Drug Utilization Review Board (DURB) Agenda

July 22, 2022 - 9:00 am

Texas Health and Human Services Commission (HHSC), North Austin Complex (NAC), Room 1.400, 1st Floor
4601 West Guadalupe 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 North Austin Complex 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 April 22, 2022, draft meeting minutes
  3. Consideration of Officer Election Procedure and Chair and Vice-Chair Elections
  4. Value-Based Agreements Overview
  5. Public comment on the drug classes to be reviewed for the Medicaid Preferred Drug List (PDL):
    1. Alzheimer’s agents
    2. Antihistamines, minimally sedating
    3. Antihypertensives, sympatholytics
    4. Calcium channel blockers
    5. Cephalosporins and related antibiotics
    6. Cytokine and cell adhesion module (CAM) antagonists
    7. Fluoroquinolones, oral
    8. Glucocorticoids, oral
    9. Immunomodulators, Lupus
    10. Immunosuppressives, oral
    11. Iron, oral
    12. Leukotriene modifiers
    13. Nonsteroidal anti-inflammatory drugs (NSAIDs)
    14. Ophthalmic antibiotics
    15. Ophthalmic antibiotic-steroid combinations
    16. Ophthalmics for allergic conjunctivitis
    17. Ophthalmics, anti-inflammatories
    18. Ophthalmics, anti-inflammatory/immunomodulator
    19. Ophthalmics, glaucoma agents
    20. Otic antibiotics
    21. Otic anti-infectives and anesthetics
    22. Penicillins
    23. Progestational agents
    24. Rosacea agents, topical
    25. Skeletal muscle relaxants
    26. Steroids, topical high
    27. aa. Steroids, topical low
    28. bb. Steroids, topical medium
    29. cc. Steroids, topical very high
    30. dd. Ulcerative colitis agents
    31. ee. Uterine disorder treatments
  6. Public comment on single new drugs to be reviewed for the Medicaid PDL:
    1. Twyneo, cream (topical)/ Acne Agents, topical 
    2. Seglentis (oral) / Analgesics, narcotics short         
    3. Livtencity (oral)/ Antivirals, orals  
    4. Releuko, syringe (subcutaneous)/ Colony Stimulating Factors  
    5. Releuko, vial (injection) / Colony Stimulating Factors  
    6. Ibsrela, tablet (oral) / Gastrointestinal(GI) Motility, chronic
    7. Takhzyro, syringe (subcutaneous)/ Heridatry Angioedema (HAE) Treatments   
    8. Triumeq Pediatric (PD), tablet, suspension (oral) /  HIV / AIDs    
    9. Zimhi (injection) / Opiate Dependence Treatments
  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 on this agenda as permitted by the Texas Open Meetings Act.

  9. Announcements of drugs recommended for the Medicaid PDL: Magellan Medicaid Administration (vote required)
  10. Retrospective drug utilization review (DUR):  Conduent, LLC
    1. Recent interventions
      1. Combined use of opioids and central nervous system depressants drug use evaluation
      2. Heart failure management
      3. Management of psychotropic drugs in pediatric patients
    2. Recent outcome reports
      1. Benzodiazepines, anxiolytics, and/or controlled sedative-hypnotics management
      2. Dyslipidemia management
      3. Major depressive disorder management
    3. Potential RetroDUR interventions (vote required)
      1. Influenza Prevention: vaccination and education
  11. Prospective prior authorization proposals (clinical edits):  Kepro, LLC (vote required)
    1. Allergen Extracts – Oralair (revised criteria)
    2. Fintepla (fenfluramine)  -  new criteria
    3. Gastrointesinal Mobility – add new criteria for Ibsrela (tenapanor)
    4. Monoclonal Antibody Agents – add new criteria for Xolair (omalizumab)
    5. Sodium-glucose cotransporter-2 (SGLT2) - Farxiga (dapagliflozin) and Jardiance (empagliflozin) – revised criteria
  12. Retrospective drug use criteria for outpatient use in Vendor Drug Program:
    The University of Texas at Austin College of Pharmacy (vote required)
    1. Fluoroquinolones (oral)
    2. Hepatitis C (new criteria)
    3. Immune globulins
    4. Non-sedating antihistamines
    5. Non-steroidal anti-inflammatory drugs
    6. Rifaximin (Xifaxan)
    7. Sickle cell disease products
    8. Skeletal muscle relaxants
  13. Review of action items for next meeting:  Oct 21, 2022, 9:00 a.m.
  14. Adjourn

Public Comment: 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_Jul222022 and submitting a completed Public Comment Form, HHS Form 1320 no later than 5:00 p.m. Wednesday, July 20, 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, July 13, 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_Jul222022. 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, July 13, 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.