Drug Utilization Review Board (DURB) REVISED Agenda

January 21, 2022 - 9:00 am

Health and Human Services Commission, John H. Winters Building, Public Hearing Room 125, 1st Floor
701 W. 51st Street Austin, TX
78751
United States

This meeting will be webcast. Members of the public may attend the meeting in person at the address above or access a live stream of the meeting at https://texashhsmeetings.org/HHSWebcast. Select the tab for the Winters Public Hearing Room Live on the date and time for this meeting. Please e-mail Webcasting@hhsc.state.tx.us if you have any problems with the webcasting function.

This meeting will also be conducted via videoconference call in accordance with the requirements of Section 551.127, Government Code. The member of the Board presiding over the meeting will be physically present at the location specified above.

Attendees who would like to provide public comment should see the Public Comment section below.

  1. Call to order
  2. Consideration of November 12, 2021, draft meeting minutes (vote required)
  3. Announcement:  Drug Utilization Review Board Conflict of Interest Policy Review
  4. HHS Ethics Policy - refresher training for the board
  5. Public comment on the drug classes to be reviewed for the Medicaid Preferred Drug List (PDL):
    1. Acne agents, oral
    2. Acne agents, topical
    3. Analgesics, narcotics long
    4. Analgesics, narcotics short
    5. Angiotensin modulator combinations
    6. Angiotensin modulators
    7. Antiparkinson's agents
    8. Antimigraine agents, other
    9. Antimigraine agents, triptans
    10. Bladder relaxant preparations
    11. Glucagon agents
    12. H. pylori treatment
    13. Immunomodulators, atopic dermatitis
    14. Intranasal rhinitis agents
    15. Movement disorders
    16. Neuropathic pain
    17. Oncology, oral - breast
    18. Oncology, oral - hematologic
    19. Oncology, oral - lung
    20. Oncology, oral - other
    21. Oncology, oral - prostate
    22. Oncology, oral - renal cell
    23. Oncology, oral - skin
    24. Phosphate binders
    25. Platelet aggregation inhibitors
    26. Potassium binders
    27. aa. Progestins for cachexia
    28. bb. Proton pump inhibitors
    29. cc. Smoking cessation
    30. dd. Stimulants and related agents
  6. Public comment on single new drugs to be reviewed for the Medicaid PDL:
    1. Bylvay capsule (oral) / Bile salts
    2. Bylvay pellet (oral) / Bile salts
    3. Invega Hafyera (intramuscular) / Antipsychotics
    4. Livmarli (oral) / Bile salts
    5. Loreev XR capsule ER 24H (oral) / Anxiolytics
    6. Lybalvi (oral) / Antipsychotics
    7. Miconatate OTC (topical) / Antifungals, topical
    8. Mucinex instasoothe cough OTC (oral) / Cough and Cold, non-narcotic
    9. Rezurock (oral) / Immunosuppressives, oral
  7. Therapeutic and clinical drug reviews and updates:  Magellan Medicaid Administration
  8. Executive work session

Pursuant to Texas Government Code Section 531.071, and in accordance with Texas Administrative Code Title 1, Part 15, Subchapter F, Section 354.1941(c)(2), the DURB may meet in executive session on one or more items listed under new business as permitted by the Texas Open Meetings Act.

  1. Announcements of drugs recommended for the Medicaid PDL: Magellan Medicaid Administration (vote required)
  2. Retrospective drug utilization review (DUR):  Conduent, LLC
    1. Recent interventions
      1. Caring for patients with bipolar disorder
      2. Caring for patients with diabetes
      3. Caring for patients with dyslipidemia or at risk for coronary heart disease
      4. Influenza prevention: vaccination and education
    2. Recent outcome reports
      1. Anticonvulsants drug use evaluation (DUE)
      2. Contraceptive DUE
    3. Potential RetroDUR interventions (vote required)
      1. Attention-deficit/hyperactivity disorder management
      2. Management of psychotropic drugs in pediatrics
      3. Opioids and central nervous system depressants drug use evaluation
  3. Prospective prior authorization proposals (clinical edits):  Kepro, LLC (vote required)
    1. Antimigraine agents, triptans – new criteria
    2. Bile salts
      1. Add Bylvay™ (odevixibat) - new criteria
    3. Calcitonin gene-related peptide (CGRP) agents, chronic
      1. Add Quilpta™ (atogepant) – new criteria
    4. Immunomodulators, atopic dermatitis
      1. Add Opzelura™ (ruxolitinib)
    5. Phosphate binders -  revised criteria
    6. Pulmozyme®  (dornase alfa) – new criteria 
  4. Retrospective drug use criteria for outpatient use in Vendor Drug Program:
    The University of Texas at Austin College of Pharmacy (vote required)
    1. Fentanyl
    2. Gabapentin
    3. Hydrocodone Bitartrate/Hydrocodone Polistirex
    4. Ivacaftpor (Kalydeco®) and combination therapy
    5. Topical Calcineurin Inhibitors – Pimecrolimus (Elidel®) and Tacrolimus (Protopic®)
    6. Tramadol (Utram®)
  5. Review of action items for next meeting:  April 22, 2022, 9:00 a.m.
  6. Adjournment

Public Comment: The Health and Human Services Commission (HHSC) welcomes public comments pertaining to topics related to DURB and Medicaid PDL. Members of the public who would like to provide public comment may choose from the following options:

  1. Oral comments provided virtually: Members of the public must pre-register to provide oral comments virtually during the meeting by completing a Public Comment Registration form at https://texashhsmeetings.org/DURB_PCReg_012022 and submitting a completed Public Comment Form, HHS Form 1320 no later than 5:00 p.m. Wednesday, January 19, 2022. Please mark the correct box on the Public Comment Registration form and provide your name, either the organization you are representing or that you are speaking as a private citizen and your direct phone number. If you have completed the Public Comment Registration form, you will receive an email the day before the meeting with instructions for providing virtual public comment. Public comment is limited to three minutes. Each speaker providing oral public oral comments virtually must ensure their face is visible and their voice audible to the other participants while they are speaking. Each speaker providing oral public comment must state their name and on whose behalf they are speaking (if anyone). If you pre-register to speak and wish to provide a handout before the meeting, please submit an electronic copy in accessible PDF format with a completed Written Public Comment form, HHS Form 1334, that will be distributed by HHS staff to DURB members and State staff. Handouts are limited to two pages (paper size: 8.5” by 11”, one side only). Handouts must be emailed to VDP-Advisory@hhsc.state.tx.us immediately after pre-registering, but no later than 5:00 p.m. Wednesday, January 12, 2022, and include the name of the person who will be commenting. Do not include health or other confidential information in your comments or handouts. Staff will not read aloud handouts aloud during the meeting, but handouts will be provided to DURB members and State staff.

  2. Written comments: Members of the public may provide written public comments by completing a Public Comment Registration form,  HHS Form 1334 at https://texashhsmeetings.org/DURB_PCReg_012022. A member of the public who wishes to provide written public comments must email the comments to VDP-Advisory@hhsc.state.tx.us no later than 5:00 p.m. Wednesday, January 12, 2022. Please include your name and the organization you are representing or that you are speaking as a private citizen. Written comments must be emailed to HHSC immediately after pre-registering and include the name of the person who will be commenting. Written comments are limited to two pages (paper size: 8.5” by 11”, one side only). Do not include health or other confidential information in your comments. Staff will not read written comments aloud during the meeting, but comments will be provided to DURB members and State staff. 

  3. Oral comments provided in-person at the meeting location: Members of the public may provide oral public comment during the meeting in person at the meeting location either by pre-registering using the form above or without pre-registering by completing a form at the entrance to the meeting room. Do not include health or other confidential information in your comments.

Note: These procedures may be revised at the discretion of HHSC.

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed to Maribel O. Castoreno, DUR/PDL Oversight Specialist, Health and Human Services Commission, Medicaid and CHIP Services, 512-552-7672, and VDP-Advisory@hhsc.state.tx.us.

This meeting is open to the public.  No reservations are required, and there is no cost to attend this meeting.

Persons who want to attend the meeting and require assistive technology or services should contact Castoreno at 512-552-7672 or VDP-Advisory@hhsc.state.tx.us
at least 72 hours before the meeting so appropriate arrangements can be made.