications – Appendix H Annual Review of Osteoporosis Medications and 30-Day Notice to Prior Authorize Tymlos™ (Abaloparatide) – Appendix I Annual Review of Antiviral Medications and 30-Day Notice to Prior Authorize Prevymis™ (Letermovir Tablets and Injection) – Appendix J Annual Review of Glaucoma Medications and 30-Day Notice to Prior Authorize Rhopressa® (Netarsudil Ophthalmic Solution) and Vyzulta™ (Latanoprostene Bunod Ophthalmic Solution) – Appendix K ORI-4403 • P.O. BOX 26901 • OKLAHOMA CITY, OKLAHOMA 73126-0901 • (405) 271-9039 • FAX: (405) 271-2615 Annual Review of Parkinson’s Disease (PD) Medications and 30-Day Notice to Prior Authorize Xadago® (Safinamide) and Gocovri™ (Amantadine Extended-Release) – Appendix L 30-Day Notice to Prior Authorize Mepsevii™ (Vestronidase Alfa-vjbk) – Appendix M Annual Review of Anti-Migraine Medications and 30-Day Notice to Prior Authorize Ergomar® (Ergotamine Sublingual Tablets) – Appendix N Industry News and Updates – Appendix O U.S. Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) Updates – Appendix P 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 – February 14, 2018 @ 4:00 p.m. 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. December 13, 2017 DUR Minutes – Vote B. December 13, 2017 DUR Recommendations Memorandum C. January 10, 2018 DUR Recommendations Memorandum Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 4. Update on Medication Coverage Authorization Unit/Chronic Medication Adherence Program Update – See Appendix B A. Medication Coverage Activity for January 2018 B. Pharmacy Help Desk Activity for January 2018 C. Chronic Medication Adherence Program Update Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 5. Action Item – Vote to Prior Authorize Zerviate™ (Cetirizine Ophthalmic Solution) – See Appendix C A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 6. Action Item – Vote to Prior Authorize ArmonAir™ RespiClick® (Fluticasone Propionate), Trelegy™ Ellipta® (Fluticasone Furoate/Umeclidinium/Vilanterol), QVAR® RediHaler™ (Beclomethasone Dipropionate), AirDuo™ RespiClick® (Fluticasone Propionate/Salmeterol), and Fasenra™ (Benralizumab) and to Update Nucala® (Mepolizumab) and Xolair® (Omalizumab) Criteria – See Appendix D A. Introduction B. Nucala® (Mepolizumab) for Eosinophilic Granulomatosis with Polyangiitis (EGPA) C. College of Pharmacy Recommendations Items to be presented by Dr. Chandler, Dr. Muchmore, Chairman: 7. Action Item – Vote to Prior Authorize Emflaza® (Deflazacort) – See Appendix E A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Nichols, Dr. Muchmore, Chairman: 8. Action Item – Vote to Prior Authorize Zilretta™ (Triamcinolone Acetonide Extended-Release Injectable Suspension) – See Appendix F A. Introduction B. College of Pharmacy Recommendations Items to be presented by Dr. Adams, Dr. Muchmore, Chairman: 9. Action Item – Vote to Prior Authorize Varubi® IV (Rolapitant) and Cinvanti™ (Aprepitant) – See Appendix G A. Introduction B. Market News C. College of Pharmacy Recommendations Items to be presented by Dr. Adams, Dr. Muchmore, Chairman: 10. Action Item – Annual Review of Seizure Medications – See Appendix H A. Current Prior Authorization Criteria B. Utilization of Seizure Medications C. Prior Authorization of Seizure Medications D. Market News and Updates E. College of Pharmacy Recommendations F. Utilization Details of Seizure Medications Items to be presented by Dr. Chandler, Dr. Muchmore, Chairman: 11. Annual Review of Osteoporosis Medications and 30-Day Notice to Prior Authorize Tymlos™ (Abaloparatide) – See Appendix I A. Current Prior Authorization Criteria B. Utilization of Osteoporosis Medications C. Prior Authorization of Osteoporosis Medications D. Market News and Updates E. Tymlos™ (Abaloparatide) Product Summary F. College of Pharmacy Recommendations G. Utilization Details of Osteoporosis Medications Items to be presented by Dr. Nichols, Dr. Muchmore, Chairman: 12. Annual Review of Antiviral Medications and 30-Day Notice to Prior Authorize Prevymis™ (Letermovir Tablets and Injection) – See Appendix J A. Current Prior Authorization Criteria B. Utilization of Antiviral Medications C. Prior Authorization of Antiviral Medications D. Market News and Updates E. Cytomegalovirus Prevention in Hematopoietic Stem Cell Transplant Recipients F. Prevymis™ (Letermovir) Product Summary G. College of Pharmacy Recommendations H. Utilization Details of Antiviral Medications Items to be presented by Dr. Nichols, Dr. Muchmore, Chairman: 13. Annual Review of Glaucoma Medications and 30-Day Notice to Prior Authorize Rhopressa® (Netarsudil Ophthalmic Solution) and Vyzulta™ (Latanoprostene Bunod Ophthalmic Solution) – See Appendix K A. Current Prior Authorization Criteria B. Utilization of Glaucoma Medications C. Prior Authorization of Glaucoma Medications D. Market News and Updates E. Rhopressa® (Netarsudil Ophthalmic Solution) Product Summary F. Vyzulta™ (Latanoprostene Bunod Ophthalmic Solution) Product Summary G. College of Pharmacy Recommendations H. Utilization Details of Glaucoma Medications Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 14. Annual Review of Parkinson’s Disease (PD) Medications and 30-Day Notice to Prior Authorize Xadago® (Safinamide) and Gocovri™ (Amantadine Extended-Release) – See Appendix L A. Current Prior Authorization Criteria B. Utilization of PD Medications C. Prior Authorization of PD Medications D. Market News and Updates E. Xadago® (Safinamide) Product Summary F. Gocovri™ [Amantadine Extended-Release (ER)] Product Summary G. College of Pharmacy Recommendations H. Utilization Details of PD Medications Items to be presented by Dr. Abbott, Dr. Muchmore, Chairman: 15. 30-Day Notice to Prior Authorize Mepsevii™ (Vestronidase Alfa-vjbk) – See Appendix M A. Introduction B. Mepsevii™ (Vestronidase Alfa-vjbk) Product Summary C. College of Pharmacy Recommendations Items to be presented by Dr. Abbott, Dr. Muchmore, Chairman: 16. Annual Review of Anti-Migraine Medications and 30-Day Notice to Prior Authorize Ergomar® (Ergotamine Sublingual Tablets) – See Appendix N A. Current Prior Authorization Criteria B. Utilization of Anti-Migraine Medications C. Prior Authorization of Anti-Migraine Medications D. Market News and Updates E. Ergomar® (Ergotamine Sublingual Tablets) Product Summary F. College of Pharmacy Recommendations G. Utilization Details of Anti-Migraine Medications Non-Presentation; Questions Only: 17. Industry News and Updates – See Appendix O A. Introduction B. News and Updates Items to be presented by Dr. Cothran, Dr. Muchmore, Chairman: 18. U.S. Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) Updates – See Appendix P Items to be presented by Dr. Holderread, Dr. Muchmore, Chairman: 19. Future Business* (Upcoming Product and Class Reviews) A. Multiple Sclerosis Medications B. Spinraza® (Nusinersen) C. Luxturna™ (Voretigene Neparvovec-rzyl) D. Erythropoiesis Stimulating Agents (ESAs) E. Chronic Lymphocytic Leukemia (CLL) Medications *Future business subject to change. 20. Adjournment Appendix A OKLAHOMA HEALTH CARE AUTHORITY DRUG UTILIZATION REVIEW BOARD MEETING MINUTES OF MEETING OF DECEMBER 13, 2017 BOARD MEMBERS: PRESENT ABSENT Stephen Anderson, Pharm.D. x Theresa