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System Formulary Update
Hepatitis A and Hepatitis B Vaccine Standardization

Situation

The Hepatitis A, Hepatitis B, and Hepatitis A/B Combination vaccine standardization was approved at the November 2020 System Pharmacy and Therapeutics Committee meeting.

Background

The following medications were reviewed:

• Hepatitis A vaccines – Havrix® (adult & pediatric), Vaqta® (adult & pediatric)
• Hepatitis B vaccines – Engerix-B® (adult & pediatric), Recombivax HB® (adult & pediatric), Heplisav-B®
• Hepatitis A/B combination vaccine – Twinrix®

Assessment/Recommendations

Changes Effective: Tuesday, February 23, 2021

Based on contracting opportunities System P&T voted to include the following products on the UNC Health System Medication Formulary:

• Hepatitis A Vaccine
  • Adult – Havrix® (1440 ELISA units/mL) (syringe)
  • Pediatric – Vaqta® (25 units/0.5 mL) (syringe, vial)
• Hepatitis B Vaccine
  • Adult – Heplisav-B® (20 mcg/0.5 mL) (syringe)
  • Pediatric – Recombivax HB® (5 mcg/0.5 mL) (syringe, vial)
• Hepatitis A/B Vaccine
  • Adult – Twinrix® (720 ELISA units/20 mcg/mL) (syringe)
    • RESTRICTED to outpatient clinic administration ONLY

Note: Stock of these formulary products may vary at individual entities

As a result, the following products will be removed from the inpatient drug formulary:

• Vaqta® (50 units/mL)
• Havrix® pediatric (720 ELISA units/mL)
• Recombivax HB® (10 mcg/mL)
• Recombivax HB® High-Dose (40 mcg/mL)
  • Note: this is the ‘dialysis’ formulation; the P&T Committee has determined Heplisav-B is an appropriate alternative for patients receiving dialysis who require Hepatitis B vaccination
• Engerix-B® (20 mcg/mL)
• Engerix-B® pediatric (10 mcg/0.5 mL)