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.

Meeting Notice: The use of artificial intelligence (AI) bots is prohibited in this meeting.

In accordance with HHS policy, the use of Artificial Intelligence also known as “AI” Notetakers is expressly prohibited. Producers will not admit a ‘bot’ or other autonomous agent into the meeting. If a ‘bot’ should inadvertently gain entrance, it will be removed from the meeting by one of our producers.

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

1. Call to order
2. Consideration of January 31, 2025, draft meeting minutes
3. DURB chair and vice-chair elections
4. Public comment and discussion 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 (SSRI)
   6. Antidepressants, tricyclic
   7. Antihyperuricemics
   8. Antivirals (oral/nasal)
   9. Anxiolytics
   10. Beta blockers (oral)
   11. Bile salts
   12. Benign Prostatic Hyperplasia agents
   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. Hemophilia treatment
   21. Hereditary angioedema (HAE) treatments
   22. Immune globulins
   23. Immunomodulators, asthma
   24. Immunomodulators, atopic dermatitis
   25. Lincosamides/oxazolidinones/streptogramins
   26. Lipotropics, other
   27. aa. Lipotropics, statins
   28. bb. Multiple sclerosis agents
   29. cc. Pediatric vitamin preparations
   30. dd. Prenatal vitamins
   31. ee. Sedative hypnotics
   32. ff. Sickle cell anemia treatments
   33. gg. Thrombopoiesis stimulating proteins
   34. hh. Urea cycle disorder, oral
5. Public comment and discussion on single new drugs to be reviewed for the Medicaid PDL:
   1. Danziten / Oncology, oral - hematologic
   2. Erzofri / Antipsychotics
   3. Imkeldi / Oncology, oral - hematologic
   4. Opipza / Antipsychotics
   5. Revuforj / Oncology, oral - hematologic
   6. Voquezna paks / H.pylori treatment
   7. Voquezna tabs / Proton pump inhibitors (PPI), - oral
6. Therapeutic and clinical drug reviews and updates, discussion, and recommendations:  Gainwell Technologies and DURB members
7. 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.
8. Announcements of drugs recommended for the Medicaid PDL: OptumRx
9. Retrospective drug utilization review (DUR):  Acentra Health
   1. Recent interventions
      1. Chronic Opioid Use without Naloxone
      2. Congestive Heart Failure without Guideline-Directed Medication Therapy
      3. Duplicative Antidiabetic Therapies
      4. Psychiatric Therapies with Conflicting Mechanisms of Action
   2. Recent outcome reports
      1. Concurrent Use of Benzodiazepines and/or Sedative-Hypnotic Agents
      2. Monitoring Antipsychotic Induced Metabolic Syndrome
      3. Psychotropic Therapy During Pregnancy
      4. Risks of Long-Term Proton Pump (PPI) Use
      5. Use of Benzodiazepines in Patients with Chronic Obstructive Pulmonary Disease (COPD)
   3. Potential retro DUR interventions
      1. Anticonvulsant Drug Interactions
      2. Antihyperlipidemic Drug Interactions
      3. Drugs Lowering Seizure Threshold
10. Prospective prior authorization proposals: Acentra Health
    1. Cytokine and CAM - Revisions
       1. Omvoh - add new indication
       2. Bimzelx – add new indication
       3. Kevzara – add new indication
       4. Skyrizi – add new indication
    2. Transthyretin Agents
       1. Add Attruby
    3. Yorvipath – new criteria
    4. Zepbound – new criteria
11. Retrospective drug use criteria for outpatient use in the 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 - MDIs: Anti-Inflammatory Drugs
    3. Aerosolized Agents - MDIs: Beta2 Adrenergic Drugs (long-acting)
    4. Aerosolized Agents - MDIs: Beta2 Adrenergic Drugs (short-acting)
    5. Anti-Depressants, oral (other)
    6. Anti-Depressants, SSRI
12. Review of action items for next meeting
13. 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_APR2025 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, April 23, 2025. 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, April 21, 2025, 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 pre-registering at https://texashhsmeetings.org/DURB_PCReg_APR2025 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, April 21, 2025. 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 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.

People 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.