Idaho Medicaid Drug Utilization Review Program . 18 April 2013. ADURS (American Drug Utilization Review Society). February 21-23, 2013 Scottsdale, Arizona Representatives present from 40 state Medicaid programs 109 total participants. ADURS.
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18 April 2013
February 21-23, 2013
Representatives present from 40 state Medicaid programs
109 total participants
Participants Receiving Over 500 mg Morphine Equivalents per Day
Lowest = 10 mg
Highest = 2421 mg
Payment Amount to Pharmacy: 12/12 - $25,787; 3/13 - $24,555
Same decision for all indications ?
Topical formulation of testosterone requires a prior authorization
Injectable testosterone does not require a prior authorization
Are testosterone injections being prescribed appropriately?
Are there duplicative treatments between outpatient pharmacy benefit and medical benefit (J-codes)?
Age: 0- 75 years Average of 41 years
Average days supply: 28 days ( range: 14-34 days
Average dispensed quantity: 4 mls (range: 1-10 mls)
The most prescribed: Testosterone cypionate 200mg vial
Prior Authorization of injectable testosterone for therapeutic diagnosis may be required to evaluate appropriate use and maintain consistency across the two programs
*12 children’s therapy counted in 2-4 different entities included an IR/ER combination of one of the entities, not counted here
atomoxetine (Strattera) 22%
clonidine IR 32%
guanfacine IR 30%
guanfacine ER (Intuniv) 15%
dexmethylphenidate IR 5 mg daily
dexmethylphenidate XR 15 mg daily
clonidine 0.2 mg daily
guanfacine 5 mg daily
atomoxetine 40 mg daily