ALC-State Insurance Programs Oversight Subcommittee
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Senator Jim Petty
Unverified
3:30
we're going to call the uh meeting of the state insurance programs oversight committee or subcommittee to order um and our first order of business is item b which is a consideration to adopt the draft rules I would entertain a motion to draft adopt the draft rules see a motion
second all those in favor let it be known by aye any opposed all right next autopsy is approval of actions approved by the state board of finance and I believe Amanda Land is going to help us with that.
Speaker 15
4:32
Good morning, Mr. Chair. Amanda Land with the Deputy Director of the
Speaker 17
4:37
Employee Benefits Division. So we just have the April pharmacy formulary, the May pharmacy
Representative Nicole Clowney
Unverified
4:47
formulary and then the May medical formulary for review. I can just go through month by month if that's okay. Just a couple of drugs I'd like to highlight on each of the formularies. So for the April formulary, which is exhibit C1A of your packet, just wanted to highlight that Paxlovid,
we are adjusting the quantity limits on that to be more in line with CDC recommendations. So just finessing that right there. Skipping down to page two of that exhibit, under the row of drugs from P&T review, there are several that are new to market that we have noted there. They will continue to be not covered. We put those on there just to highlight that they are, again, new to market,
and we continue to monitor those for efficacy and just getting more data on the clinical efficacy of those drugs. The one that is new to market that we will be covering is on page 4 of that packet, and I'm going to butcher the name. it's Nymluvio, we will be keeping that as a specialty drug so that we can have some steps therapy in place for that drug.
Senator Jim Petty
Unverified
6:32
pharmacy formulary. Any questions? Representative Blundstrom, you have
Representative Robin Lundstrum
Unverified
6:37
a question? Yes. Could you give us a little bit of background on how this chart is formed and why these particular drugs are
Representative Nicole Clowney
Unverified
6:45
on it and then how you've come to the cost? Yes. So EBD, in conjunction with its partnership with EBRX,
it's the evidence-based prescription program through the College of Pharmacy at UAMS. We have pharmacists on site at EBD, and we review those monthly, and they use their data with their team of pharmacists and they go over the clinical data of each of those drugs to monitor whether they are cost-effective and just keeping tabs on whether they should be moved to tiers or taken off the formulary or added to the formulary.
So that is also done in conjunction with our contractor, Navitus, as well. Okay, and
Representative Robin Lundstrum
Unverified
7:29
I noticed on some of these COVID drugs, they're $1,496 per course. Are these shopped and compared? That's
a lot of money for one course of drugs.
Representative Nicole Clowney
Unverified
7:53
It's the only drug to treat that. Okay.
Representative Robin Lundstrum
Unverified
7:55
Yes. Only drug. okay I'll get back out of the queue and let some other folks get in thank you you're welcome looks like we
Senator Justin Boyd
Unverified
8:10
have senator Boyd thank you mr. chair so first of all thank you for what appears to me be a common-sense approach on the Pax Lovett and changing that to per 90 days that certainly makes a lot of sense and could save some money and then I appreciate that you're looking at these
high cost brand medications do we have any cases of people you know receiving statin drugs that are brand name i mean have we looked at that specifically as is one i mean senator i would have to check in
Representative Nicole Clowney
Unverified
8:41
to that and get back with you but i can certainly pull some information and see that can be
Senator Justin Boyd
Unverified
8:47
a high dollar medication brand that you know there's also a lot of very inexpensive generics available and I'd just be curious where we are on
Representative Frances Cavenaugh
Unverified
8:56
that yes yes sir you're welcome representative Cavanaugh thank you mr. chair just real quick question do you know how many lives we actually have
Representative Nicole Clowney
Unverified
9:15
insured in the through this program approximately 160,000
Representative Frances Cavenaugh
Unverified
9:17
give or take okay and that includes dependents and yes ma'am okay thank you you're
Senator Jim Petty
Unverified
9:26
welcome I don't see anyone else if not I would
entertain a motion for approval motion and second all those in favor let it be known by I any opposed
Representative Nicole Clowney
Unverified
9:43
motion carries all right continuing on so I'll continue on to the May EBD pharmacy formulary. A couple of additional drugs to highlight on this one is the first one on your list is Rivo Roxaban that is moving to from not covered. It's a brand that
is going generic so that has been updated on our formulary. And then the only other one that I wanted to highlight on this formulary would be the following page of this exhibit on the multivitamin maintenance there are several multivitamin drugs that have been moved to not covered simply because those can all be obtained over-the-counter now so happy to answer any questions on that exhibit any
Senator Justin Boyd
Unverified
10:39
questions looks like senator Boyd thank you mr. chair so has there been any change to formulary status on ivermectin since the state of Arkansas said that it will be over-the-counter in this this state no sir I believe it's over
Senator Jim Petty
Unverified
11:15
the counter said it Senator Boyd I can't see you there all
right thank you all right representatives I think I cut you
Representative Les D. Eaves
Unverified
11:24
off a minute ago no problem thank you mr. chairman just a quick question on the the trim FIA that is that currently not covered and now it's going to be covered. That's the $14,000 injection. Yes, sir. It was, is it now being covered as a result of any legislation or what's the reason it was not covered and now it
Representative Nicole Clowney
Unverified
11:47
is covered? It's a, it's a new strength of the drugs. So in reviewing that with EBRX,
um, what i was talking about earlier with respect to the clinical efficacy that was something that they considered to now add it to the formulary thank
Senator Jim Petty
Unverified
12:07
you you're welcome any other questions if not i would entertain a motion for approval motion and second all those in favor let it be known by i any opposed motion carries All right, continuing on.
Representative Nicole Clowney
Unverified
12:23
Thank you. Moving on to Exhibit C1C of your packet. This would be the May medical formulary. Just a reminder that this formulary is a medical drug that is administered through our partnership with Health Advantage, meaning these drugs are administered in a clinical setting versus getting them at a pharmacy. So the one drug I'll highlight on here is that ILEA. We are adding it back to the formulary for now because it has a partner biosimilar,
but there have been some access issues with our members, so we're adding this back for a year just to make sure there is continuity of care for our members, and we continue to monitor that to make sure that they're getting access to this treatment.
Speaker 17
13:15
I'm happy to answer any questions on this formulary. Representative
Representative Robin Lundstrum
Unverified
13:26
Lundstrom. Yes, could you give us some background? There's, and I would butcher these names every single time,
but it says recommendation to exclude, to exclude, no EBRX exclude. How do you come up with these? And I understand there's some serious price at $39,000 for a course, but just some background of how this works. Yes, Representative, it would
Representative Nicole Clowney
Unverified
13:50
be the same process that I was highlighting earlier that we go through with the College of Pharmacy and reviewing these monthly. They review the price, the efficacy of the drugs, and just the data that's out there.
And we sit down and discuss and make recommendations on whether to keep them off or put them onto the formulary. Okay,
Representative Robin Lundstrum
Unverified
14:11
so we'll see this again and again at each of the meetings, and we can
Representative Nicole Clowney
Unverified
14:16
ask some more questions. Absolutely. that when as an example on the April formulary when drugs are new to the market they do continue to monitor those on a pretty regular cadence just to make sure that if any new data is coming out we can get those added to the extent
Senator Justin Boyd
Unverified
14:33
it's appropriate as soon as possible okay thank you you're welcome senator Boyd thank you mr. chair and this should be my final question for the day Uh, so there was a lot of discussion and insurance and commerce committee during the session about a couple rather, uh, expensive Alzheimer drugs. Um, has, have you, is EBD looked at those again to see if there's any way they can be accommodated or is that an ongoing process or is it just the conversations over and we're not going to talk about that anymore?
Representative Nicole Clowney
Unverified
15:06
yes sir we're continuing to uh look at that and study study that it is certainly not um a process that's over okay i just we we had the
Senator Justin Boyd
Unverified
15:16
may 2025 in doctor's office drugs and none neither
of them were on there so i just wanted to make sure conversations were continuing thank you yes sir all right next
Speaker 12
15:25
up we have representative eaves thank you mr
Representative Les D. Eaves
Unverified
15:29
chairman on the other two exhibits you had a column that showed impacted members and there's not a column that shows that on exhibit C1C, the drugs that we're excluding, how many members would be affected by that? Do you
Representative Nicole Clowney
Unverified
15:42
know? I don't know that off the top of my head right now, but
Representative Les D. Eaves
Unverified
15:47
I can get that information for you. But certainly there are some that would be affected.
Speaker 58
15:52
Somebody's shaking their head behind you. No. Or he's having some
Speaker 52
15:58
seizure. Yeah. These would be the new to market drugs that um no one's
Speaker 58
16:02
currently using them and so that's is that the reason you're excluding them yes sir so we can continue to study
Senator Jim Petty
Unverified
16:14
the efficacy okay thanks yes all right i don't see any other uh questions uh if uh if that's the case i would entertain a motion
for approval motion second all those in favor let it be known by i any opposed motion carries all right is there any other business that needs to come before the committee if not we are adjourned
Agenda
A. Call to Order
B. Consideration to Adopt the Draft Rules of the Arkansas Legislative Council State Insurance Programs Oversight Subcommittee [Exhibit B]
C. Review and Approval of Actions Approved by the State Board of Finance - Amanda Land, Deputy Director, Employee Benefits Division (EBD), Department of Transformation and Shared Services
D. Other Business
E. Adjournment
Documents
Speakers
Speaker 2
Speaker 5
Speaker 6
Speaker 3
Speaker 10
Senator Jim Petty
Unverified
Speaker 15
Speaker 17
Representative Nicole Clowney
Unverified
Speaker 20
Representative Robin Lundstrum
Unverified
Senator Justin Boyd
Unverified
Representative Frances Cavenaugh
Unverified
Representative Les D. Eaves
Unverified
Speaker 12
Speaker 58
Speaker 52