Medical Professional Publications

Pharmacy & Therapeutics Committee Updates

(From the May 2015 Issue of MedStat)

For more detailed information, contact Kimberly Novak at Kimberly.Novak@NationwideChildren.org.

The following actions were taken at the April 2 Pharmacy & Therapeutics Committee meeting.

Clinic medication stock lists for Adolescent Pediatric Gynecology Main Campus, Teen and Pregnancy Clinic, Clinical Research Services, and Rheumatology Clinic were APPROVED.

Sample requests for Cystic Fibrosis Clinic (MVW Complete Formulation CF specialty vitamin - liquid, chew tab and capsule formulations) were APPROVED.

A Medication Use Evaluation of our non-formulary use of ziprasidone (Geodon®) was presented. Ziprasidone has been associated with a higher risk for QTc interval prolongation than other comparator atypical antipsychotic medications on the Formulary. Between March 2013 and March 2014, 38 patients with a mean age of 14.5 years (range 9-19 years) received ziprasidone. All doses were oral, and the majority of use was continuation of home therapy. Most patients (68%) were admitted to the Hospital Pediatrics service and were on the youth crisis stabilization unit. Approximately 50% of patient had ECG monitoring performed during their hospitalization. No patients met strict criteria for QTc prolongation, though one patient had a QTc interval approaching prolongation. Ziprasidone is a lower cost atypical antipsychotic due to generic availability; however, most Ohio Medicaid programs have restrictions via quantity limitations or prior authorization requirements. APROVED recommendations included: 1) Maintenance of non-formulary status for continuation of home therapy (all prescribers), with initiation of therapy restricted to or in consultation with Psychiatry prescribers, 2) Strict ban of intramuscular ziprasidone use, and 3) Removal of oral ziprasidone from Epic preference lists.

Ulipristal acetate (ella®) [emergency contraception] was APPROVED for formulary addition. The monograph will be posted on the P&T intranet website. A review of formulary drug use will be presented in six months.

Levonorgestrel (Plan B®) [emergency contraception] was REMOVED from Formulary. Official product transition to ulipristal acetate will commence with release of Epic changes and updates to clinic stock. The transition will be communicated to affected work areas at a later date.

The following clinic medication stock lists were UPDATED to reflect the Formulary change to ulipristal acetate (ella®) from levonorgestrel (Plan B®): Near East, Whitehall, Linden, Eastland, Northland, Westside, South High, Primary Care Red, Primary Care Yellow, Adolescent E. Main St, Adolescent E. Broad St, Adolescent Pediatric Gynecology, IDC/Faces Clinic, and Child Advocacy Center for Family Safety and Healing.

Bevacizumab (Avastin®) was APPROVED for formulary addition. A review of formulary drug use will be presented in six months.

Bortezomib (Velcade®) was APPROVED for formulary addition with restriction to Solid Organ Transplant and Oncology attending/fellow prescribing only. The monograph will be posted on the P&T intranet website. A review of formulary drug use will be presented in six months.

Vedolizumab (Enyvio®) was APPROVED for formulary addition with restriction to Gastroenterology prescribing in adult patients (> 18 years of age). The monograph will be posted on the P&T intranet website. A review of formulary drug use will be presented in six months.

The next meeting will take place on Thursday, May 7th at 7am.  

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