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 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.

All attachments below are PDF unless otherwise noted.

1. Call to order
2. Consideration of July 26, 2024, draft meeting minutes
3. Public comment and discussion on the drug classes to be reviewed for the Medicaid Preferred Drug List (PDL):
   1. Androgenic agents, topical
   2. Antibiotics, gastrointestinal (GI)
   3. Antibiotics, topical
   4. Antibiotics, vaginal
   5. Anticonvulsants
   6. Antiemetic-Antivertigo agents (excludes injectables)
   7. Antifungals, oral
   8. Antifungals, topical
   9. Antihistamines, first generation
   10. Antiparasitics, topical
   11. Antivirals, topical
   12. Bone resorption suppression and related agents
   13. Colony stimulating factors
   14. Epinephrine, self-injected
   15. GI motility, chronic
   16. Growth hormone
   17. Hepatitis C agents
   18. HIV/AIDS
   19. Hypoglycemics, incretin mimetics/enhancers
   20. Hypoglycemics, insulin
   21. Hypoglycemics, meglitinides
   22. Hypoglycemics, metformin
   23. Hypoglycemics, sodium-glucose cotransport-2 (SGLT2)
   24. Hypoglycemics, thiazolidinediones (TZDs)
   25. Macrolides (oral)
   26. Opiate dependence treatments
   27. Tetracyclines
4. Public comment and discussion on single new drugs to be reviewed for the Medicaid PDL:
   1. Adalimumab-adbm(CF) 40 mg pen / Cytokine and Cellular Adhesion Molecule (CAM) Antagonists
   2. Adalimumab-adbm(CF) 40 mg syrg / Cytokine and CAM Antagonists
   3. Adbry autoinjector / Immunomodulators, Atopic Dermatitis
   4. Cyltezo(CF) 40 mg/0.4ml pen / Cytokine and CAM Antagonists
   5. Cyltezo(CF) 40 mg/0.4ml syringe / Cytokine and CAM Antagonists
   6. Entresto sprinkle pellet / Angiotensin Modulators
   7. Ingrezza sprinkle cap / Movement Disorders
   8. Iqirvo / Bile Salts
   9. Myhibbin / Immunosuppressives, oral/sq
   10. Ojemda / Oncology, oral - other
   11. Omvoh syringe / Cytokine and CAM Antagonists
   12. Rinvoq LQ / Cytokine and CAM Antagonists
   13. Xolair autoinjector / Immunomodulators, Asthma
   14. Zoryve / Immunomodulators, Atopic Dermatitis
5. Therapeutic and clinical drug reviews and updates:  Gainwell Technologies
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 public comment on the drug classes to be reviewed for the Medicaid PDL, and as permitted by the Texas Open Meetings Act.
7. Announcements of drugs recommended for the Medicaid PDL: OptumRx
8. Retrospective drug utilization review (DUR):  Acentra Health
   1. Recent interventions
      1. April
         1. Asthma Management
         2. Psychotropic Pharmacy
         3. SUPPORT Act
      2. July
         1. Concurrent Use of Benzodiazepines and/or Sedative-Hypnotic Agents
         2. Monitoring Antipsychotic Induced Metabolic Syndrome
         3. Risks of Long-Term Proton Pump Inhibitor (PPI) Use
         4. Use of Benzodiazepines in Patients with Chronic Obstructive Pulmonary Disease (COPD)
   2. Potential retro DUR interventions
      1. Appropriate Treatment of Selected Diabetes Comorbidities in Adults
      2. Drug Abuse Risk Mitigation
      3. Non-Adherence to Antiepileptic Therapies
      4. Under-Treatment of Chronic Hepatitis C Virus Infections
9. Prospective prior authorization proposals: Acentra Health
   1. Agamree – New criteria
   2. Biliary Cholangitis Treatment Agents – New criteria
   3. Cytokine and CAM Antagonists – New criteria
      1. Bimzelx
      2. Omvoh
   4. Cytokine and CAM Antagonists - Revisions
      1. Rinvoq LQ (oral)
   5. Wegovy – New criteria
   6. Zoryve – New criteria
10. Retrospective drug use criteria for outpatient use in Vendor Drug Program: 
    The University of Texas at Austin College of Pharmacy
    1. Anti-diabetic Agents (oral)
    2. Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder Medications
    3. Glucagon-like Peptide 1 Receptor Agonists
    4. Pramlintide
    5. Serotonin 5-HT3 Receptor Antagonists for Nausea and Vomiting (oral)
    6. Substance P/Neurokinin 1 Receptor Antagonists
11. Review of action items for next meeting: January 31, 2025, 9:00 a.m.
12. Adjourn

The board may take action on any agenda item.

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_Oct2024 and submitting a completed Public Comment Form, HHS Form 1320 at https://www.txvendordrug.com/advisory/dur-board-documents no later than 5:00 p.m. Wednesday, October 23, 2024. If both the pre-registration and HHS Form 1320 are not completed and submitted by the due date, members of the public may register on-site the day of the meeting to provide oral comments. 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 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 at https://www.txvendordrug.com/resources/drug-utilization-review-board/dur-board-documents, 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, October 21, 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 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 pre-registering at https://texashhsmeetings.org/DURB_PCReg_Oct2024 and completing a Public Comment Registration form, HHS Form 1334 at https://www.txvendordrug.com/resources/drug-utilization-review-board/dur-board-documents. A member of the public who wishes to provide written public comments must email the comments to VDP-Advisory@hhsc.state.tx.us and pre-register no later than 5:00 p.m. Monday, October 21, 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 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 comments 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.