Baton Rouge Market P&T - 2022

SESE, ASMP, LACH, LALK

Baton Rouge Market P&T - 2021

SESE, ASMP, LACH, LALK

Bupivacaine-meloxicam (Zynrelef) added to formulary

Liposomal bupivacaine (Exparel) dosing and preparation guidelines reviewed

The following pharmacy protocol updates were approved:

• Vancomycin
• Aminoglycoside 
• Dose rounding

Meropenem will include a hard stop for prescribers to select an indication button in Epic

Methotrexate oral will default to a weekly frequency; daily frequency will require a hard stop in Epic to confirm an appropriate oncologic indication, per ISMP Best Practices

Request to restrict injectable promethazine to PACU, ED, and Oncology ordersets only, per ISMP Best Practices, was NOT approved

October

Enfortumab vedotin (Padcev) was reviewed and added to formulary, restricted to outpatient use only

Avelumab (Bavencio) dosing updated to include 800 mg flat dose

Inpatient pegfilgrastim MUE presented with no changes to formulary status or criteria for use. Consider annual MUE due to cost. 

Lanreotide 60 mg and 90 mg strengths added to formulary, restricted to outpatient use only approved by consent agenda 

August

Aducanumab (Aduhelm) reviewed and NOT added to OLOL formulary

Pertuzumab, trastuzumab, and hyaluronidase (Phesgo) was reviewed and added to formulary, restricted to outpatient setting only

Medication Samples in Provider-Based Clinics was reviewed and approved

Vancomycin 6 month safety review was discussed

Renal dosing policy and protocol were approved by consent agenda

April

Trastuzumab biosimilars reviewed. Ogivri approved as preferred agent for both inpatinent and outpatient settings (see Biosimilar and reference product interchange list)

Ofirmev approved through the Improving Surgical Care and Recovery Pathway workgroups will be approved by the P&T committee via consent agenda moving forward

Tacrolimus Pharmacy Monitoring Protocol approved. Start date TBD

Restrictions removed from tranexamic acid. All formulations approved for formulary

Alum 1% reviewed and NOT added to formulary

Tafasitamab-cxix (Monjuvi) added to formulary, restricted to outpatient setting only

February

Caplacizumab (Cablivi) added to formulary, restricted to hematology/oncology and nephrology

Acetaminophen (Ofirmev) restriction expended to include Head & Neck ERAS

Pegfilgrastim formulary status changed. Fulphila is inpatient formulary preferred agent. Added to inpatient formulary with following restriction criteria:

• Prescribed by hematology/oncology providers
• Patient received myelosuppressive therapy within 24-72 hours prior to pegfilgrastim therapy
• Patient will not be able to receive pegfilgrastim injection in outpatient setting 24-72 hours after completion of anticancer therapy but is anticipated to be discharged within 5 days after anticancer therapy

Filgrastim (Granix) formulary status changed. Granix is now preferred formulary agent.

Lutetium Lu-177 Dotate (Lutathera) process map approved. Formulary changes specifically related to Lutathera include:

• Pre-medication with special amino acid solution for use only with Lutathera treatment
• Long acting octreotide approved for same day use with Lutathera treatment

Tacrolimus medication use evaluation presented. Pharmacy to develop a monitoring protocol for presentation at April P&T meeting.

Baton Rouge Market P&T - 2020

December

Lipid emulsion (SMOF Lipid) added to formulary for expanded use in adults (previously only used in pediatrics)

Carbidopa/Levodopa Extended Release (Rytary) added to formulary

Infliximab-abda (Renflexis) added to formulary as the preferred inpatient and outpatient product

Updated Biosimilar Protocol approved

Updated Dose Rounding Protocol approved

Updated Pharmacist Managed Warfarin Dosing Policy approved

Daratumumab/hyaluronidase (Darzalex Faspro) added to forumlary and restircted to OUTPATIENT use only

October

Moxifloxacin (Avalox) added to formulary and restricted to Critical Care/Pulmonology or Infectious Diseases physicians for the use in mycobacterial infections ONLY

Exparel restriction criteria expanded to Head and Neck surgery

Poractant alfa (Curosurf) added to formulary for use in the NICU ONLY

Cannabidiol (Epidiolex) added to formulary at the Children's Hospital ONLY and restricted to continuation of home medication

Sacituzumab govitecan-hziy (Trodelvy) added to formulary and restricted to OUTPATIENT use only

Epoprostenol (Veletri) formulary interchange approved

Crizanlizumab (Adakveo) added to formulary and restricted to OUTPATIENT use only

Removed from formulary:

• Cangrelor (Kengreal)

August

Meropenem/Vaborbactam (Vabomere) added to formulary and restricted to ordering by an Infectious Diseases provider

Polatuzumab vedotin (Polivy) added to formulary

Topical antifungals reviewed and formulary streamlined (Formweb updated)

Updated Renal Dosing Protocol approved

Updated Biosimilary Policy approved

June

Addition of non-acetaminophen induced acute liver injury (NAI-ALI) added as an approved indication of intravenous acetylcysteine

Truxima (rituximab-abbs) approved as the preferred inpatient and outpatient formulary agent for rituximab and rituxima biosimilars

Updated Aminoglycoside Pharmacokinetic Protocol approved

Updated Fomularly Management Policy approved

Pharmacy to automatically monitor anti-Xa levels in morbidly obese patients approved

Ultomiris added to formulary, restricted to outpatient only

February

Eravacycline (Xerava) added to formulary and restricted to ordering by Critical Care providers for specific indications (see monograph on Formweb) and Infectious Disease providers

Advate was deleted from formulary. Use Humate-P if factor VIII is needed

Fixed-dose Kcentra approved for use in anti-Xa related life-threatening bleeding in addition to warfarin-related life-threatening bleeding

Phenylephrine and ketorolac ophthalmic injection (Omidria) was not approved

Baton Rouge Market P&T - 2019

December

Blinatumomab (Blincyto) added to formulary and restricted to FDA approved indications of acute lymphoblastic leukemia (B-cell precursor)

Heplisav-B added to formulary as preferred Hepatitis B vaccine

Updated Vancomycin Pharmacokinetic Protocol approved

Probiotic therapeutic interchange to Culterelle approved

Acebutolol therapeutic interchange to atenolol approved

October

68ga-dotatate (NETSPOT) reviewed. Tabled for next meeting after review by oncology service-line committee

Synthetic Human Secretin added to formulary

Bevacizumab-awwb (Mvasi) added to formulary-restricted to new outpatient starts only

Trastuzumab-anns (Kanjinti) added to formulary-restrictioned to outpatient only

ANAVIP reviewed and added to formulary in addition to, not replacement for Crofab. Process to be developed for envenomations

August

Liposomal daunorubicin and cytarabine (Vyxeos) added to formulary**

Ceftolozane/tazobactam (Zerbaxa) added to formulary and restricted to ID provider for use in treatment of MDR Pseudomonas aeruginosa

Ceftazidime/Avibactam (Avycaz) added to formulary and restricted to ID providers for the treatment of CRE and MDR Pseudomonas aeruginosa resistant to Zerbaxa

Esketamine (Spravato) reviewed. Decision tabled until defined process is in place

Cetuximab and Vectibix added to Medications Restricted to Outpatient List

June

Sodium Zirconium Cyclosilicate (Lokelma) added to formulary

Nebivolol (Bystolic) REMOVED from formulary. Therapeutic interchanged to atenolol

April

Cangrelor (Kangreal) added to formulary. Restricted to interventional cardiology and only used in patients with no enteral access requiring emergency PCI

Kcentra fixed dosing strategy for warfarin-related life threatening bleeding was approved

February

Glucarpidase (Voraxaze) added to formulary with restrictions to inpatient use

Meningococcal Group B Vaccine (Bexsero) added to formulary

Perflutren Protein-Type A Microspheres (Optison) reviewed. Addition tabled

Perampanel (Fycompa) reviewed and added for use only as a home medication, no new starts