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Kaiser Permanente Georgia 1
u Formulary additions . . . . . .1
ISSUE 2 VOLUME 7 APRIL 2013
u new standing order . . . . . 2
u medications reviewed at P&t, But not added to the
Formulary . . . . . . . . . . . . 3
Ipratropium bromide (generic Atrovent) 0.03% nasal spray is currently available on the National Medicare Part D (MPD) Formulary as Tier 2, generic, and was added to the Commercial Formulary effective April 18, 2013. Ipratropium bromide 0.03% nasal spray, an anticholinergic agent, is indicated for the symptomatic relief of rhinorrhea associated with allergic perennial rhinitis and nonallergic perennial rhinitis. Ipratropium 0.03% nasal spray provides an alternative therapy for the treatment of rhinorrhea associated with allergic and nonallergic perennial rhinitis for patients who have inadequate control of rhinorrhea on conventional therapy. Ipratropium bromide provides an alternative therapy for the treatment of rhinorrhea associated with allergic and nonallergic perennial rhinitis for patients who have inadequate control of rhinorrhea on conventional therapy. Inhaled corticosteroids, flunisolide (generic Nasarel) or fluticasone (generic Flonase), remain the first line option with greatest efficacy in managing rhinitis.
Ambrisenten (Letairis) 5 mg and 10 mg tablets are currently available on the National MPD Formulary as Tier 5, specialty, and were added to the Commercial Formulary effective April 18, 2013. Ambrisentan is an oral endothelin receptor antagonist FDA-approved for the
treatment of pulmonary arterial hypertension (PAH) in patients with WHO Group 1 PAH with Functional Class II or III disease to improve exercise capacity and delay clinical worsening. Due the serious risk of birth defects with ambrisentan, it is only available to prescribers and patients enrolled in the Letairis Education and Access Program [LEAP]. The KP Specialty Pharmacy (KPSP) is an authorized pharmacy for LEAP and helps to coordinate prescriber and patient enrollment. Prescriptions dispensed through KPSP can be seen in the KP electronic medical record. Letairis shoud be considered after therapy with sildenafil (generic Revatio).
Ethinyl estradiol and norgestrel (generic Cryselle) 0.03 mg/0.3 mg tablets are currently available on the National MPD Formulary as Tier 2, generic, and were added to the Commercial Formulary effective April 18, 2013. Cryselle is a monophasic prescription estrogen and progestin combination oral contraceptive indicated for the prevention of pregnancy. The safety and efficacy
u national medicare Part d Formulary . . . . . . . . . . . . . . 2
A PUBL ICAT ION OF THE GEORGIA PHARMACY AND THERAPEUT ICS (P&T) COMMITTEE . The Formulary Update contains information regarding formulary additions, deletions, exclusions, brief descriptions of products, and current drug related news. It also lists items to be discussed at upcoming P&T meetings. Please refer to the web site http://kpnet.kp.org:81/ga/healthcare/formularies.html or providers.kp.org for the full KP GA Drug Formulary. If you have Lexi-Comp PDA access to the KPGA Online Formulary, remember to sync your device for the most current information.
u Quantity limits . . . . . . . . . 3 u Floorstock additions . . . . . 3
u clinical uPdate . . . . . . . . . 3
u aPPendix a: dePartment Floorstock list additions . . . 4 u aPPendix B: Quantity limits . 6
2 Kaiser Permanente Georgia
uPcoming Formulary decisions
An important aspect of the formulary process is the involvement of all practitioners. So that each of you has an opportunity to participate in the process, upcoming P&T agenda items are listed below. Please contact your P&T Committee representative or your clinical service chief by May 15, 2013 if you wish to comment on any of the medications, class reviews, or other agenda items under consideration. To make formulary addition requests, you must submit a Formulary Additions/Deletions Form and Conflict of Interest Form to Drug Information Services or call (404) 949-5331.
Formulary Reviews (June 2013):
medication class reviews
Gastrointestinal Agents, Misc
Approved standing orders are written instructions issued by medical practitioners, in ac-cordance with the regulations, authorizing pharmacy personnel at pharmacies owned or operated by Kaiser Foundation Health Plan to supply and administer specified medica-tions under circumstances specified in the order. Asacol/Asacol HD to Lialda: Mesalamine delayed-release 400 mg tablets (Asacol) have been discontinued by the manufacturer because the product contins pthalate. Lialda con-tains the same active ingredients as Asacol and does not contain phthalate. In response to the change in the market, a standing order has been approved for the conversion of Asacol to Lialda. Patients should be counseled to take Lialda once daily with food.
New Standing Order
National Medicare Part D FormularyKaiser Permanente has a National Medicare Part D (MPD) Formulary. Each regional P&T Committee reviews drugs and decides on tier status. The National Medicare Part D Pharmacy and Therapeutics Committee is charged with reconciling regional differences in MPD Formulary recommendations through consensus building in order to maintain one National MPD Formulary for Kaiser Permanente. National MPD Formulary tier placement and changes are listed below with the corresponding effective date:
medication name tier eFFective date
Mesalamine (Lialda) 1.2 gm 3 4/18/2013
Linaclotide (Linzess) 145 mcg, 290 mcg 4 2/5/2013
Apixaban (Eliquis) 2.5 mg, 5 mg 4 3/5/2013
Alogliptan (Nesina) 6.25 mg, 12.5 mg, 25 mg 4 3/5/2013
Alogliptin and pioglitazone (Oseni) 12.5 mg-15 mg, 12.5 mg-30 mg, 12.5 mg-45 mg, 25 mg -15 mg, 25mg -30 mg, 25-45 mg
Alogliptin and metformin (Kazano) 500 mg, 1000 mg 4 3/5/2013
Budesonide (Uceris) 9 mg 5 2/12/3013
Tier 1 = Value Generic Tier 3 = Brand Tier 5 = Specialty Tier 2 = Generic Tier 4 = Non-Preferred Brand Tier 6 = Injectable Part D Vaccine
Formulary Additions, Continuedof Cryselle is similar to other available combination oral contraceptives. It is similar in cost to other combination oral contraceptives available on the formulary. Cryselle provides a low-cost oral contraceptive option on the formulary containing a second generation progestin.
Ipratropium bromide-albuterol (generic Duoneb) nebulizer solution is currently available on the National MPD Formulary as Tier 2, generic, and was added to the Commercial Formulary effective April 18, 2013. Ipratropium bromide-albuterol solution is a combination nebulizer solution for the treatment of bronchospasm associated with chronic obstructive pulmonary disease in patients requiring more than one bronchodilator. Nebulized medications
may be indicated in patients unable to effectively use MDIs with spacers.
Mesalamine (Lialda) 1.2 gm delayed-release tablets were added to the Commercial Formulary and placed on Brand Tier 3 on the National MPD Formulary effective April 18, 2013. Lialda is a locally acting 5-aminosalicylic acid (5-ASA) indicated for the induction of remission and maintenance of remission of mildly- to moderately-active ulcerative colitis. Lialda is dosed once daily and is recommended to be taken with food. Lialda replaces Asacol as the mesalamine containing product on our formulary. Please see standing order article below.
Kaiser Permanente Georgia 3
Questions and concerns?
If you have any questions or concerns, please contact any of the following P&T Committee members and designated alternates:
P&T Chair:Daniel Lee, MD, FACS
Physician Program Director of Pharmacy
P&T Committee Members:Seeme Ahmad, MD*
Debbi Baker, PharmD, BCPSClinical Pharmacy
Gary Beals, RPhDirector of Pharmacy
Karen Bolden, RN, BSNClinical Services
Deborah Burzotta, PharmDPharmacy Operations
Alyssa Dayton, MDObstetrics and Gynecology
Carole Gardner, MDElder Care
Patrice Gaspard, MDPediatrics
Marcus Griffith, MD*Behavioral Health
Donald Hanchett, MDAmbulatory Medicine
David Jones, MDPediatrics
Felecia Martin, PharmDPharmacy/Geriatrics
LaJune Oliver, MDAmbulatory Medicine
Rachel Robins, MDHospitalist
Designated Alternates:Jacqueline Anglade, MD
Obstetrics and Gynecology
Lesia Jackson, RNClinical Services
*Attend alternating meetings
Medications Reviewed, but Not Added to the Formulary Taliglucerase alpha (Elelyso) 200 units for injection, decision pending for the National MPD Formulary Ponatinib (Iclusig) 15 mg & 45 mg tablets, decision pending for the National MPD Formulary Sodium picosulfate, magnesium oxide and anhydrous citric acid for oral solution (Prepopik), not
added to the Commercial Formulary; decision pending for the National MPD Formulary Tofacitinib (Xeljanz) 5 mg tablet, not added to the Commercial Formulary; decision pending for the
National MPD Formulary Teriflunomide (Aubagio) 7 mg and 14 mg film coated tablets, not added to the Commercial
Formulary; decision pending