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HCV Medicaid DURB Hearing Outcome, Feb 26, 2015
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The following is from
Colleen Flanigan, Director, Viral Hepatitis Section, NYS Dept of Health
Hi all,
At yesterday's NYSDOH Drug Utilization Review Board meeting, the board voted to approve Viekira Pak as its preferred drug for persons chronically infected with HCV and enrolled in FFS Medicaid. Viekira Pak will be available for all chronically infected persons regardless of disease severity. This drug is also FDA approved for HIV coinfection and has transplant indications.
Note that this only applies to patients enrolled in FFS Medicaid and does not apply to persons enrolled in Medicaid Managed Care Plans. Providers should consult the formularies of each of the managed care plans to determine which drug(s) is/are approved, drug restrictions and for additional prior authorization information.
NYS Medicaid Managed Care drug look-up web page now has a feature that allows you to quickly view the formularies of the various managed care plans, to see if a specific HCV medication is covered.
Click on the link - http://pbic.nysdoh.suny.edu/search/
Click on the tab "Therapeutic Classes, Other"
Check "Hepatitis C Agents- Direct Acting Antivirals"
Below is the link to the audio version of the DURB meeting.
http://www.health.ny.gov/events/webcasts/2015/2015-02-26_durb.htm
We know that this is a moving target with more drug soon to be approved that may impact cost. The DURB will continue to monitor and provide additional updates at the next meeting.
Colleen
Colleen Flanigan
Director, Viral Hepatitis Section
New York State Department of Health
AIDS Institute
Empire State Plaza, Corning Tower - 429
Albany, NY 12237
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