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Members of P&T Committee

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Presentation on theme: "Members of P&T Committee"— Presentation transcript:

1 Members of P&T Committee
Member Background Randy Axelrod (MD) Anthem Chief Medical Officer (Chairman) Roy Beveridge (MD) Oncologist Avtar Dhillon (MD) Psychiatrist (CSB) James Reinhard (MD) Psychiatrist (DMHMRSAS) Arthur Garson, Jr (MD) Dean, UVA Med. School Mariann Johnson (MD) Family Practice Eleanor (Sue) Cantrell (MD) Local Health District Director Christine Tully (MD) Geriatrician, VCU/MCV Mark Szalwinski (Pharmacist) Sentara Healthcare (Vice Chairman) Gill Abernathy (Pharmacist) INOVA Health System Mark Oley (Pharmacist) Westwood Pharmacy Renita Warren (Pharmacist) Edloe’s Pharmacies

2 2003 Appropriations Act: P&T Committee Responsibilities
The P&T Committee shall recommend to the Department: therapeutic classes of drugs to be subject to the PDL and prior authorization requirements specific drugs within each class to be included on the PDL appropriate exclusions for medications, including atypical anti-psychotics, used for the treatment of serious mental illnesses such as bi-polar disorders, schizophrenia, and depression appropriate exclusions for medications used for the treatment of brain disorders, cancer, and HIV-related conditions other appropriate exclusions and “grandfather” clauses conduct clinical reviews of preferred and non-preferred drugs as needed to maintain the PDL conduct clinical reviews of new drugs provide advice to DMAS and Contractor on clinical issues regarding all aspects of the PDL program, including the prior authorization process for non-preferred drugs

3 Medicaid FFS Pharmacy Costs 89% Increase since 1997
Source: Statistical Record of the Virginia Medicaid Program, costs net of rebates

4 Drug Classes Excluded from the PDL Program
Therapeutic Class Description Insulins……………………………. Cholinesterase Inhibitors……….. Platelet Aggregation Inhibitors…. Antivirals for HIV…………………. Cancer Chemo. Agents…………. Anti-convulsants…………………. Immunosupressants…………….. Antiemetics………………………. Anti-psychotics…………………… (Atypical and Typicals) Used in the Treatment of Diabetes Alzheimers Clotting Disorders HIV/AIDS Cancer Seizure Disorders, Mental Health Transplant rejections, Arthritis Nausea in cancer patients, Aging Serious Mental Illness

5 Top 10 Therapeutic Classes $301 Million of $380 Million (79%)
DOLLARS RX $45,715,563 $63,275,613 $36,776,608

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