WYDUR Board Meeting Minutes

Thursday, September 30, 2004

Cheyenne, Wyoming

The Hitching Post

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

Members Excused: George Zaharas, Mike Carpenter

Guests: Teresa Andersen (RPh student), Gerry Kiplinger APS, Michelle Crist APS, DJ Vogele APS, Brett Brasfield (RPh student), Angela McCoy (Janssen), Dyan McGrath (AstraZeneca), Marcelo Kort (Lilly), Joan Solem (Lilly), Tim Hynek (Lilly), Alan Sloan (Purdue), Bert Jones (GSK), Chris Lepore (J&J), Betty Iverson (Wyeth), Bob Schultz (BCBS WY), Pat Teegarden (Schering-Plough), Lori Howarth (Berlex), Larry Bridger (Pfizer)

Dr. Kohler called the meeting to order at 11:00 a.m.

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

Department of Health-

APS- Gerry Kiplinger presented a brief summary of the new disease management contract between Wyoming Medicaid and APS. APS is "at risk" for the entire Wyoming MK population of which 8000 recipients are aged, blind and disabled.

APS has contracts for 25% of the entire US MK population In 13 states. They have a clinical staff of 30 comprised of RNs and social workers. The telephonic case management portion resides In Montana. The Medical Director for the contract Is Dr. Marion Smith from Torrington.

Prior Authorization-no new statistics were available for the July additions. There continues to be a shift to the preferred drugs. Rankings for the top 20 drugs in the Wyoming MK population for SFY 2004 are attached.

Preferred Drug List-next meeting is October 21. The therapeutic categories discussed will be skeletal muscle relaxants, long acting opioids and calcium channel blockers. The final statin report will also be considered. There will be a short meeting on December 2 to discuss non-sedating antihistamines.

Other-a supplemental budget request for MK including the pharmacy program was submitted to the governor's office. The increased amount of brand use and diversion of narcotics are of concern. Beginning October 1, 2004, all controlled substance prescriptions are submitted electronically to the Board of Pharmacy.

Newsletter-

Steve Brown will write an article on adolescent use of SSRIs. Other suggestions for inclusion are antihypertensive utilization and information about consultative services.

Brett Brasfield reported on the incidence of diabetes with atypical antipsychotic use. The mechanism of the adverse effect is not entirely known. There is a black box warning on all agents in the class.

Open Comments-Dr. Brown updated the Board and asked for support for denying prescriptive privileges for clinical psychologists. There are valid concerns about the pharmacology education and expertise in addition to quality care and cost issues.

The question was also raised as to what percent of prior authorization requests are being approved?

Alert Changes-

Criteria #383-change mg strength to 160 mg

Change ADHD age to <5 yo

Criteria # 650-increase Effexor SR to 300 mg

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

Respectfully Submitted,

Debra S. Devereaux MBA, R.Ph.

DUR Manager