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Following is a P and T Committee update (from the July 24th meeting). Starting date for specific programs is 6 August 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 |
| inFLIXimab-abda (Renflexis) Biosimilar | Formulary, Restricted |
Classified as equivalent to Remicade and Inflectra. Same restrictions as Remicade. inFLIXimab product selection will depend on comparative costs of products and reimbursement issues, and choice of product will likely change over time |
| pitavastatin magnesium (Zypitamag) |
Formulary Automatic Interchange Approved |
The lower cost pitavastatin salt (Livalo, Zypitamag, Nikita) will be stocked and dispensed. |
| pitavastatin sodium (Nikita) |
Formulary Automatic Interchange Approved |
The lower cost pitavastatin salt (Livalo, Zypitamag, Nikita) will be stocked and dispensed. |
| ARIPiprazole lauroxil (Aristada) 1,064 mg | Formulary, Restricted |
Only the 1,064 mg strength (dosed q 2 months) will be stocked under a Patient Free Trial Program similar to Invega Sustenna. This will require maintaining a patient use log and screening for previous doses. Use is restricted to psychiatrists (or psychiatrist consult) for initiation of Aristada therapy only. Other dosages of Aristada remain Non-Formulary. |
| fluticasone (Xhance) Nasal Spray |
Non-Formulary Automatic Interchange Approved |
Xhance is a more concentrated fluticasone product used to treat nasal polyps. Automatically interchange to generic Flonase nasal spray at approximately the same total daily dose. |
| oxyCODONE Liquid Concentrated (20 mg/mL) | Formulary, Restricted |
Due to safety concerns with this more concentrated opiate liquid, restrictions similar to those of concentrated morphine oral solution will be put in place. Anticipate this to be used mainly in palliative care for patients who cannot take morphine oral solution. |
| memantine-donepezil (Namzaric) Update |
Non-Formulary Automatic Interchange Updated |
memantine-donepezil (Namzaric) will continue to be interchanged to the two agents dispensed separately. Two new strengths, 7 mg/10 mg and 21 mg/10 mg, were added to the interchange program. |
| L-glutamine (Endari) | Non-Formulary |
Drug is managed per specialty pharmacy and sent directly to patient’s home. Inpatients may use own supply. |
| Novo-Seven MUE | Overall, 80% of doses met criteria for use in 2017 N = 36 adult patients, 45 doses |
Follow-up plans include physician and pharmacist education, Cerner build for PCC – NovoSeven drug interactions, and continuing ongoing MUE. |
| Medication Shortage Report | Critical Shortages Discussed |
Includes diltiazem inj, hydralazine inj, opiate injs, some IVFs, Amicar inj., diazepam inj., some local anesthetics, pamidronate inj, scopolamine patch |
| gemtuzumab ozogamicin (Mylotarg) | Formulary, Restricted |
Reviewed by High Value Committee and approved use restrictions as follows: restricted to use by oncologists in outpatient and inpatient setting, inpatient setting restricted to newly diagnosed CD33 positive AML patients receiving combination therapy induction or consolidation treatment. |
| daunorubicin liposomal-cytarabine liposomal (Vyxeos) | Formulary, Restricted |
Reviewed by High Value Committee and approved use restrictions as follows: use restricted to oncology, in outpatient and inpatient setting, inpatient setting restricted to patients receiving induction phase therapy, and consolidation phase therapy in patients who require hospitalization during that phase. |
| sugammadex (Bridion) | Formulary, Restricted |
Reviewed by High Value Committee. Criteria for use narrowed to: |