20-141 Medication Trend Updates and Preferred Drug List Changes - 1st Quarter 2020
Date: 02/11/20
This information applies to Physicians and Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Fresno, Kings and Madera counties.
Review changes that improve patient safety and encourage medication adherence
Stay up to date with information about:
- Patent expiration for commonly used brand-name medications
- Changes to the CalViva Health Medi-Cal Preferred Drug List (formulary) for the first quarter of 2020.
Patent expiration for commonly used brand-name medications
Patents are granted by the United States Patent and Trademark Office along the development lifeline of a medication. Patents expire 20 years from the date of filing. Many factors can affect the duration of a patent. When a brand-name medication loses its patent, lower-priced generics enter the market. U.S. Food & Drug Administration (FDA)-approved generic drugs are made under the same rigorous standards as their brand-name counterparts and are bioequivalent. In other words, they deliver the same amount of active ingredients into a patient's bloodstream in the same amount of time as their brand-name product. During the upcoming year, the medications below are anticipated to be available as generic equivalents.
Medication patent expirations | |
| 2020 |
1st Quarter | Noxafil®1, Zortress® |
2nd Quarter | Travatan Z® |
3rd Quarter | Truvada®, Atripla® |
4th Quarter | Absorica®1, Chantix®, Dulera®1, Jadenu® |
1 Nonformulary
CalViva Health Medi-Cal Preferred Drug List changes
The Pharmacy and Therapeutics (P&T) Committee, which includes practicing physicians, pharmacists and other health care professionals, reviews medications on the
CalViva Health Medi-Cal Preferred Drug List each quarter to determine medications to stay on or be moved to a different status. A list of some recent changes is provided in the table beginning on page 2. A complete CalViva Health Medi-Cal Preferred Drug List is available on the provider website at provider.healthnet.com under Pharmacy Informationes
Medication | Status | Formulary alternative(s) | Comments |
Oral medications | |||
Aemcolo™ (rifamycin) delayed-release tablet | NF | ciprofloxacin, levofloxacin, ofloxacin, azithromycin | Treatment of travelers’ diarrhea (TD) caused by noninvasive strains of Escherichia coli in adults Limitation(s) of use: Aemcolo is not indicated in patients with diarrhea complicated by fever or bloody stool or due to pathogens other than noninvasive strains of Escherichia coli. |
Nubeqa® (darolutamide) tablet | NF | Anti-androgens: bicalutamide (Casodex®)**, flutamide** | Treatment of patients with non-metastatic castration resistant prostate cancer (nmCRPC) |
Piqray® (alpelisib) tablet | NF | Endocrine therapy: anastrozole (Arimidex®)**, exemestane (Aromasin®)**, letrozole (Femara®)**, megestrol acetate**, tamoxifen (Nolvadex®)**, toremifene (Fareston®)** | In combination with fulvestrant for the treatment of postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, PIK3CA-mutated, advanced or metastatic breast cancer as detected by an FDA-approved test following progression on or after an endocrine-based regimen |
Sunosi™ (solriamfetol) tablet | NF | Narcolepsy, OSA: armodafinil (Nuvigil)*, modafinil (Provigil®)* Narcolepsy: amphetamine immediate-release (IR), amphetamine/dextroamphetamine (Adderall®), dextroamphetamine (Dexedrine®), methylphenidate (Ritalin®) | To improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea (OSA) |
Turalio™ (pexidartinib) capsule | NF |
| Treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery |
Xpovio™ (selinexor) tablet | NF | Proteasome inhibitors: Ninlaro*,** Immunomodulatory agents: Pomalyst®** Anti‐CD38 monoclonal antibody: Darzalex®* | In combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti‐CD38 monoclonal antibody
|
Medication | Status | Formulary alternative(s) | Comments |
Zelnorm® (tegaserod maleate) tablet | NF | polyethylene glycol (MiraLax®) Bulk-forming laxative: psyllium (Metamucil®), methylcellulose powder (Citrucel®), calcium polycarbophil (FiberCon®) Stimulant laxative: bisacodyl | Treatment of adult women less than age 65 with irritable bowel syndrome with constipation (IBS-C) |
Vaginal preparations | |||
Annovera™ (segesterone acetate and ethinyl estradiol) vaginal ring | NF | Nuvaring® Oral contraceptives: ethinyl estradiol/norethindrone (Junel®, Necon®, Ortho-Novum®) ethinyl estradiol/levonorgesterol (Lessina®) ethinyl estradiol/norgesterol (Cryselle™, Ogestrel®) ethinyl estradiol/ethynodiol (Kelnor®, Zovia®) ethinyl estradiol/desogestrel (Mircette®) ethinyl estradiol/drospirenone (Yasmin®) ethinyl estradiol/norgestimate (Ortho-Cyclen®) | For use by females of reproductive potential to prevent pregnancy |
Injectable preparations | |||
Ultomiris™ (ravulizumab-cwvz) single-dose vial | NF | Soliris®* | Treatment of adult patients with paroxysmal nocturnal hemoglobinuria (PNH) |
Vyleesi™ (bremelanotide) single-dose prefilled autoinjector | NF |
| Treatment of premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD) as characterized by low sexual desire that causes marked distress or interpersonal difficulty and NOT due to: • A co-existing medical or psychiatric condition, • Problems with the relationship, or • The effects of a medication or drug substance. |
*Prior authorization (PA) is required to verify member eligibility and that the member satisfies clinical protocols to ensure appropriate use of the medication.
**CCS = California Children’s Services: refer to www.dhcs.gov for the local telephone number to determine member’s coverage eligibility.
- NF indicates nonformulary. These medications require member-specific medical reasons why formulary medications cannot be considered. Requests are reviewed via the plan’s prior authorization process.
If you need additional information regarding the CalViva Health Medi-Cal Preferred Drug List, contact the Pharmacy Department by telephone at 1-800-867-6564, press option #2, or by fax at 1-800-977-8226. For all other questions contact CalViva Health at 1-888-893-1569.