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MAC Meeting Minutes April 7, 2017

OFFICIAL MINUTES
Texas HIV Medication Advisory Committee Meeting
April 7, 2017


The April 7, 2017 meeting of the Texas HIV Medication Advisory Committee (MAC) was held at 4110 Guadalupe Street in the Nifty-Fifty conference room in Austin, Texas.

MAC Members in Attendance: Philip Keiser, M.D., Chair, Natalie Vanek, M.D., Vice-Chair, Mary Paul, M.D., Raul Castaneda, R.Ph., Nancy Miertschin, Demetra Tennison, Yolanda Rodriguez-Escobar, Frank Rosas, Bruce Turner

DSHS Staff in Attendance: Janna Zumbrun, Shelley Lucas, Rachel Sanor, Jennifer Hills, Laura Ruiz, Juliet Garcia, Lester Mattson, R.Ph., Mary Richards

Registered Guests: Ana Sanaseros, Danielle Costa, Sunil Arvihettu, Jesse Jones, Sunnye Simmons, Raquel Deans, Tyler Hunter, Tony Duran, Anthony Valdez, Mark Vane, Scott Brooks, Suzanne Erickson, Doug Wood, Gary L. Lang, Anand Yaparla, Victoria Ford, Kathy Ada, A. Daniel Ramos, Chris Rideaux, Holly Turner, Jim Osburn


Action and Discussion Items Covered:

  1. The meeting was called to order by Dr. Keiser at 12:30 pm. 


  2. The committee reviewed and unanimously approved the minutes from the June 17, 2016 meeting. 


  3. Janna Zumbrun provided an update on the Division for Disease Control and Prevention, the organizational transition which will be affecting the Division and THMP, and the state of the legislative session and budget allocations.


  4. Jessica Hills, from the Budget Office, presented an update on the THMP Budget and a snapshot of current ADAP expenditures and rebate projections. The question was asked if the budget update can be shared electronically, to which Shelley Lucas referred the questioner to Mr. Rotan in the Budget Office. A question was asked about what will happen with the rebates for medications, and if they will continue, which is not known yet. There was discussion about how the rebate funds are distributed, and that the distribution is done via a formula based on the number of cases of HIV in the local areas. 


  5. Rachel Sanor presented ADAP/SPAP/TIAP update reports detailing clients served per month and program, clients served by month and over the past four quarters, percentage of clients served by EMA over the past two quarters, the top ten drugs dispensed per number of orders through ADAP over the past two quarters, a breakdown of ADAP clients by sex and race/ethnicity, the percentage changes for specific drugs dispensed through ADAP over the past four quarters, utilization to date of recently approved drugs, data regarding the Hepatitis C Virus (HCV) pilot  program to date, and information on THMP mailing lists and a customer survey now available on the THMP website. Bruce Turner requested information regarding the percentage of clients per sex and race in comparison to the incidence of the epidemic. 


  6. There was a discussion of the addition of Egrifta to the THMP formulary. A motion was made to table the discussion for now and poll doctors regarding the usage of Egrifta, which failed. After further discussion, Yolanda Rodriguez-Escobar motioned for a pilot program of 10 people, currently on HIV medication, with a diagnosis of lipodystrophy, with a viral load under 400. The measures for the pilot are to be whether 10 people used the medication within six months, and the cost of the medication. The motion was seconded by Dr. Vanek, and approved unanimously.

    Dr. Keiser requested a change to the Medical Certification form to track if clients have been tested for Abacavir hypersensitivity. The test is available, part of the standard of care, and is only needed once per client. After discussion, Dr. Keiser motioned to add to the Medical Certification Form that any change regarding Abacavir will require the hypersensitivity test. The motion was seconded and unanimously approved.


  7. Rachel Sanor presented regarding the recertification changes taking place in THMP. There was vigorous discussion regarding the changes and difficulties, led by Frank Rosas. Dr. Keiser requested that it be pointed out to the HRSA project officer that this is harming patients. Shelley Lucas replied that THMP would be referred to the legislation, and that we are in communication with HRSA. Dr. Keiser would like the Medication Advisory Committee to have more input on program matters. 


  8. The next MAC meeting was tentatively scheduled for Friday, June 16, 2017.


  9. There were no public comments.


  10. The meeting was adjourned by Dr. Keiser at 3:40 pm.


Approved by:
Phillip H. Keiser, M.D. – Chairman, Texas HIV Medication Advisory Committee
Date



Last updated January 30, 2018