FormWeb • P & T Update Memo April 2018

Huntsville Hospital

Approved Hospital Formulary

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Huntsville Hospital

Approved Hospital Formulary

Suggestions or Corrections? Above and Beyond Nominations Formulary Request

P & T Update Memo April 2018

Following is a P and T Committee update (from the April 24^th meeting). Starting date for specific programs is 30 April 2018, unless otherwise noted. Please let me know if you have any questions or comments. Don’t forget to check the “New Drug Monitoring Spotlight” section of the website, which provides important monitoring information about newly approved drugs. Also, attached is the updated version of the “Not Stocked, Not Ordered” drug list with the new additions highlighted in red.

Below is the memo with links to the drug monographs, protocols, and formulary documents. Click to access the full P&T packet for this month, or here to access the P&T packet archive.

Drug or Drug Class	Formulary Decision	Comments
gemtuzumab ozogamicin (Mylotarg)	Formulary, Restricted Referred to High Value Care Committee	This intravenous drug will be restricted to oncologists. Inpatient use would be restricted to newly diagnosed CD33 positive AML patients receiving combination induction or consolidation treatment. Other indications would be restricted to outpatient infusion areas. Pending further evaluation from HVCC.
abemaciclib (Verzenio)	Non-Formulary	Defer initiation of this oral drug until after hospital discharge. Inpatients may use own supply.
acalabrutinib (Calquence)	Non-Formulary	Defer initiation of this oral drug until after hospital discharge. Inpatients may use own supply.
letermovir (Prevymis)	Non-Formulary	Indicated for CMV prophylaxis in allogeneic stem cell transplant patients. HH is currently only involved in autologous stem cell transplants.
leuprolide acetate (Lupron vs. Eligard)	Formulary, Restricted Automatic Interchange Approved for Prostate Cancer	All orders for leuprolide acetate should continue to be deferred to the outpatient infusion areas or clinics if possible. Eligard is the formulary agent for prostate cancer; Lupron is the formulary agent for other indications. If inpatient therapy is required, pharmacist should contact MD to determine if the dose can be deferred to the outpatient setting. If not, Eilgard will be the formulary workhorse for prostate cancer treatment (maximum inpatient dose is 7.5 mg). Lupron remains formulary restricted. Inpatient use limited to endometriosis, or uterine leiomyomas (maximum inpatient dose 3.75 mg) if dose unable to be deferred to outpatient setting.
bevacizumab-awwb (Mvasi)	Formulary, Restricted Therapeutic Equivalent to Avastin for Oncology Indications	Restricted to use by oncology in the outpatient setting. Approved as a therapeutic equivalent to Avastin in oncologic indications. An automatic interchange between based on cost/reimbursement issues for the patient case and time period also approved. Use in other indication (e.g. retinopathy of prematurity) will be evaluated at a later date.
trastuzumab-dkst (Ogivri)	Formulary, Restricted Therapeutic Equivalent to Herceptin	Restricted to use by oncology in the outpatient setting. Approved as a therapeutic equivalent to Herceptin. An automatic interchange between based on cost/reimbursement issues for the patient case and time period also approved.
cetuximab (Erbitux)	Formulary Restrictions Updated	Remains restricted to oncology. Inpatient use restricted to treatment of head or neck cancer in patients being treated with radiation therapy and not candidates for cisplatin therapy. May be utilized in the outpatient setting.
antihemophilic factor-von Willebrand factor complex [human] (Alphanate)	Formulary, Workhorse Agent	Compared to Humate-P, Alphanate has a lower cost, easier reconstitution and administration, and a variety of available dosage strengths. Alphanate should be used unless “no sub” written with Humate P. Contact prescriber if Humate P written to discuss change to Alphanate.
Antihemophilic factor-von Willebrand factor complex [human] (Humate-P)	Reclassified as Formulary, Restricted Interchange Approved	Restricted to “no substitution” orders. The prescriber will be contacted to determine the specific dose of Alphanate for each patient case.
Corticosteroid inhaler update for pediatrics	Pediatric Formulary Interchange Program Updated	mometasone furoate (Asmanex HFA) will replace Qvar as the workhorse corticosteroid inhaler in pediatric patients.
Otic products update	Domeboro Otic Solution has been discontinued	acetic acid 2% (without aluminum acetate) will serve as a preferred formulary agent; replacing Domeboro (aluminum acetate/acetic acid) Otic Solution.
Anti-Fibrinolytic Order Set for Spinal Surgery / Amicar Shortage	Order Set Approved	Adds the option for tranexamic acid use in spinal procedures. Implementation of the order set to be determined; pending approval from other institutional committees.

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