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    Phone: 737-255-4300

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MAC Meeting Minutes July 17, 2015

Texas HIV Medication Advisory Committee Meeting
July 17, 2015

The July 17, 2015 meeting of the Texas HIV Medication Advisory Committee (MAC) was held at 4110 Guadalupe Street, West Auditorium, Building 582 in Austin, Texas.

MAC Members in Attendance: Philip Keiser, M.D., Chair, Natalie Vanek, M.D., Vice-Chair, Mary Paul, M.D., Fernando Garcia, M.D., Nancy Miertschin, M.P.H., Raul Castaneda, R.Ph., David Huse, Frank Rosas, Demetra Tennison, Bruce Turner

DSHS Staff in Attendance: Janna Zumbrun, Felipe Rocha, Shelley Lucas, Rachel Sanor, Margaret Vaaler, John Allen, Mary Richards, Heather Nagy, Lester Mattson, R.Ph., William Ayres

Registered Guests: Becky Gonzales, Jay Dee Fredericksen, Jack McClure, Suzanne Erickson, Jami Durham, Michelle Flores, Sunnye Simmons, Sheldon Skinner, Karen Petties, Michelle Puyear, Tyler Hunter, Venita Ray, Myra Leo, Armando Chavez, Mark Vane, Roger Grotzinger, Sylvia Moreno, Bruce McLaughlin, Mary Pasley, Quynh Chau Doan

Action and Discussion Items Covered:

  1. The meeting was called to order by Dr. Keiser at 12:15 pm, July 17, 2015.

  2. The committee reviewed and unanimously approved the December 5, 2014 meeting minutes

  3. Felipe Rocha, Manager of the TB/HIV/STD/Viral Hepatitis Unit, presented an update on the THMP Budget and a snapshot of current ADAP projections.

  4. Rachel Sanor presented ADAP/SPAP update reports detailing first time enrollment by month and program, clients served by month and over the past four quarters, monthly medication order costs over the past four quarters, clients served by EMA during the first half of Fiscal Year (FY) 2015 as well as all of FY 2014, clients served by county during the first half of FY 2015, medication order costs by EMA for the first half of FY 2015, comparison graphs of ADAP clients and persons living with HIV in Texas by sex and by race, ADAP client demographics for the first half of FY 2015 by gender, by race and by age group, the average monthly cost per client over time, the top ten drug prescription expenditures for the first half of FY 2015 and a comparison of increases and decreases in bottles dispensed for drugs between the first half of FY 2014 versus the first half of FY 2015.

  5. Felipe Rocha informed the MAC that the DSHS Pharmacy Branch was now incorporated into the TB/HIV/STD/Viral Hepatitis Unit and introduced Lester Mattson, R.Ph. as a new employee within the Pharmacy Branch.

  6. Margaret Vaaler, data team lead from the Care Services Group within the HIV/STD Prevention and Care Branch give a presentation covering the HIV Treatment Cascade and unmet need statistics for Texas. The report covered 2013 data; Ms. Vaaler explained that the 2014 data was currently being compiled and not yet finalized. The data indicated 80% of ADAP clients in Texas had achieved viral suppression, which was a higher level than those patients receiving their HIV care through other resources in Texas including Medicare or Medicaid.

  7. Assistant Commissioner Janna Zumbrun presented an update on the Division for Disease Control and Prevention Services, including the legislative session that had recently wrapped up and the proposed changes to agencies within HHSC in response to the Sunset Review process.

  8. The recommendation to add the drug elvitegravir (Vitekta) to the THMP formulary was approved unanimously by the Committee pending successful national ADAP Task Force negotiations with the manufacturer to secure an ADAP contract pricing agreement. It was explained that Vitekta was already approved as a component of the combination therapy drug Stribild, much like the other unique component of Stribild known as cobicistat (Tybost) had been added to the formulary per the recommendation made at the previous MAC meeting.

  9. Mary Pasley with Abbvie regarding the Viekira Pak as a treatment for Hepatitis C and its efficacy for those patients co-infected with HIV. After discussion amongst the MAC members, request was made to have Margaret Vaaler present data on coinfection rates amongst the Texas ADAP population. The request to add the Viekria Pak to the ADAP formulary was tabled awaiting feasibility information on financial impact; in the meantime the doctors on the MAC would also take time to consider potential clinical criteria for that class of drug.

  10. Texas ADAP Manager Rachel Sanor provided an explanation of Modified Adjusted Gross Income (MAGI) and the recommendation by HRSA to begin using it as a primary component of the financial criteria for greater uniformity in the eligibility process between state ADAPs and local Ryan White Care Services. The MAC members expressed concerns about the MAGI requirements for IRS documentation presenting a barrier to care in light of recent restrictions to nline accessibility of transcripts and non-filing verifications. Felipe Rocha said that the Unit would present an update at the next Committee meeting concerning issues encountered by staff and Part A agencies in getting the MAGI process rolled out statewide.

  11. Rachel Sanor updated the MAC on the HMS contract for third party health insurance verification that began in January 2015. HMS is providing monthly data matching reports to the Texas ADAP for clients who appear to have active health insurance coverage for prescription drugs, and those clients are being dropped from standard ADAP eligibility unless the client can provide proof of coverage termination or they work in cooperation with ADAP staff to contact the insurer directly for specific policy details. Each of the data mangers at the Administrative Agencies are being notified via the confidential Public Health Information Network of the ADAP clients in their respective areas that are being flagged for insurance coverage.

  12. The next MAC meeting was tentatively scheduled for Friday, November 20, 2015.

  13. There were no public comments.

  14. The meeting was adjourned by Dr. Keiser at 2:53 pm.


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

Last updated June 11, 2020