Drug Utilization Review (DUR) Board Meeting Summary - November 20, 2008

Agenda and Introduction

The Drug Utilization Review Board Meeting scheduled on Thursday, November 20, 2008 from 9:00 A.M. to 5:00 P.M., was held in Meeting Room 4, Computer Science Corporation, Rensselaer, New York.

A. Background Materials Provided:

The Board was provided copies of written materials to be presented at the meeting.

B. Public Comment Period:

There were no public speakers.

C. Speaker Period:

The following speakers provided comment to the Board:

  1. Jones, Linda, RN, Director, Medicaid Pharmacy Program, Office of Health Insurance Programs, New York State Department of Health (NYSDOH)
  2. Figge, James, MD, Medical Director, Office of Health Insurance Programs, New York State Department of Health (NYSDOH)
  3. Lehmann, David, MD, PharmD, Professor of Medicine and Pharmacology, SUNY Upstate Medical University
  4. Finnerty, Molly, MD, Director, New York State Office of Mental Health
  5. McNamara, Daniel, RPh, Medicaid Pharmacy Program, Office of Health Insurance Programs, New York State Department of Health (NYSDOH)
  6. Naioti, John, Jr., RPh, DUR Manager, Medicaid Pharmacy Program, Office of Health Insurance Programs, New York State Department of Health (NYSDOH)

D. DUR Board Meeting Summary:

  • The election of the Chair and Vice Chair was held. Joseph Paladino, PharmD, was elected Chair. Leigh Briscoe-Dwyer, PharmD, BCPS, CGP, was elected Vice Chair.
  • The Medicaid Medication Therapy Management Program was presented. The purpose of the program is to improve compliance with drug therapy and improve clinical outcomes. The following comments from the Board were addressed: mechanisms of communication between MTM pharmacists and primary care physicians, time lines of the program, and target/control populations.
  • The Prescriber Education Program was introduced to the Board. The purpose of the program is to provide prescribers with evidence based, non-commercial sources of the latest objective information about pharmaceuticals. Collaboration with an academic institution is required for program development.
  • The Psychiatric Services and Clinical Knowledge Enhancement System (PSYCKES) was presented. The program focuses on improving the safety and quality of psychotropic medication management in New York State. Discussion from the Board addressed evaluation processes of the program and where the program may go in the future.
  • A review of the Prospective DUR (ProDUR) process was presented. The ProDUR process enables the pharmacy provider to screen for drug therapy problems at point-of-sale or distribution.
  • A review of the Retrospective DUR (RetroDUR) process was presented. RetroDUR involves reviews of patient drug history profiles generated from medical assistance paid claims data by a panel of active practicing physicians and pharmacists.

E. Executive Session:

  • The Board recessed the public session at 1:15 P.M. to go into executive session for review of confidential RetroDUR beneficiary cases. No official action was taken in the executive session. The executive session was recessed at 2:00 P.M.

F. Additional Discussion:

  • A review of asthma RetroDUR criteria was discussed. The criteria are predetermined elements that are used to measure drug use on an ongoing basis to determine if the use is appropriate, medically necessary and not likely to result in adverse medical outcomes. The Board reviewed, commented and voted on twenty asthma and COPD related criteria.

The meeting adjourned at 3:00 P.M.

Meeting Summary Posted 12/29/08