Drug Utilization Review Board (DURB) Agenda

January 26, 2024 - 9:00 am

Texas Department of State Health Services (DSHS), Robert D. Moreton Building, Public Hearing Room M-100, 1st Floor
1100 W. 49th Street, Austin, TX
78756
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 Morton M-100 Live tab 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 October 12, 2023, and October 13, 2023, draft meeting minutes
  3. HHS Ethics Policy overview
  4. 88th Texas Legislature, Regular Session (2023), House Bill 3286 Update
  5. Public comment and discussion 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. Antihypertensives, Sympatholytic
    8. Antimigraine Agents, other
    9. Antimigraine Agents, triptans
    10. Antiparkinsons Agents
    11. Bladder Relaxant Preparations
    12. Glucagon Agents
    13. H. Pylori Treatment
    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. PAH Agents, oral and inhaled
    25. Pancreatic Enzymes
    26. Phosphate Binders
    27. aa. Platelet Aggregation Inhibitors
    28. bb. Potassium Binders
    29. cc. Progestins for Cachexia
    30. dd. Proton Pump Inhibitors
    31. ee. Smoking Cessation
    32. ff. Stimulants and Related Agents
  6. Public comment and discussion on single new drugs to be reviewed for the Medicaid PDL:
    1. Rykindo (intramuscular) / Antipsychotics
    2. Motpoly XR (oral) / Anticonvulsants
    3. Adalimumab-Adbm Kit (Injection) (CF) 50 mg/ml / Cytokine and CAM Antagonists
    4. Adalimumab-Adbm Pen Kit (Injection) (CF) 50 mg/ml / Cytokine and CAM Antagonists
    5. Entyvio Pen (subcutane.) / Cytokine and CAM Antagonists
    6. Jesduvroq tablet (oral) / Erythropoiesis Stimulating Proteins
    7. Airsupra HFA (inhalation) / Glucocorticoids, Inhaled
    8. Narcan Spray OTC (nasal) / Opiate Dependence Treatments
    9. Ojjaara (oral) / Oncology, Oral - Hematologic
    10. Akeega (oral) / Oncology, Oral - Prostate
  7. Therapeutic and clinical drug reviews, updates, and discussion:  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 Public comment on the drug classes to be reviewed for the Medicaid Preferred Drug List (PDL) as permitted by the Texas Open Meetings Act.
     
  9. Announcements of drugs recommended for the Medicaid PDL: Magellan Medicaid Administration
  10. Prospective prior authorization proposals (clinical edits):  Kepro, LLC
    1. Antimigraine Agents, Triptans
      1. Revisions
    2. Antipsychotic Agents
      1. New criteria for Rykindo
    3. Colchicine Agents
      1. New criteria for Lodoco
    4. Cytokine and CAM Antagonists
      1. New criteria for Entyvio Pen
    5. Phosphate Binders
      1. Revisions
    6. Topical Immunomodulators
      1. New criteria for Zoryve
  11. Retrospective drug use criteria for outpatient use in Vendor Drug Program: 
    The University of Texas at Austin College of Pharmacy
    1. Fentanyl
    2. Gabapentin
    3. Hydrocodone Bitartrate/ Hydrocodone Polistirex
    4. Ivacaftor (Kalydeco) and Lumacaftor/Ivacaftor (Orkambi)
    5. Topical Calcineurin Inhibitors
    6. Tramadol
  12. Review of action items for next meeting: April 26, 2024, 9:00 a.m.
  13. 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_Jan2024 and submitting a completed Public Comment Form, HHS Form 1320  no later than 5:00 p.m. Wednesday, January 24, 2024. 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. Monday, January 22, 2024, 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_Jan2024. 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. Monday, January 22, 2024. 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.