Drug Utilization Review Board (DURB) Agenda

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 January 20, 2023, draft meeting minutes
3. Public comment on the drug classes to be reviewed for the Medicaid Preferred Drug List (PDL):
   1. Anti-Allergens, oral
   2. Antibiotics, inhaled
   3. Anticoagulants
   4. Antidepressants, other
   5. Antidepressants, selective serotonin reuptake inhibitors (SSRIs)
   6. Antidepressants, tricyclic
   7. Antihyperuricemics
   8. Antivirals, oral
   9. Anxiolytics
   10. Beta-Blockers
   11. Bile Salts
   12. BPH Treatments
   13. Bronchodilators, beta agonist
   14. Chronic Obstructive Pulmonary Disease (COPD) Agents
   15. Cough and Cold, cold
   16. Cough and Cold, narcotic
   17. Cough and Cold, non-narcotic
   18. Cytokine and Cam Antagonists
   19. Erythropoiesis Stimulating Proteins
   20. Glucocorticoids, inhaled
   21. Hereditary angioedema (HAE) Treatments
   22. Hemophilia Treatment
   23. Immune Globulins, IV
   24. Immunomudoulators, Asthma
   25. Immunomodulators, Atopic Dermatitis
   26. Lincosamides/Oxazolidinones/Streptogramins
   27. aa. Lipotropics, other
   28. bb. Lipotropics, statins
   29. cc. Multiple Sclerosis Agents
   30. dd. Pediatric Vitamin Preparations
   31. ee. Prenatal Vitamins
   32. ff. Sedative Hypnotics
   33. gg. Sickle Cell Anemia Treatments
   34. hh. Thrombopoiesis Stimulating Proteins
   35. ii. Urea Cycle Disorder, oral
4. Public comment on single new drugs to be reviewed for the Medicaid PDL:
   1. Noxafil suspension powder packet (oral) / Antifungals, oral
   2. Rolvedon syringe (subcutaneous) / Colony Stimulating Factors
   3. Stimufend syringe (subcutaneous) / Colony Stimulating Factors                             
   4. Sunlenca tablet (oral) /  HIV/AIDs      
   5. Basaglar Tempo pen (subcutane) / Hypoglycemics, Insulin and Related Agents
   6. Humalog Tempo pen (subcutane) / Hypoglycemics, Insulin and Related Agents
   7. Lyumjev Tempo pen (subcutane) / Hypoglycemics, Insulin and Related Agents
5. Therapeutic and clinical drug reviews and updates:  Magellan Medicaid Administration
6. 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.   
    
7. Announcements of drugs recommended for the Medicaid PDL: Magellan Medicaid Administration
8. Retrospective drug utilization review (DUR):  Conduent, LLC
   1. Recent interventions
      1. Hypertension Disease Management
      2. Management of Psychotropic Drugs in Adults
      3. Naloxone for High-Risk Patients
   2. Recent outcome reports
      1. Combined Use of Opioids and Central Nervous System Depressants Management 2022
      2. Management of Psychotropic Drugs in Pediatric Patients 2022
   3. Potential RetroDUR interventions
      1. Single Maintenance and Reliever Therapy (SMART) Alternative for Patients with Asthma
9. Prospective prior authorization proposals (clinical edits):  Kepro, LLC
   1. Antimigraine Agents, Ergot Derivatives
      1. New criteria
   2. Cytokine and CAM Antagonists - revisions
      1. Rinvoq – revision for new diagnosis
      2. Skyrizi – revision for new diagnosis
      3. Sotyktu – add criteria
   3. Erythropoiesis-Stimulated Agents
      1. Mircera – new criteria
      2. Reblozyl – new criteria
   4. Gattex (teduglutide)
      1. New criteria
10. Retrospective drug use criteria for outpatient use in Vendor Drug Program:    
    The University of Texas at Austin College of Pharmacy
    1. Aerosolized Agents - Metered-Dose Inhalers (MDIs): Anti-Cholinergic Drugs
    2. Aerosolized Agents - Metered-Dose Inhalers (MDIs): Anti-Inflammatory Drugs
    3. Aerosolized Agents - Metered-Dose Inhalers (MDIs): Beta2 Adrenergic Drugs (long-acting)
    4. Aerosolized Agents - Metered-Dose Inhalers (MDIs): Beta2 Adrenergic Drugs (short-acting)
    5. Anti-Depressants, Oral (other)
    6. Anti-Depressants, Selective Serotonin Reuptake Inhibitors
11. Review of action items for next meeting: July 21, 2023, 9:00 a.m.
12. Adjournment

The board may take action on any agenda item.

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_Apr2023 and submitting a completed Public Comment Form, HHS Form 1320 no later than 5:00 p.m. Wednesday, April 26, 2023. 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, April 19, 2023, 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_Apr2023. 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, April 19, 2023. 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 ten 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.