Deferred pending further information

Discussion
The Committee was presented with further information regarding the safety of rosuvastatin. The Committee has deferred the addition of rosuvastatin to Formulary until further safety data are obtained.

Approved with restrictions

Discussion
The Committee was presented with the request to add bevacizumab (Avastin) to Formulary. Bevacizumab, a monoclonal antibody that works by inhibiting the action of vascular endothelial growth factor (VEGF), has FDA approval in combination with 5-fluorouracil-based chemotherapy as a treatment for patients with first-line or previously treated metastatic cancer of the colon or rectum. The drug will be included in COE regimens for standard-of-care FDA-approved indications.

Approved with restrictions

Discussion
The Committee was presented with the request to add cetuximab (Erbitux) to Formulary. Cetuximab, a monoclonal antibody, has FDA approval to treat colon cancer in combination with irinotecan, or alone in patients intolerant to irinotecan. The drug will be included in COE regimens for standard-of-care FDA-approved indications.

Approved

Discussion
The Committee was presented with the "Heparin to Maintain Patency of Central Lines"-Newborn Collaborative Policy. Due to an increased risk of intraventricular hemorrhage in low birth weight newborns, the heparin concentration was changed from 1 unit/ml to 0.5 unit/ml. The Committee approved the document with no suggested revisions.

PCHI Formulary request: Niacin/Lovastatin (Advicor)

Approved: PCHI Yellow Grid

Discussion
The Committee was presented with the request to add niacin/lovastatin (Advicor) to the PCHI Formulary. The Committee was provided with an extensive overview of niacin/lovastatin. The lipid-altering agents niacin (extended-release) and lovastatin are available in a fixed-dose combination formulation for the treatment of primary hypercholesterolemia and mixed dyslipidemia. The fixed combination of extended-release niacin/lovastatin is not recommended for initial therapy by the manufacturer. Patients receiving niacin alone or lovastatin alone may be switched to the fixed combination using titration regimens. Usual effective doses of the fixed combination have ranged from 1000 milligrams (mg) extended-release niacin/20 mg lovastatin to 2000/40 mg once daily.
The review included a discussion of:

• Dosing consideration regarding transition from dual therapy to combination therapy.
  
• Indications for use; not intended for initial therapy; patients must have had previous prescriptions for individual agents
  
• Compliance with the convenience of a single dosage form
  
• Cost effective option for one copay versus two and minimal drug cost and comparable LDL and TG reductions
  

Approved with restrictions

Discussion
The Committee was presented with the request to add perflexane lipid microspheres (Imagent) to Formulary. Perflexane lipid microspheres are an imaging agent used to aid in visualization of the left ventricle chambers and delineating cardiac borders during echocardiogram procedures. This agent is relatively less expensive compared to the other imaging agents currently on Formulary. Its efficacy compared to other imaging agents has not been studied. The Cardiac Imaging Unit agreed to perform a 10-month review of the agent to determine the efficacy as compared to other agents. The Committee requests a formal product evaluation by the echocardiologists at the end of the 10-month period to determine clinical benefit and potential cost savings measures.