WYDUR Board Meeting Minutes

Thursday, July 29, 2004

Laramie, Wyoming

 

 

Members Present:  Bill Harrison, Roxanne Homar, Deb Devereaux, Kay Kohler, Becky Drnas, Dean Winsch, Kendra Grande, Aimee Lewis, Antoinette Brown, Richard Johnson, Lenny Kosirog

 

Members Excused: Steve Brown, George Zaharas, Mike Carpenter, Linda Martin

 

Guests:  Dr. Melinkovich, Bobbie Cesko, Laura Miller, Patrick Teegarden (Schering-Plough), Bert Jones (GSK), Alan Sloan (Purdue), Tim Hynek (Lilly), Larry Bridger (Pfizer), Bob Schultz (BCBS-Wy), Jeff Jenkins (Merck), Laura Hill (Takeda)

 

Dr. Kohler called the meeting to order at 11:10a.m.   

The minutes of the May 27, 2004 meeting were approved as presented.

 

Department of Health-

Prior Authorization statistics:  for PPIs $133.48 average per claim cost prior to PA-currently $64.48 average per claim cost.  For the period Jan-June 2004, savings are $237,000.

For ACEI:  prior to PA avg. per claim cost of $27.31 now is $23.54 average per claim cost.  Total 3 month savings = $23,525

Legislature:  DAW legislation pending for this upcoming session which would circumvent the PA/PDL process.  The Board discussed narrow therapeutic index drugs and what data there is to substantiate the NTI designation.  The legislative special session has been meeting to limit non-economic damages as part of tort reform.  OB/GYN reimbursement codes were also bumped up and help with malpractice insurance for OB/GYNs who deliver fewer than 35-50 babies per year.

The substance abuse division has requested that the pharmacy program cover smoking cessation products.  The department will look at potential usage.  There may be some general funds from the tobacco settlement to use for these products.  There will be more information in September.

The APS group will present their disease management programs to the DUR Board in September. 

Prilosec OTC is in short supply-the ACS help desk will allow the patients to have generic omeprazole.

The State MAC program will be expanding and a tiered co-pay will be implemented November 1, 2004 ($3-non preferred brand, $2-preferred brand, $1-generic)

The PDL Advisory Group meeting for August was cancelled because the final reports from Oregon were not available.  The October meeting will be considering 3 classes-non sedating antihistamines and two others.

The 2005-2006 budget for the pharmacy program is $80.1 million.  About $5 million was removed from the requested budget amount.  At the end of FFY 2004, $37.2 million (net of rebates of $11.1 million) had been spent.  Average recipients per month have increased from 17,000 to 18,700.  A supplemental budget request will be submitted by August 2004.

 

Disease Management programs-the Berlex MS program is at the IRB approval stage.

 

Neurontin-ACS now has the ability to add ICD9 codes and provider specialty types.  The Board discussed asking providers to enter the diagnosis on the face of the prescription.  The Board discussed various strategies to deal with the off label usage of Neurontin.  The general perception is that Neurontin is being used for pain as a drug of last resort--there are no alternatives.  Insuring provider access has to be weighed against Neurontin restrictions which will be unpopular.  The Board decided to ask APS to look at Neurontin patients and providers, send out data on utilization and Dr. Johnston's article to the top prescribers of Neurontin.  Dr. Johnston will also provide a newsletter article for the DUR newsletter.  The Board also requested that the PDL advisory committee consider Neurontin use for pain during its review of the anticonvulsant category.

 

Dr. Johnston reviewed the results of an analysis of asthma drug utilization.  He will provide an article for the newsletter on this analysis.  A recommendation will be sent to HID to add criteria for daily inhaled beta agonist use as high risk.

 

Kendra reported that the Somatotropin review shows three patients that may need follow-up.

 

Alert changes:  #132  suppress tricyclic antidepressants and SSRIs

            Add criteria Spiriva and ipratropium is duplication (Combivent and Atrovent)

 

There being no further business the meeting was adjourned at 3:00p.m.

 

Respectfully Submitted,

 

Debra S. Devereaux MBA, FASHP

DUR Manager