FMOLHS P&T - 2022

February

(System P&T)

Kcentra will remain formulary with the following fixed dosing strategy

• Warfarin related life-threatening bleeding-1500 units
• Anti-Xa related life-threatening bleeding-2000 units

Idarucizumab (Praxbind) added to system formulary

• Each market to determine formulary status

Andexanet alfa (Andexxa) reviewed and NOT approved for formulary addition

Drug Class Reviews

• Antidepressants - no autosubstitutions 
  • Noradrenergic and Specific Serotonin Reuptake Inhibitors
  • Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
• Calcium Channel Blockers-restrictions removed from clevidipine
• Benzodiazepines
• Diuretics, Thiazides
• Beta Blocker therapeutic substitution approval-Bisoprolol to metoprolol

January

(System P&T)

Oxacillin added to formulary, nafcillin removed from formulary.

Meropenem dose buttons added in Epic

Drug classes reviewed:

• Bone Resorption Inhibitors
• P2Y12 Inhibitors

Calcitonin restriction criteria discussed and approved

FMOLHS P&T - 2021

December

(System P&T)

Ubrogepant (Ubrelvy) reviewed and NOT approved for formulary addition

Appeals:

• Bupivacaine-meloxicam (Zynrelef) added to formulary
• Bupivacaine-collagen implant (Xaracoll) removed from formulary
• Empaglifozin (Jardiance) added to formulary

Drug classes reviewed:

• Tricyclic Antidepressants (TCAs)
• Monoamine Oxidase Inhibitors (MAOIs)
• Atypical Antipsychotics, injectables
• Atypical Antipsychotics, oral/topical
• Typical Antipsychotics, oral
• Phosphodiesterase Type 5 (PDE-5) Inhibitors
• Phosphodiesterase (PDE) Inhibitors, Nonselective
• Ophthalmic Antimicrobials
• Ophthalmic Corticosteroids

Approved vaccine appeals:

• Meningitis ACWY Vaccines
  • Menveo will be formulary restricted to inpatient
  • Menactra will be formulary restricted to outpatient
  • MenQuadfi will be non-formulary
• Rabies Vaccines
  • Imovax will be formulary
  • RabAvert will be non-formulary
• Tetanus, Reduced Diphtheria, and Acellular Pertussis (Tdap) Vaccines
  • Adacel will be formulary
  • Boostrix will be non-formulary
• Tetanus and Diphtheria (Td) Vaccines
  • Tenivac will be formulary
  • TdVax will be non-formulary
• Hepatitis A Vaccines
  • Vaqta will be formulary
  • Havrix will be non-formulary

October

(System P&T)

Formulary addition request form presented and approved

Ubrogepant (Ubrelvy) reviewed; approval pending further review

Enfortumab vedotin (Padcev) reviewed and approved for outpatient use only

Appeals:

• Empagliflozin (Jardiance) new indications reviewed; approval pending further review
• IV acetaminophen (Ofirmev) reviewed and current restrictions remain

Drug classes reviewed:

• Thrombolytics
• Antidepressants 
  • Noradrenergic and Specific Serotonin Reuptake Inhibitors
  • Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
• Non-depolarizing Neuromuscular Blockers
• Hepatitis B Immune Globulins

September

(System P&T)

Bupivacaine-collagen implant (Xaracoll) reviewed and added to formulary for FDA-approved indications only

Prevnar-20 reviewed and approved as substitution for Prevnar-13

Pegfilgrastim-apgf (Nyvepria) reviewed and approved for outpatient use only

Drug classes reviewed:

• Antiviral Agents
• Antiviral Topical Agents
• Amphotericin B 
• Thyroid Agents
• Glycoprotein IIb/IIIa Inhibitors
• Pegfilgrastim, biosimilar updates

August

(System P&T)

Aducanumab (Aduhelm) reviewed and NOT added to system formulary

Following vaccine appeals were approved:

• Menveo will be formulary. Menactra will be non-formulary
• Havrix will be formular. Vaqta will be non-formulary

Therapeutic substitutions were presented and approved

Drug classes reviewed:

• Trastuzumab, biosimilars
• Bevacizumab, biosimilars
• Infiximab, biosimilars
• Rituximab, biosimilars

July

(System P&T)

Ofirmev restriction approved:

• restricted to first 24 hours in surgeries as part of an ERAS protocol
• PDA in the pediatric population

Kayexalate oral appeal was made to expand restriction criteria to NPO in the pediatric population

Zofran max dose was reduced from 32 mg to 16 mg in accordance with the FDA recommendations

Drug classes reviewed:

• SGLT2 Inhibitors
• LMWH
• Fondaparinux
• Filgrastim, biosimilars
• Pegfilgrastim, biosimilars
• Erythropoiesis stimulating agents, biosimilars

June

(System P&T)

Anavip approved as sole formulary antivenom

Drug classes reviewed:

• Analgesics and antipyretics
• Opiate agonists
• Opiate partial agonists
• NSAIDs
• Direct Thrombin Inhibitor/Factor Xa Inhibitor

All oral antihyperglycemic medications will be removed from formulary except in the follow situations (see attached):

• Mental health units
• Outpatients and patients undergoing 23-observation stays
• Patients receiving oral anti-hyperglycemic agents for non-type II diabetes mellitus indications
• Patients <18 years of age
• Labor and delivery
• Post-acute care units
• Antepartum unit

All inpatients, except those listed above will be converted to insulin therapy

Oral Antihyperglycemic Conversion to Insulin Recommendations

May

(System P&T)

Drug classes reviewed:

• Antihistamines
• Antihyperglycemics
• Insulins