WYDUR Board Meeting Minutes

Thursday March 25, 2004

Laramie, Wyoming

Ramada Inn

11:00a.m.-3:00p.m.

Members Present: Kay Kohler, Becky Drnas, Kendra Grande, Antoinette Brown, Dawn Ford, Scott Johnston, Mike Carpenter, Richard Johnson, George Zaharas, Bill Harrison, Lenny Kosirog, Deb Devereaux

Members Excused: Steve Brown

Guests: Bobbie Cesko, John Vandel, Justin Woods (VA resident), Laura Miller, Lori Howarth (Berlex), Dennis Sagendorf (Purdue Pharma), Paul Pereira (TAP), Linda Pryor (Pfizer), Larry Bridger (Pfizer), Joan Solem (Lilly), Betty Iverson (Wyeth), Kelly Steiner (Merck), Jeff Jenkins (Merck), Angela McCoy (Janssen), Bob Schultz (BCBS), Michelle Simmons (Ortho McNeil), Allison Kaelberer (Ortho McNeil), Mike Ross (Takeda), Bill Thomson (Pharma Counsel)

The meeting was called to order by Chair Kay Kohler at 11:05a.m.

I. Retrospective and Prospective DUR

Alert Changes: (a.) suppress alert for progesterone contraceptives/migraine because estrogen component is associated with headaches (b) suppress oral contraceptive/antibiotic alert because data surrounding the interaction is weak (c) add alert for acetaminophen maximum dose per day >4gm.

Provider response forms were reviewed.

Other: Data regarding Somatropin (human growth hormone) was reviewed. Most patients are under 17 years old but a few are greater than 18 yo.

The Board discussed the evaluation of drugs for off label use. There are difficulties in identifying those cases purely by data analysis. Dr. Johnston suggested that a review of Viagra, Cialis and Levitra be conducted to ensure that there is no utilization by females. If that use exists, it was suggested that a hard edit would be appropriate.

A special celebration and awards were presented to Dawn Ford for her 12 years of service to the Wyoming Drug Utilization Review Board and program.

The minutes of the January 29, 2004 meeting were approved as presented.

Antoinette presented prior authorization statistics. The next PDL Advisory Group meeting is Thursday April 15 from 10-2 in Cheyenne. Drug classes to be discussed include statins, NSAIDS and an updated PPIs report. The cost savings report recently mandated by the legislature is due sometime in October.

Newsletter suggestions: ACEI equivalency chart, atypical antipsychotics

Dr. Johnston presented data on the utilization of Marinol-delta 9 thc which is the schedule III drug indicated for HIV induced anorexia and cancer induced nausea. There were 29 patients who received the drug at a cost of $105,000. Five patients had an HIV diagnosis, 1 had cancer and 11 had MS. In MS studies, there is no objective improvement in spasticity although subjectively patients reported feeling better. The side effect profile is problematic for non-prior users: heavy sedation with a 30-40% dropout rate. Other states policies regarding this drug will be looked at with a possible hard edit for dosage.

A utilization review report of Mimenda was discussed. There were 20 patients currently utilizing the medication-16 had Alzheimers and 4 had a pain diagnosis. This medication will continue to be monitored.

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

Respectfully Submitted,

Debra S. Devereaux MBA, R.Ph.

Manager, Wyoming DUR