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Following is a P and T Committee update (from the January 26nd meeting). Starting date for specific programs is 1 February 2016, 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 |
| acetaminophen IV (Ofirmev) | Formulary, Restricted Use expanded |
Acetaminophen approvedâ€use has been expanded to include bariatric surgical procedures. Protocol to be created. |
| filgrastimâ€sndz (Zarxio) | Therapeutic Interchange approved for GCSF products (Neupogen, Granix, Zarxio) | The Committee approved therapeutic interchanges between available GCSF products based on procurement costs. |
| trabectedin (Yondelis) | Formulary status, not routinely stocked |
Investigate deferring use to the outpatient setting. A few patients may need to receive as inpatients. |
| fulvestrant (Faslodex) | Reclassified as nonâ€formulary, not stocked. | Reclassified due to rare use and expiring drug stock leading to waste. |
| estramustine (Emcyt) | Reclassified as nonâ€formulary, not stocked. | Reclassified due to rare use and expiring drug stock leading to waste. |
| aspirin CR (Durlaza) | Nonâ€formulary, not stocked. Therapeutic Interchange Approved. | Interchange to immediateâ€release aspirin 81 mg daily. |
| amphotericin B Formulary |
amphotericin B liposomal (AmBisome) classified as formulary workhorse product. Formulary interchange approved. Amphotec & Abelcet: Nonâ€formulary, not stocked. Fungizone: Formulary, not routinely stocked. Restricted. |
Abelcet, Amphotec, and Fungizone will be interchanged to Ambisome at the respective dosages; the MD should be notified. Note that dosing conversions are not 1:1. Fungizone (conventional amphotericin B) may be ordered for restricted use in neonatal patients. |
| elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide (Genvoya) | Nonâ€formulary, not stocked. |
Patient may use home supply. Defer initiation to outpatient setting. If patient’s supply unavailable, contact MD to see if tenofovir DF can be used in place of tenofovir alafenamide, and give drugs separately. Note that the 2 tenofivir salts have different recommendations on use in renal insufficiency. |
| idarucizumab (Praxbind) |
Formulary. Criteria for Use / Protocol Approved. |
Currently no prescriber restrictions, restrictions apply to patient situation. |
| ertapenem MUE Results | MUE Results Discussed | A July 2015 review of ED patients showed 90.2% (n=55) of cases did not meet criteria for use. |
| pipercillin-tazobactam (Zosyn) Drug Shortage Update | 4.5 g vial on shortage. Regimen interchange approved. |
Change 4.5 g every 8 hours dosing regimens to 3.75 g every 6 hrs. If ordered 4.5 g every 6 hours, verify as written. |