Payor possibly to remove Avandia from formulary, demote Actos

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HealthTrans pharmacy and therapeutics (P &T) committee recommended removal of Avandia (rosiglitazone) from its value-based formulary effective Jan. 1, 2008 due to cardiovascular concerns surfacing in clinical data in recent months. The P &T committee also recommended moving Actos (pioglitazone) to the third tier of the formulary and to continue monitoring clinical data for both products.

The Greenwood Village, Colo.-based HealthTrans reported that it processes over 70 million claims annually, representing more than 13 million clients and approximately $3 billion in prescription drug spending.

“Our P &T committee, which is comprised of independent physicians, pharmacists, and nurses, is committed to always doing what is best for the patient,” said Jack McClurg, CEO of HealthTrans. “This means they have to make some tough decisions about discontinuing drugs that they have determined present significant risks.”

The P &T committee noted that the FDA is currently scrutinizing the class of drugs because of increased adverse cardiac events reported in some type-2 diabetic patients taking either of the medications.  

“Our first concern is the safety of individuals taking medications included in our value-based formulary,” said Ryan Haynes, RPh, director of clinical services for HealthTrans. “Our P &T committee analyzed available data and weighed the benefits with the potential risks and determined that Avandia presents a greater risk for adverse events than benefits at this time.”

Other products containing the medication rosiglitazone, including Avandamet and Avandaryl, were also recommended for removal from the value-based formulary. Other products containing the medication pioglitazone including, ACTO plus met and Duetact, were recommended to be moved to the third tier of the formulary, Haynes noted.