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Following is a P and T Committee update (from the October 27th meeting). Starting date for specific programs is 1 November 2015, 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 |
|
Non-formulary, not stocked. Therapeutic Interchange Approved. |
Stioloto Respimat will be converted to albuterol-ipratropium (DuoNeb) nebulizations four times per day. | |
| fluticasone furoate (Arnuity Ellipta) |
Non-formulary, not stocked. Therapeutic Interchange Approved. |
Arunity Ellipta will be converted to mometasone furoate 200 mcg either once or twice daily depending on ordered dosage. |
| secukinumab (Cosentyx) | Non-formulary, not stocked. | Supplied mainly by specialty pharmacy directly to patient, patient to use own drug supply if needed, defer initiation to outpatient therapy. |
| lenvatinib (Lenvima) | Non-formulary, not stocked. | Supplied mainly buy specialty pharmacy directly to patient, patient to use their own drug as an inpatient, initiation deferred to outpt setting. |
| HYDROcodone-guaiFENesin oral solution (Obredon) |
Non-formulary, not stocked. Therapeutic Interchange Approved. |
Interchange to the two separate agents at similar doses. |
| perindopril-amLODIPine (Prestalia) |
Non-formulary, not stocked. Therapeutic Interchange Approved. |
Dispense as separate components. Amlodipine will be dispensed as the same dose. The perindopril component will be interchanged to lisinopril at an equivalent dose. |
| alirocumab (Praluent) | Non-formulary, not stocked. | Defer to outpatient therapy. |
| evolocumab (Repatha) | Non-formulary, not stocked. | Defer to outpatient therapy. |
| hetastarch (Hextend) Shortage | Hextend has been hetastarch workhorse formulary agent. | Dispense Hespan during Hextend shortage, to start when Hextend supply used up (likely will take a few months). |
| Tbo-filgrastim (Granix) | MUE results evaluating appropriate discontinuation of Granix once ANC level> 1,500, showed an opportunity for improvement and cost savings. |
Pharmacists approved to automatically discontinue G-CSF products if ANC > 1,500 and expected to rise, pharmacists may also order CBC with differential on these patients if has not been ordered in past 48 hrs, and G-CSF to be administered at standard 4 pm time to allow for lab evaluation. Starting date of these activities TBA. |
| Carbepenam Shortage | Meropenem shortage expected to continue for at least several months. | Some Primaxin is now available for use as interchange for meropenem. |
| ADE Report | Reports have increased over the last few months. | 9% were preventable, several related to excessive insulin doses. Vancomycin, levofloxacin, and morphine were 3 most common drugs involved in ADEs |