Drug Utilization Review Board Meeting Information
2023
- Agenda
- MO Pharmacy Advisory Board Slides Oct. 2023
- Edit Implementation Schedule
- New Drug Edits with No Changes
- PDL Announcements
- PDL Recommendations
- Conduent Reports
- Missouri DUR Board Retrospective - DUR Interventions
Old Business
Clinical Edit Proposals – Existing Criteria
- Alpelisib
- Emsam
- Entresto
- Immunoglobulins (IVIG and SCIG)
- Narcolepsy Inhibitors
- Nuedexta
- Palforzia
- Parathyroid Hormone and Bone Resorption Suppression Related Agents
- Sickle Cell Disease
- Spinal Muscular Atrophy (SMA)
- SSRI Step Therapy
- Transthyretin-Mediated Amyloidosis (ATTR)
- Xcopri
Clinical Edit Proposals - New or Revised Criteria
- Botulinum Toxin
- Diagnosis Code Required Policy
- Enzyme Deficiency, Select Agents
- Generalized Myasthenia Gravis
- Lambert-Eaton Myasthenic Syndrome (LEMS)
- Psychotropic Medications Polypharmacy
- Ranolazine
- RSV Prophylaxis – Pediatric
- Skyclarys
- SNRI
- Vyjuvek
Preferred Drug List Edit Proposals – Existing Criteria
- ACE Inhibitors/Calcium Channel Blocker Combinations
- ADHD, Amphetamines Short Acting
- ADHD, Methylphenidate Short Acting
- ADHD, Non-Stimulants
- Angiotensin Receptor Blocker/Calcium Channel Blocker Combinations
- Anticonvulsants, Rescue Agents
- Antiplatelet Agents
- Beta Adrenergic Blockers & Beta Adrenergic Blockers/Diuretic Combinations
- Bone Ossification Agents
- Calcium Channel Blockers, Dihydropyridine
- Direct Renin Inhibitors & Combinations
- Electrolyte Depleting Agents, Phosphate Lowering
- Niacin Derivatives
- Proprotein Convertase Subtilisin Kexin type 9 (PCSK9) Inhibitors
- Pulmonary Arterial Hypertension (PAH) Agents, Endothelin Receptor Antagonists (ETRAs)
- Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Inhaled
- Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Injectable
- Pulmonary Arterial Hypertension (PAH) Agents, Prostacyclin Pathway Agonists, Oral
- Triglyceride Lowering Agents
Preferred Drug List Edit Proposals – New or Revised Criteria
- ACE Inhibitors and ACE Inhibitors/Diuretic Combinations
- ADHD, Amphetamines Long Acting
- ADHD, Methylphenidate Long Acting
- Angiotensin Receptor Blockers and Angiotensin Receptor Blocker/Diuretic Combinations
- Anticoagulants, Oral and Subcutaneous
- Antihyperuricemic Agents
- Benign Prostatic Hyperplasia Agents
- Beta Adrenergic Agents, Short Acting
- Bile Salt Agents
- Calcium Channel Blockers, Non-Dihydropyridine
- Electrolyte Depleting Agents, Potassium Lowering
- Homozygous Familial Hypercholesterolemia (HoFH) Agents
- Keratoconjunctivitis Agents
- Mineralocorticoid Receptor Antagonists (MRA)
- Proton Pump Inhibitors (PPIs)
- Pulmonary Arterial Hypertension (PAH) Agents, Phosphodiesterase-5 (PDE5) and Soluble Guanylate Cyclase (SGC) Stimulators
- Statins (HMG-CoA Reductase Inhibitors) and Combinations
- Sympatholytics
- Urea Cycle Disorder Agents
Agenda
Draft Minutes
Edit Implementation Schedule
New Drugs Edits
PDL Announcements
PDL Recommendations
Conduent Reports
MO Pharmacy Advisory Board Slides July 2023
Clinical Edit Proposals – Existing Criteria:
Ampyra
Besremi
C5 Complement Inhibitors
CAR-T Cell
Crysvita
DMD
Gamifant
Iron – Injectable
Koselugo
Luxturna
NMOSD
Reblozyl
TIMS, Small Molecule JAK Inhibitor
Tolvaptan
Vyvgart
Zometa
Clinical Edit Proposals – New or Revised Criteria:
Daybue
Enjaymo
Filspari
Givlaari
Joenja
Synagis
Tepezza
Preferred Drug List Edit Proposals – Existing Criteria:
Alpha Glucosidase Inhibitors
Amylin Analogs
Biguanides & Combination Agents
Cryopyrin-Associated Periodic Syndrome (CAPS)
DPPIV Inhibitors
Erythropoiesis Stimulating Agents
GLP-1s and Combination Agents
Insulin, Mixed
Insulin, Non-Analogs
Insulin, Rapid Acting
LHRH, GnRH Agents, Oral
Meglitinides
Methotrexate Agents
Psoriasis Agents, Oral
Sulfonylurea Agents, 2nd Generation
Thiazolidinediones & Combos
TIMs, IL17 Receptor Antagonists
TIMs, IL23-12 Inhibitors
Preferred Drug List Edit Proposals – New or Revised Criteria:
Atopic Dermatitis Agents, ImmunomodulatorsBleeding Disorder Agents
Colony Stimulating Factors
Growth Hormone Agents, Somatropin
Growth Hormone Releasing Factors, Select Agents
Insulin, Long Acting
LHRH, GnRH Agents, Non-Oral
Multiple Sclerosis Agents, Injectable
Multiple Sclerosis Agents, Oral
Psoriasis Agents, Topical
SGLT Inhibitors
Thrombocytopenia Agents
TIMs, IL6 Receptor Inhibitors
TIMs, JAK Inhibitors
TIMs, Misc Allergy & Asthma Related Monoclonal Antibodies
TIMs, Select Agents
TIMs, TNF Inhibitors
Urinary Tract Antispasmodics
Agenda
Minutes
Edit Implementation Schedule
New Drugs Edits
PDL Announcements
PDL Recommendations
Conduent Reports
Missouri Board of Pharmacy Continuing Education
MO Pharmacy Advisory Board Slides April 2023
Clinical Edit Proposals – No New Criteria:
Acne and Rosacea – Select Topical Agents Step Therapy Edit
Fabry Disease
Givlaari
Imcivree
Isturisa
Megestrol Acetate
Nulibry
Oxervate
Oxlumo
Scenesse
Sickle Cell Disease
Spravato
Systemic Antifungals
Tavneos
Voxzogo
Zokinvy
Zulresso
Clinical Edit Proposals – New Criteria or Revision of Existing Criteria:
Hemgenix
Tzield
Preferred Drug List Edit Review – Existing Criteria:
Actinic Keratosis Agents, Topical
Androgenic Agents
Antibiotics, Inhaled
Anticholinergics, Long Acting Beta Adrenergic (LABA) CombinationsAnticholinergics, Short Acting and Combinations Inhaled
Antifungals, Topical
Antihistamines and Antihistamine/Decongestant Combinations, 2nd Generation
Antihistamines, Intranasal
Antiparasitics, Topical
Antivirals, Herpes Oral
Benzoyl Peroxide/Antibiotic Combinations
Beta Adrenergic Agents, Nebulized
Beta Adrenergic Agents, Short Acting
Corticosteroids, Ophthalmic “Soft”
Corticosteroids, Oral Inhaled
Corticosteroids, Topical
Cough and Cold Preparations
Fluoroquinolones, Ophthalmic
Fluoroquinolones, Otic
Hepatitis C Agents
Leukotriene Receptor Modifiers
Mast Cell Stabilizers, Ophthalmic
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Ophthalmic
Pancreatic Enzyme Agents
Retinoids, Topical
Preferred Drug List Edit – New Criteria or Revision of Existing Criteria:
Anticholinergics, LABAs/ICS Combinations and PDE4 Inhibitors
Anticholinergics, Long Acting Inhaled
Antifungals, Oral
Antihistamines, Ophthalmic
Antivirals, Tropical
Beta Adrenergic Agents, Long Acting
Corticosteroids & Rhinitis Agents, Intranasal
Epinephrine Agents, Self-Injectable
Glaucoma Agents
Inflammatory Bowel Disease Agents, Oral
Inflammatory Bowel Disease Agents, Rectal
January Minutes
Agenda
Edit Implementation Schedule
PDL Announcements
PDL Recommendations
New Drugs & Edits with No Changes
Drug Prior Authorization Process
December 2022 DUR Reports
Clinical Edit Proposals - No New Criteria
Aduhelm Clinical Edit
Antipsychotics - 1st Generation (Typical) Clinical Edit
Benzodiazepines (Select Oral) Clinical Edit
Butalbital Combinations without Codeine Clinical Edit
Corlanor Clinical Edit
Empaveli Clinical Edit
HBV Nucleotide Analog Reverse Transcriptase Inhibitors Fiscal Edit
High Risk Therapies Clinical Edit
Kerendia Clinical Edit
Morphine Milligram Equivalent Accumulation Clinical Edit
Non-Oral Contraceptives Fiscal Edit
Oxazolidinone Fiscal Edit
Pompe Disease Clinical Edit
Selzentry Clinical Edit
Transmucosal Immediate Release Fentanyl (TIRF) Clinical Edit
Verquvo Clinical Edit
Clinical Edit Proposals – New Criteria or Revision of Existing Criteria
Camzyos™ Clinical Edit
Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Modulators Clinical Edit
Opioids – Short-Acting Clinical Edit
Skysona Clinical Edit
Xenpozyme Clinical Edit
Ztalmy Clinical Edit
Zynteglo Clinical Edit
Resource List Edit Review
New Criteria or Revision of Existing Criteria
Antipsychotics - 2nd Generation (Atypical) Depot Agents Resource List
Antipsychotics - 2nd Generation (Atypical) Oral & Transdermal Agents Resource List
Preferred Drug List Edit Review
Existing Criteria
Alzheimer’s Agents, Acetylcholinesterase Inhibitors, N-Methyl-D-Aspartate Receptor Antagonists & Combinations PDL Edit
Antiemetics, 5-HT3 and NK1 Injectables PDL Edit
Antiemetics, 5-HT3, NK1 and Other Select Non-Injectables PDL Edit
Antiplatelet Agents PDL Edit
Anti-Migraine, Serotonin (5-HT1) Receptor Agonists PDL Edit
Anti-Parkinsonism, MAO-B Inhibitors PDL Edit
Anti-Parkinsonism Non-Ergot Dopamine Agonists PDL Edit
Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors PDL Edit
Glucagon Agents PDL Edit
Hereditary Angioedema Agents PDL Edit
NSAIDs PDL Edit
Opioid Emergency Reversal Agents PDL Edit
Opioids, Long Acting PDL Edit
Somatostatin Analogs PDL Edit
Vesicular Monoamine Transporter 2 (VMAT2) Inhibitors PDL Edit
Preferred Drug List Edit Review New Criteria or Revision of Existing Criteria
Anticonvulsants, Dravet Syndrome PDL Edit
Anti-Migraine, Alternative Oral Agents PDL Edit
Antiandrogenic Agents PDL Edit
Antiretroviral Therapy (ART) PDL Edit
Calcitonin Gene-Related Peptide (CGRP) Inhibitors PDL Edit
Fibromyalgia Agents PDL Edit
GI Motility Agents, Chronic PDL Edit
Mitogen-activated Extracellular Kinase Inhibitors (MEKi) & B-raf Kinase Inhibitors (BRAFi) PDL Edit
Neuropathic Pain Agents PDL Edit
Opioid and Select Alcohol Dependence Agents PDL Edit
Sedative Hypnotics PDL Edit
Skeletal Muscle Relaxants PDL Edit
Tramadol-Like Agents PDL Edit
2022
October Meeting Minutes
Agenda
Edit Implementation Schedule
New Drugs and Edits with No Annual Changes
PDL Announcements
PDL Recommendations
Missouri DUR Board Retrospective - DUR Interventions
MO Healthnet Pharmacy Program and Budget Update
Preventing Overdose in Patients Using Medication-Assisted Treatment
Conduent Reports
Clinical Edit Proposals – No New Criteria
Clinical Edit Proposals – New Revised Criteria
PDL Proposals – No New Criteria
ACEI_ACEI-Diuretic Combinations
ACEI_CCB Combinations
ADHD, Methylphenidate SA
ADHD, Non-Stimulants
Alpha Glucosidase Inhibitors
Amylin Analogs
Antibiotics, Mupirocin Topical
Antihyperuricemic Agents
ARB_ARB-Diuretic Combos
ARB-CCB Combos
BB_BB-Diuretic Combos
Benign Prostatic Hyperplasia (BPH) Agents
Biguanides and Combination Agents
Bone Ossification Agents
CCB, Non-DHP
Cephalosporins
Direct Renin Inhibitors and Combos
DPPIV Inhibitors
Electrolyte Depleting Agents, Phosphate Lowering
Fluoroquinolones, Oral
Homozygous Familial Hypercholesterolemia (HoFH)
Insulin, Mixed
Insulin, Non-Analogs
Insulin, Rapid Acting
Macrolides
Meglitinides
Methotrexate Agents
Niacin Derivatives
PAH, ETRAs
PAH, PDE5-SGC
PAH, Prostacyclins Oral
Penicillins
SGLT2 Inhibitors
Statins and Combos
Sulfonylurea Agents, Second Generation
Tetracyclines
Thiazolidinediones and Combinations
Thrombocytopenia Agents
Triglyceride Lowering Agents
PDL Proposals – New Revised Criteria
ADHD, Amphetamines Long Acting
ADHD, Amphetamines Short Acting
ADHD, Methylphenidate Long Acting
Antibiotics, GI Oral
Antibiotics, Vaginal
Anticoagulants, Oral and Subcutaneous
Anticonvulsants, Rescue Agents
Bile Salt Agents
CCB, DHP
Colony Stimulating Factors
Cryopyrin-Associated Periodic Syndrome (CAPS)
Dry Eye Disease Agents
Electrolyte Depleting Agents, Potassium Lowering
Erythropoiesis Stimulating Agents
GLP-1 Receptor Agonists and Combination Agents
Growth Hormone Agents, Somatropin
Growth Hormone and Growth Hormone Releasing Factors, Select Agents
Insulin, Long Acting
LHRH, GnRH Agents, Non-Oral
LHRH, GnRH Agents, Oral
Multiple Sclerosis Agents, Injectable
Multiple Sclerosis Agents, Oral
PAH, Prostacyclins Inhaled
PAH, Prostacyclins Injectable
PCSK9 Inhibitor
Proton Pump Inhibitors (PPIs)
Sympatholytics
Targeted Immune Modulators JAK Inhibitors
Targeted Immune Modulators, IL6 Receptor Inhibitors
Targeted Immune Modulators, IL17 Receptor Antagonists
Targeted Immune Modulators, IL23-12 Inhibitors
Targeted Immune Modulators, Misc Allergy and Asthma Related Monoclonal Antibodies
Targeted Immune Modulators, Select Agents
Targeted Immune Modulators, TNF Inhibitors
Urinary Tract Antispasmodics
Approved July Meeting Minutes
Agenda
Edit Implementation Schedule
PDL Announcements
New Drugs and Edits With No Annual Changes
Conduent Reports
July 2022 DUR Reports
Clinical Edit Proposals – No New Criteria:
Ampyra
ATTR
Botulinum Toxin
DMD
Emsam
Gamifant
Immunoglobulin
Koselugo
Luxturna
Narcolepsy Inhibitors
NMOSD
Nuedexta
Oxandrin
Palforzia
Palynziq
Ranexa
Reblozyl
SSRI
Synagis
Tepezza
Tolvaptan
Xcopri
Zometa
Clinical Edit Proposals – New Revised Criteria:
Besremi
CAR-T Cell
Crysvita
Enjaymo
Enzyme Deficiency, Select Agents
Iron – Injectable
LEMS
Manufacturers Requiring PA
PolyPharm
PTH and Other Agents
SNRI
TIMS, Small Molecule JAK Inhibitor
Vyvgart
Minutes
Agenda
MHD Rescue Inhaler Policy
Edit Implementation Schedule
PDL Announcements
PDL Recommendations
New Drugs & Edits with No Annual Changes Presentation
March DPAC Reports
Clinical Edit Proposals – No New Criteria:
Imcivree
Megestrol Acetate
Nulibry
Oxervate
Oxlumo
Spravato
Zokinvy
Zulresso
Clinical Edit Proposals – New Revised Criteria:
Acne or Rosacea - Select Topical Agents
C5 Complement Inhibitors
CFTR Modulators
Fabry Disease
Givlaari
Isturisa
Scenesse
Sickle Cell Disease
Systemic Antifungals
Tavneos
Voxzogo
PDL Proposals – No New Criteria:
Actinic Keratosis Agents, Topical
Androgenic Agents
Antibiotics, Inhaled
Antifungals, Topical
Antihistamines and Antihistamine-Decongestant Combinations, Second Generation
Antihistamines, Intranasal
Antivirals, Herpes Oral
Antivirals, Topical
Benzoyl Peroxide-Antibiotic Combinations
Corticosteriods, Oral Inhaled
Corticosteroids and Rhinitis Agents, Intranasal
Corticosteroids, Topical
Cough-Cold Preparation
Epinephrine Agents, Self-Injectable
Fluoroquinolones, Ophthalmic
Fluoroquinolones, Otic
Glaucoma Agents
Mast Cell Stabilizers, Ophthalmic
NSAIDS, Ophthalmic
Psoriasis Agents, Oral
Psoriasis Agents, Topical
Retinoids, Topical
Ulcerative Colitis Agents, Oral
Ulcerative Colitis Agents, Rectal
PDL Proposals – New Revised Criteria:
Anticholinergics LABAs-ICS Combinations and PDE4 Inhibitors
Anticholinergics, Long Acting Beta Adrenergics Combinations
Anticholinergics, Long Acting Inhaled
Anticholinergics, Short Acting and Combinations Inhaled
Antifungals, Oral
Antihistamines, Ophthalmic
Antiparasitics, Topical
Atopic Dermatitis Agents, Immunomodulators
Beta Adrenergic Agents, Short Acting
Beta Adrenergic Agents, Long Acting
Beta Adrenergic Agents, Nebulized
Corticosteroids, Ophthalmic Soft
Hepatitis C Agents
Leukotriene Receptor Modifiers
Pancreatic Enzymes
Respiratory Monoclonal Antibodies
Agenda
Edit Implementation Schedule
PDL Announcements
PDL Recommendations
New Drugs & Edits with No Changes
Pharmacy Program & Budget Update Presentation
Conduent Reports
Opioid Policy Review Edits/Proposals
High Risk Therapies
MHD Opioid Policy Update
MME
Opioid Dependence Agents
Opioid Emergency Reversal Agents
Opioids, Long Acting
Opioids, Short Acting
TIRF
Tramadol-Like Agents
PDL Proposals - No New Criteria
Alzheimer's Agents
Anticonvulsants, Dravet Syndrome
Antiemetics, THC Derivativ1
Anti-Parkinsonism, MAO-B Inhibitors
Anti-Parkinsonism, Non-Ergot Dopamine Agonists
GI Motility Agents, Chronic
Somatostatin Analogs
PDL Proposals – New Revised Criteria
Antiandrogenic Agents
Antiemetics, 5-HT3 and NK1 Injectables
Antiemetics, 5-HT3, NK1 and Other Select Non-Injectables
Anti-Migraine, Alternative Oral Agents
Anti-Migraine, Serotonin (5-HT1) Receptor Agonists
Antiretroviral Therapy (ART)
Bile Salt Agents
Calcitonin Gene-Related Peptide (CGRP) Inhibitor
CDK4-6 Inhibitors
Fibromyalgia Agents
Glucagon Agents
Hereditary Angioedema Agents
Homozygous Familial Hypercholesterolemia (HoFH)
Neuropathic Pain Agents
NSAIDs
Sedative Hypnotics
Skeletal Muscle Relaxants
VMAT2 Inhibitors
Clinical Edits – No New Criteria
15 Day Supply Oral Oncology
Butalbital Combo Without Codeine
Butalbital Combo Excessive Therapy
Diabetic Supply Quantity
Out of State Pharmacies
Selzentry
Clinical Edits – New Revised Criteria
15 Day Supply
Antipsychotics, 1st Gen (Typical)
Antipsychotics, 2nd Gen (Atypical)
APAP Accumulation
Benzodiazepines Select Oral
BiDil
Biosimilar vs Reference Products
Corlanor
Empaveli
Extended Supply
High Cost Medications
Kerendia
Non-Oral Contraceptives
Pompe Disease
SMA
2021
Agenda
January 2021 Draft Meeting Minutes
Edit Implementation Schedule
PDL Announcements
PDL Recommendations
New Drugs & Edits with No Annual Changes
Conduent Reports
Helpdesk Status ReportLogging Table
MO User Stats
New Drug Summary
Top 25 Drugs Quarterly Report
Clinical Edit Proposals
15 Day Supply15 Day Supply Oral Oncology
Antipsychotics, 1st Generation (Typical)
Antipsychotics, 2nd Generation (Atypical)
APAP Accumulation
Benzodiazepines Select Oral
BiDil
Biosimilar vs Reference
Butalbital Combo without Codeine
Butabital Combo Excessive Therapy
Car T Cell
Corlanor
Diabetic Supply Quantity
DMD
Entresto
High Cost Medication Kits
High Risk Therapies
Isturisa
MME
NMOSD
Non-Oral Contraceptive
Opioids Single Agent – Short Acting
Out of State Pharmacies
PolyPharm
PrEP
Selzentry
SMA
TIRF
Preferred Drug List Proposals
Alzheimer’s AgentsAntiandrongenic Agents
Anticonvulsants, Dravet Syndrome
Antiemetic 5HT3, NK1, Other Non-Injectable Agents
Antiemetic 5HT3_NK1 Agents, Injectable
Antiemetic THC Derivative Agents
Anti-Migraine Alternative Oral Agents
Anti-Migraine, 5-HT1 Agents
Anti-Parkinsonism, MAO-B Inhibitor Agents
Anti-Parkinsonism, Non-Ergot Dopamine Agonists
Antiretroviral Reference Products
Calcitonin Gene-Related Peptide (CGRP) Inhibitors
CDK4-6 Inhibitors
Fibromyalgia Agents
GI Motility Agents
Glucagon Agents
Hereditary Angioedema
Neuropathic Pain
NSAID Agents
Opioid Dependence Agents
Opioids, Long Acting
Opioids Combos Short-Acting
Sedative Hypnotics
Skeletal Muscle Relaxants
Somatostatic Analogs
Tramadol-Like Agents
VMAT2 Inhibitors
DUR Minutes 4-21-21 Approved
Agenda
Edit Implementation Schedule
PDL Announcement
PDL Recommendations
CONDUENT REPORTS:
Clinical Edit Proposals-No New Criteria:
Acne or Rosacea – Select Topical Agents
Givlaari
Megestrol
Sickle Cell Disease
Systemic Antifungals
Zulresso
Clinical Edit Proposals-New Revised Criteria:
CFTR
Clobazam Agents
Fabry Disease
Nocturnal Polyuria
Opioids – Single Agent Short Acting Oxlumo
Spravato
PDL Proposals-No New Criteria:
Actinic Keratosis Agents, Topical
Antifungals, Oral
Antihistamines, Intranasal
Antihistamines-Decongestant Combinations, Second Generation
Antivirals, Oral
Antivirals, Topical
Benzoyl Peroxide-Antibiotic Combinations
Beta Adrenergic Agents, Long Acting
Beta Adrenergic Agents, Nebulized
Cough-Cold Preparations
Fluoroquinolones, Ophthalmic
Mast Cell Stabilizers, Ophthalmic
NSAIDS, Ophthalmic
Pancreatic Enzymes
Psoriasis Agents, Oral
Psoriasis Agents, Topical
Retinoids, Topical
Ulcerative Colitis Agents, Rectal
PDL Proposals-New Revised Criteria:
Androgenic Agents
Antibiotics, Inhaled
Antifungals, Topical
Antihistamines, Ophthalmic
Antiparasitics, Topical
Atopic Dermatitis Agents, Immunomodulators
Beta Adrenergic Agents, Short Acting
COPD Agents
Corticosteroids, Inhaled
Corticosteroids, Intranasal
Corticosteroids, Ophthalmic Soft
Corticosteroids, Topical
Epinephrine Agents, Self-Injectable
Fluoroquinolones, Otic
Glaucoma Agents
Hepatitis C Agents
Hereditary Angioedema (HAE)
Leukotriene Receptor Modifiers
Respiratory Monoclonal Antibodies
Ulcerative Colitis Agents, Oral
DUR Minutes 7-21-21
Agenda
PDL Recommendations
New Drugs
Edit Implementation Schedule
PDL Announcements
Conduent Reports:
CyberAccess User StatisticsJune 2021 DPAC Reports
PDL Proposals – No New Criteria
Amylin AnalogsAntibiotic, Vaginal
Bile Sale Agents
Cephalosporin Agents
Electrolyte Depleting Agents, Phosphate Lowering
Electrolyte Depleting Agents, Potassium Lowering
Fluoroquinolone Agents, Oral
Insulin, Mixed
Insulin, Non-Analogs
Penicillin Agents
Sulfonylurea Agents, Second Generation
Targeted Immune Modulators, IL6 Receptor Inhibitors
Thrombocytopenia Agents
PDL Proposals – New Revised Criteria
Alpha Glucosidase InhibitorsAntibiotics, GI Oral
Antibiotics, Mupirocin Topical
Antihyperuricemic Agents
Benign Prostatic Hyperplasia Agents
Biguanides
Bone Ossification Agents
Colony Stimulating Factors
Cryopyrin-Associated Periodic Syndrome (CAPS)
DPPIV Inhibitor
Erythropoiesis Stimulating Agents
GLP-1 Agonists
Growth Hormone Agents, Somatropin
Growth Hormone, Growth Hormone Releasing Factors, Select Agents
Insulin, Long Acting
Insulin, Rapid Acting
LHRH_GnRH Agents, Non-Oral
Macrolide Agents
Meglitinide Agents
Methotrexate Agents
Multiple Sclerosis Agents, Injectable
Multiple Sclerosis Agents, Oral
SGLT2 Inhibitors
Targeted Immune Modulators, IL17
Targeted Immune Modulators, IL23 IL12 inhibitors
Targeted Immune Modulators, JAK Inhibitors
Targeted Immune Modulators, Select Agents
Targeted Immune Modulators, TNF Inhibitors
Tetracycline Agents
Thiazolidinediones
Urinary Tract Antispasmodics
Clinical Edits – No New Criteria
AmpyraElagolix
Gamifant
Koselugo
Luxturna
Oxervate
Reblozyl
Synagis
Tepezza
Tolvaptan
Zometa
Clinical Edits – New Revised Criteria
CAR-T CellCrysvita
DMD
Entresto
Extended Supply
HBV Nucleotide Analog
Imcivree
Iron – Injectable
Nulibry
Oxazolidinone
Palynziq
PTH and Other Agents
Verquvo
Zokinvy
Agenda
October 20, 2021 Meeting Minutes - Draft
Edit Implementation Schedule
PDL Announcements
PDL Recommendations
New Drugs & Edits With No Annual Changes Presentation
DUR Board Meeting Proposed Retrospective DUR Presentation
Conduent Reports:
PDL Proposals – No New Criteria:
Angiotensin Receptor Blocker/Angiotensin Receptor Blocker Combo
Angiotensin Receptor Blocker/Calcium Channel Blocker Combo
Calcium Channel Blockers, Dihydropyridines
Calcium Channel Blockers, Non-Dihydropyridines
Direct Renin Inhibitors & Combos
Dry Eye Disease Agents
Niacin Derivatives
PAH Agents, ETRAs
PAH Agents, Prostacylin Pathway Agonists, Inhaled
PAH Agents, Prostacyclin Pathway Agonists, Oral
Sympatholytic Agents
PDL Proposals – New Revised Criteria:
ACE Inhibitors and ACE Inhibitors/Diuretic Combo
ACE Inhibitor/Calcium Channel Blocker Combinations
ADHD, Amphetamines Long Acting
ADHD, Amphetamines Short Acting
ADHD, Methylphenidate Long Acting
ADHD, Methylphenidate Short Acting
ADHD, Non-Stimulant Agents
Anticoagulant Agents, Oral and Subcutaneous
Anticonvulsants, Rescue Agents
Antiplatelet Agents
Beta Adrenergic Blockers and Beta Adrenergic Blockers/Diuretic Combo
PAH Agents, PDE5 and SGC Stimulators
PAH Agents, Prostacyclin Pathway Agonists, Injectable
PCSK9 Inhibitors
Proton Pump Inhibitors
Statins and Combinations
Triglyceride Lowering Agents
Clinical Edits – No New Criteria:
Emsam
Immunoglobulins
Lambert-Eaton Myasthenic Syndrome
Neuromyelitis Optica Spectrum Disorder
Nuedexta
Oxandrin
Palforzia
Ranexa
Xcopri
Clinical Edits – New Revised Criteria:
Aduhelm
Botulinum Toxin
Equetro
Narcolepsy Inhibitors
Psychotropic Medications Polypharmacy
Serotonin and Norepinephrine Reuptake Inhibitors
Selective Serotonin Reuptake Inhibitor
Transthyretin-Mediated Amyloidosis
2020
Minutes
Edit Implementation Schedule
New Drugs
PDL Announcement
PDL Recommendations
Clinical Edits
Acne or Rosacea – Select Topical AgentsClobazam Agents
DMD
Epidiolex
Galafold
Givlaari
Megestrol Acetate
Nocturnal Polyuria
Reblozyl
Sickle Cell Disease
Spravato
Systemic Antifungals
Preferred Drug List (PDL)
Actinic Keratosis Agents - TopicalAndrogenic Agents
Antibiotics – Inhaled Agents
Antifungal Agents – Oral
Antifungal Agents – Topical
Antihistamines – Intranasal
Antihistamines – Ophthalmic
Antihistamines/Decongestant Combinations – Low Sedating (2nd Generation)
Antiparasitic Agents – Topical
Antiviral Agents – Herpes Oral
Antiviral Agents – Topical
Atopic Dermatitis Agents – Immunomodulators
Benzoyl Peroxide/Antibiotic Combinations
Beta-Adrenergic Agents – Long Acting
Beta-Adrenergic Agents – Nebulized
Beta-Adrenergic Agents – Short Acting
COPD Agents
Corticosteroids – Inhaled
Corticosteroids – Ophthalmic “Soft” Steroids
Corticosteroids – Topical
Corticosteroids and Rhinitis Agents – Intranasal
Cough and Cold Preparations
Epinephrine Self-Injectable Agents
Fluoroquinolones – Ophthalmic
Fluoroquinolones – Otic
Glaucoma Agents
Leukotriene Receptor Modifiers
Mast Cell Stabilizers – Ophthalmic
NSAIDs – Ophthalmic
Pancreatic Enzyme Agents
Psoriasis Agents – Oral
Psoriasis Agents – Topical
Retinoids – Topical
Ulcerative Colitis Agents – Oral
Ulcerative Colitis Agents - Rectal
Reports
Top 25 DrugsHelpdesk Status Report
Logging Table
MO User Stats
New Drug Summary
New Drugs
Clinical & Fiscal Edits
AmpyraCrysvita
Diacomit
Gamifant
Iron - Injectable
Koselugo
Luxturna
Orilissa
Oxervate
Palynziq
PTH and Other Agents
Reblozyl
Synagis
Tepezza
Tolvaptan
Preferred Drug List (PDL)
Alpha Glucosidase InhibitorsAmylin Analogs
Antibiotics - Vaginal
Antibiotics GI - Oral
Antihyperuricemic Agents
Anti-Migraine Alternative Oral
Biguanides
Bile Salt Agents
Bone Ossificiation Agents
BPH
CAPS
Cephalsporins
Colony Stimulating Factors
DPPIV
Elect Depleters - Potassium Lowering
Elect Depleters -Phosphate Lowering
Erythropoiesis Stimulating Agents
Fluoroquinolones, Oral
GH GHRF Select Agents
GH Somatropin Agents
GLP1 Agonists
Hep C Agents
Insulins - Long Acting
Insulins_Non-Analogs
Insulins_Rapid Acting
Insulins-Mixed
Macrolide
Meglitinides
Methotrexate
MS_Injectable Agents
MS_Oral Agents
Penicillins
SGLT2 Inhibitors
Sulfonylureas-2nd Generation
Tetracyclines
Thiazolidinediones
Thrombocytopenia Treatment Agents
TIMS IL6 Receptor Inhibitors
TIMS IL17
TIMS JAK Inhibitors
TIMS Select Agents
TIMS TNF Inhibitors
Urinary Antispasmodics
Minutes
Edit Implementation Schedule
PDL Announcements
PDL Recommendations
New Drug List
MHD Pharmacy Program & Budget Update
Clinical Edit Proposals
ATTRBotulinum Toxins
Elagolix
Emsam
Equetro
Fintepla
Immunoglobulin
LEMS
Narcolepsy Inhibitors
Nuedexta
Oxandrin
Palforzia
Ranexa
SNRI
SSRI
Uplizna
VMAT2
Xcopri
Zometa
Conduent Reports
Top 25 Drugs Quarterly ReportHelpdesk Status Report
Logging Table
MO User Stats
New Drug Summary
Preferred Drug List
ACEI/ACEI Diuretic CombosACEI/CCB Combos
ADHD Amphetamines Long Acting
ADHD Amphetamines Short Acting
ADHS Methylphenidates Long Acting
ADHS Methylphenidates Short Acting
ADHD Non-Stimulants
Anticoagulants
Anticonvulsants Rescue Agents
Antiplatelets
ARB/ARB Diuretic Combos
ARB/CCB Combos
BB/BB-Diuretic Combos
CCB/DHP
CCB NonDHP
Direct Renin Inhibitors-Combos
Dry Eye Agents
HFHC
Niacin Derivatives
PAH ETRAS
PAH PDE5 SGC
PAH Prostacyclins Inhaled
PAH Prostacyclins Injectable
PAH Prostacyclins Oral
PCSK9 Inhibitors
PPIs
Statins
Sympatholytics
Triglyceride Lowering Agents