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Pharmacy and Therapeutics Committee Meeting Minutes - Coverage Criteria

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Minutes summarizing P&T Committee attendance, therapeutic class reviews, public testimony, motions and approvals, and follow-up items affecting internal pharmacy management, formulary and DUR staff, and stakeholders monitoring P&T decisions.

Policy Summary

PayerExecutive Office of Health and Human Services

PolicyPharmacy and Therapeutics Committee Meeting Minutes

Policy CodePolicy N/A

Change TypeInformational — formulary and therapeutic class recommendations

Effective DateN/A

Next Review DateN/A

Key ActionAccept committee recommendations for therapeutic class updates and formulary additions/removals.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1meeting on record

multipletherapeutic categories reviewed

3public testimony speakers

2follow-up DUR items

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CurrentExecutive Office of Health and Human ServicesPolicy N/A

Pharmacy and Therapeutics Committee Meeting Minutes - Coverage Criteria

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Policy Summary

PayerExecutive Office of Health and Human Services

PolicyPharmacy and Therapeutics Committee Meeting Minutes

Policy CodePolicy N/A

Change TypeInformational — formulary and therapeutic class recommendations

Effective DateN/A

Next Review DateN/A

Key ActionAccept committee recommendations for therapeutic class updates and formulary additions/removals.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1meeting on record

multipletherapeutic categories reviewed

3public testimony speakers

2follow-up DUR items

Coverage Criteria Summary

No explicit coverage exclusions or not medically necessary determinations are recorded in these P&T Committee meeting minutes. The document summarizes therapeutic class reviews, motions, and unanimous approvals across multiple categories but does not state any therapies or uses that were denied or deemed not covered.

Formulary Decisions and Provider Actions

Prior Authorization

Formulary recommendations and approvals — committee motions and provider impact

The P&T Committee recorded multiple formulary and therapeutic-class recommendations and approved them by motion (unanimous unless noted). Providers should monitor the committee-approved additions/removals and any subsequent formulary updates that may affect coverage or preferred status.

Motions were made to accept recommendations for each reviewed therapeutic class; most passed unanimously.
Specific product changes were approved for otic antibiotics (addition of ciprofloxacin and polymyxin neomycin suspension and solution; removal of ofloxacin).
Stimulant category recommendations passed with one opposition; watch for formulary placement of new generics and solution/suspension formulations.

Step Therapy

Therapeutic class adjustments (no step therapy specified)

Therapeutic-class adjustments were recommended and accepted for several categories; no step-therapy sequences or prior authorization criteria were specified in the minutes.

Otic antibiotics: add ciprofloxacin; add polymyxin neomycin otic (suspension and solution); remove ofloxacin.
Androgenic agents: add Androderm to achieve full compliance.
Stimulants: new generics and products noted, including dextroamphetamine oral solution and Quillivant XR (methylphenidate suspension).

Documentation Required

Meeting minutes accepted; attendance and quorum recorded

Meeting minutes were reviewed and accepted as presented; the meeting was called to order once a quorum was present and attendance is documented in the minutes.

June 13, 2017 meeting minutes were reviewed and accepted as presented.
The meeting was called to order once a quorum was present (noted time: 8:08 am); members present and absent are listed.

Denial Risk

Motions to accept recommendations across categories — no explicit authorization/denial criteria recorded

Motions were made to accept the committee's recommended changes across multiple therapeutic categories; the minutes do not specify explicit authorization or denial criteria tied to these motions.

Each therapeutic-class presentation concluded with a motion to accept recommendations; most passed unanimously (one stimulant motion passed with one opposition).
No authorization/denial criteria, prior authorization requirements, or affected billing codes are listed in the minutes — providers should await formal formulary or PA policy updates for implementation details.

Key Definitions

PDL

TermPreferred Drug List (PDL)

ContextReferenced in discussion about available oral solution products and formulary composition during P&T therapeutic class reviews.

Actionable notePDL status guides which oral solution and otic products are listed or recommended (e.g., additions of ciprofloxacin and polymyxin neomycin otic formulations were recommended for the formulary).

Clinical implicationProviders should consult the PDL to confirm preferred formulations and product availability before prescribing or dispensing.

Related committee actionRecommendations to add ciprofloxacin and polymyxin neomycin (suspension and solution) and remove ofloxacin were accepted by the committee and inform PDL updates.

Policy Background

The Pharmacy & Therapeutics Committee meets to review therapeutic classes and make formulary recommendations to inform Medicaid pharmacy management. At this meeting, MMA presented multiple categories (Alzheimer agents through Otic Antibiotics and others) for review; for each category the committee discussed findings, considered product changes, and then voted. Motions to accept the recommendations for each presented class were made and unanimously approved.

The minutes record specific actions taken as part of the annual review process, including additions and removals within classes (for example, addition of ciprofloxacin and addition of polymyxin neomycin otic — suspension and solution, and recommendation to remove ofloxacin), noting biosimilar activity in the Cytokine and Calmodulin (CaM) Antagonists category and follow-up items for DUR where applicable.

Step Therapy / Prior Authorization Status

Step Therapy Requirement	Details / Notes
No step therapy requirements recorded
Committee meeting focused on formulary and therapeutic class recommendations, product additions (e.g., ciprofloxacin; polymyxin neomycin otic suspension and solution) and removals (e.g., ofloxacin). Minutes state that no step therapy sequences were specified.

Biosimilar Review Notes

Billing Rule

Biosimilar discussion noted — no policy action recorded

The Cytokine and Calmodulin (CaM) Antagonists presentation included a general biosimilar review and mention of recent news and a new biosimilar, but the minutes record no specific policy action or biosimilar preference to implement.

Category presentation noted updated indications, a new biosimilar and three new products, and included a general biosimilar review.
No recommended changes or specific biosimilar preference were recorded in the minutes.