Enterprise P&T Meeting
Committee Meeting Minutes
July 29, 2019
Voting Members Present
Andrew Peterson, PharmD Eric Peters, PharmD Kelly Martin, PharmD Lavdena Orr, MD Rogers Elebra, PharmD
Betty Muller, MD Gus, Geraci, MD Kendra Michael, MD Lily Higgins, MD Tracey Davis, PharmD.
Christopher Anypas, PharmD Jeffrey Kreitman, PharmD Kirby Smith, MD Michelle Murphy, Pharm.D.
William Burnham, MD
Don Cooper, RPh Karen Jordan, MD Kirton Caton, MD Rodney Wise, MD
Excused Voting Members
David Batluck, DO John Floyd Brinley,
MD Susan McAllister, MD
David Petkash, MD Rani Whitfield. MD Wayne Weart, PharmD Donald Beam, MD
Invited Guests Present
Adam Root, PharmD - PRx Calla Vodoor – PharmD Prx Eric Weiss, PharmD Lanaye Lawyer, MD Michael Colvin, PharmD
Ally Seitz, PharmD-PRx Chris Meny, PharmD Fury Fecondo, PharmD Lauren Megargell, PharmD-PRx
Monica Guerriero, PharmD
April Holley, PharmD LDH Devon Trumbower, PharmD-PRx
Jeanine Plante, PharmD Linda Albandoz, NCPhT - PRx
Patrick DeHoratius, PharmD-PRx
Brent Young - GBT Dustin Brookshire, Compliance Manager
Kathleen Clement, Administrative- PRx
Melwyn Wendt, PharmD Xiang Ding, PharmD - PRx
Issue Discussion Conclusion/Results Vote Action/ Person
Responsible
1. Call to Order The meeting was called to order at 6:07 PM EST. Jeff Kreitman welcomed all external and internal participants.
Informational Only
Dr. William
Burnham
2. Conflict of
Interest
Disclosure
No conflicts announced Informational Only
Dr. William
Burnham
4. Review and
approval of April
PT and June
Proxy minutes
Minutes approved as presented
Committee approved as
recommended
Jeff Kreitman
5. Old Business PerformRx will update the criteria
and formulary/PDL with any changes
Flovent
PerformRx makes the following recommendation:
KF/AHC/AHNE/
No changes to the formulary status of these medications is recommended
Committee approved as
recommended
PerformRx
6. New Business
PerformRx will update the criteria
and formulary/PDL with any changes
Nitrofurantoin
PerformRx makes the following recommendation:
KF/AHC/AHNE/
No changes are recommended to the formulary status of these medications
PerformRx
Committee approved as
recommended
Naloxone
PerformRx makes the following recommendation:
KF/AHC/AHNE/ No changes are recommended to the formulary status of these
medications
Committee approved adding naloxone vials, carpujects, and syringes to the
formulary without quantity limits
PerformRx
Atovaquone/Proguanil
PerformRx makes the following recommendation:
KF/AHC/AHNE/
Add Atovaquone/Proquanil 250 mg/100 mg tablet to the formulary Add Atovaquone/Proquanil 62.5 mg/25 mg tablet to the formulary
with a quantity limit of 90 tablets per 30 days to ensure appropriate utilization in the pediatric population
Committee approved as
recommended
PerformRx
Melatonin
PerformRx makes the following recommendation:
KF/AHC/AHNE/
No changes are recommended to the formulary status of these medications
Committee approved as
recommended
PerformRx
Hepatitis C
PerformRx makes the following recommendation:
KF/AHC/AHN/
Removal of requirement for participating in Hepatitis C education program as this is no longer required in the state of Pennsylvania
Committee approved as
recommended
PerformRx
Opioid Containing Products
PerformRx makes the following recommendation:
KF/AHC/AHN/
Remove requirement of specialist for reauthorization requests between 50-90MME per day
Modifying specialist to be more general to allow for appropriate prescribers
Committee approved as
recommended
PerformRx
7. Drug Reviews
PerformRx will update the criteria
and formulary/PDL with any changes
Therapeutic Class:
Agents for
Constipation
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
No changes are recommended to the formulary status of these medications
Committee approved as
recommended
PerformRx
Chelating Agents with
PA criteria
PerformRx makes the following
recommendation:
KF/AHC/AHNE/ :
No changes are recommended to the formulary status of these medications
Committee approved as
recommended
PerformRx
Dopamine Agonists
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Make no changes to the formulary status of these medications
Committee approved as
recommended
PerformRx
Fluoroquinolones
PerformRx makes the following
recommendation:
KF/AHC/AHNE/ :
No changes are recommended to the formulary status of these medications
Committee approved as
recommended
PerformRx
Glaucoma with PA criteria
PerformRx makes the following
recommendation:
KF/AHC/AHNE/ No changes are recommended to the formulary status of these
medications Approve the Travoprost criteria with no changes
Committee approved as
recommended
PerformRx
HIV
PerformRx makes the following
recommendation:
KF/AHC/AHNE/ Add Delstrigo (doravirine-lamivudine-tenofovir disoproxil
fumarate) to the formulary. Add Evotaz (atazanavir-cobicistat) to the formulary.
Committee approved as
recommended
PerformRx
Multiple Sclerosis with PA criteria
PerformRx makes the following
recommendation:
KF/AHC/AHNE/ :
Add Mavenclad (cladribine) to the specialty tier with a prior authorization requirement.
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Respiratory Aids and Devices
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
No changes are recommended to the formulary status of these devices
Committee approved as
recommended
PerformRx
Single Products
PerformRx will
update the criteria and formulary/PDL with any changes
Firdapse with PA criteria
PerformRx makes the following
recommendation:
KF/AHC/AHNE/
Add Firdapse to the specialty tier with prior authorization Approve the newly developed Firdapse prior authorization criteria
Committee approved as
recommended
PerformRx
New Products
PerformRx recommends to keep the following product remain non-
formulary for KF/AHC/AHNE/
Adhansia XR Azesco Beser Ceretec Dermazene Diclovix
Committee approved as
recommended
PerformRx will update the criteria
and formulary/PDL with any changes.
Dovato Duobrii Egaten Fluovix Jeuveau Jornay PM Kenalog LidoPure Nuvakaan Plenamine Prizotral Qtern Ruzurgi Zilacaine
PerformRx recommends to add by proxy vote to Specialty Tier with
drug specific PA criteria for KF/AHC/AHN/
Zolgensma
PerformRx recommends add to Specialty Tier for
KF/AHC/AHNE/
Balversa Cutaquig Diacomit Emgality Evenity Herceptin Hylecta Infugem Ingrezza Initiation Pack Kalydeco Mavenclad Nucala Piqray Polivy Skyrizi (75mg & 150mg) Vyndaqel Zulresso Zykadia
8. Prior
Authorization
New Criteria
PerformRx will
update the criteria and formulary/PDL with any changes
Calcitonin Gene-Related Peptide (CGRP) Receptor Antagonists
PerformRx makes the following
recommendation:
KF/AHC/AHN/ :
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Transderm-Scop PerformRx makes the following
recommendation:
Committee approved as
recommended
PerformRx
KF/AHC/AHN/
Approve the criteria with no changes.
Agents for Atopic Dermatitis
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes.
Committee approved as
recommended
PerformRx
Agents for Gender Dysphoria
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Allergic Conjunctivitis Agents
PerformRx makes the following
recommendation :
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Angiotensin II Receptor Blocker and Renin Inhibitor Medications
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Antihyperlipidemia Agents
PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Chronic Dry Eye Agents
PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Crinone PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Dificid (Fidaxomicin) PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Donepezil PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Entocort EC PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Exondys 51 PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Fareston PerformRx makes the following
recommendation:
KF/AHC/AHN/ :
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Huntington's Disease Criteria
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Idiopathic Pulmonary Fibrosis
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Injectable/Specialty Medications Without Specific Prior Authorization Protocol
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the Injectable/Specialty Medications without Specific Prior Authorization Protocol with no changes
Committee approved as
recommended
PerformRx
Injectable 5-Hydroxytryptamine-3 (5HT3) Serotonin Receptor Antagonists
PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Orilissa PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Proton Pump Inhibitors
PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes.
Committee approved as
recommended
PerformRx
Pulmicort Respules (budesonide)
PerformRx makes the following
recommendation:
KF/AHC/AHN/ :
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Serostim PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Synagis PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Triamcinolone Intranasal
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Vfend PerformRx makes the following
Recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
White Blood Cell Stimulators
PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Xifaxan PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Xolair (omalizumab PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the criteria with no changes
Committee approved as
recommended
PerformRx
Rx
Prior Authoriztion
New Criteria
PerformRx will update the criteria
and formulary/PDL with any changes
Vimizim PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the newly developed Vimizim prior authorization
Committee approved as
recommended
PerformRx
Brinuera PerformRx makes the following
recommendation:
KF/AHC/AHN/
Approve the newly developed Brineura prior authorization criteria
Committee approved as
recommended
PerformRx
10. Recalls
Non-lot level recalls.
Informational
Jeff
Kreitman
11. Adjournment
The meeting adjourned at 7:31 PM EST
N/A
William Burnham
The next meeting October 29, 2019 from 6:00 PM‐
8:00 PM.
__ ___________ _9/17/2019______________ Dr. William Burnham, MD - Chair Date