Minutes
Drug Utilization Review Board Meeting
DATE: December 9, 2009		

Meeting Purpose: Quarterly Open Board Meeting 
Meeting opened at 6:03 P.M. by Chair, Andrew Balder.

Agenda Items:

I.	Welcome and Introductory Remarks
II.	Acceptance of September 2009 DUR Board Minutes
III.	Pharmaceutical Pipeline Preview
IV.	MassHealth Drug List
V.	DUR Operational Update
VI.	MassHealth Update   	Dr. Paul Jeffrey

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

Review of Minutes	
The Board reviewed and accepted the September 2009 Board Minutes. 	
Follow Up	

Action
		
Minutes accepted as written.	

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

Pharmaceutical Pipeline Preview
	
Recent trends in the FDA approval process were given. The presenter provided a comparison and contrast between emerging pipeline agents with currently available therapeutic options and an overall summary of generic availability of commonly used agents over the next three years.	
Follow Up	

Action

Conclusions: 
The FDA has increased adherence to approval timelines compared to 2008. A large generic boom lies ahead. 2011 will be a big year for high volume sales generics in cardiology, diabetes, and CNS disorders. Potential blockbuster approvals in 2010 include agents  for the treatment of diabetes, osteoporosis, thromboembolism and RA.	

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

MassHealth Drug List 

	
Effective February 1, 2010, the MassHealth Drug List will have 19 new additions. Effective February 15, 2010, Triptans, and Migranal will require PA. Dilantin capsules, Neoral, Phenytek and Sandimmune will have changes in PA status effective February 15. Ramipril capsules will no longer require PA and Invega extended release tablets will require PA. There will be several changes in PA status in the miscellaneous drug class. Therapeutic class tables 26, 29, 32, 35 and 47 will be added to the MassHealth Drug List with evaluation criteria on February 1, 2010. Dr. Jeffrey noted that the MassHealth Drug List is the second most looked at Web page on the Web site, being topped only by the Member Enrollment page.  	
Follow Up

Action

	
Conclusions: 

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

DUR Operational Update

	
DUR staff reported on Prior Authorizations from July 2008 to July 2009.  There was a spike between September and November 2008. The DUR call volume and call statistics remain relatively consistent, with 7,000-8,000 calls per month, and an abandonment rate below industry standards. The handling time of calls averages around three minutes. The number of Appeals between July 2008 and July 2009 ranged from five to 35.	
Follow Up	

Action	
DUR will continue to monitor the above mentioned areas.
	
Conclusions: 	

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

MassHealth Update
Dr. Paul Jeffrey

	
Dr. Jeffrey reported that the Atypical Antipsychotic Initiative has been keeping people busy. MassHealth has been posting and monitoring activity with this drug class and the number of claims has dropped by 5% since the beginning of the initiative. Dr. Jeffrey noted that this drug class consumes about 20% of the MassHealth budget. On the downside, the average cost of these drugs has escalated by approximately 10% which has obliterated any cost savings.  
A legal settlement returned to the state of MA a large sum of money (approximately $100 M) allowing some saving projects for 2010 to be put on hold for the time being.  	
Follow Up	

Action

	
Conclusions: 
Dr. Jeffrey reported that the FY 2011 budget deficit continues to grow. There is still much work that lies ahead in regard to the new budget. He added that the rules for FY 2010 will not work for FY 2011. Having plans to work with these issues will be very important.  National healthcare reform, medical home primary care structures, and MA payment reform may be seen in the future.   	

Meeting adjourned at 7:43 P.M.
Respectfully submitted by: Vincent Palumbo, Director of DUR

Date: 12/17/09