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MAC Meeting Minutes October 6, 2017

Texas HIV Medication Advisory Committee Meeting
October 6, 2017

The October 6, 2017 meeting of the Texas HIV Medication Advisory Committee (MAC) was held at (4110 Guadalupe Street in the West Auditorium in Austin, Texas).

MAC Members in Attendance: Nancy Miertschin, M.P.H. Mary Paul, M.D.; Natalie Vanek, M.D.; Bruce Turner; Frank Rosas

DSHS Staff in Attendance: Janna Zumbrun; Felipe Rocha; Rena Manning; Jessica Hills; Rachel Sanor; James Abshier; Mary Dalton; Christine Salinas; Laura Ruiz; Mary Richards

Registered Guests: Suzanne Erickson; Chris Rideaux; John Warren; Toni Sparrow; Michele Puyear; Sunnye Simmons; Victoria Ford; Heather Eagleton; Royce Poinsett; Kathy Adcox; Quynh Chau Doan; Doug Wood; Bruce Gilbert; Scott Brooks; Matt Sheffield; A. Daniel Ramos; Ann O’Brien

Action and Discussion Items Covered:

  1. The meeting was called to order by Natalie Vanek at 12:35 pm. Dr. Keiser intended to attend via conference call, however the call failed. Therefore, there was not a quorum present. 

  2. Approval of the previous meeting minutes could not take place, and was deferred until the next meeting. 

  3. Janna Zumbrun gave an update on the Division of Laboratories and Infectious Disease Services.

  4. The update on Ryan White Part B was skipped due to the information being unavailable at this time. 

  5. Jessica Hills gave an update on the Texas HIV Medication Program (THMP) budget. 

  6. Rachel Sanor presented the AIDS Drug Assistance Program (ADAP) Update and the State Pharmacy Assistance Program (SPAP) Update. Nancy Miertschin asked a questing regarding FEMA and ADAP reimbursement for pharmacies who dispensed medications due to Hurricane Harvey. Ms. Sanor replied that she was unaware of FEMA reimbursement for medications, however those pharmacies seeking replacement of medications must contact THMP regarding reimbursement. Natalie Vanek asked about pharmacies that remained closed due to the hurricane. Mary Richards answered that THMP has only been informed of two pharmacies that remain closed.

  7. Ms. Sanor also presented regarding the Recertification and Self-Attestation project. Frank Rosas expressed appreciation to Ms. Sanor and Janina Vazquez for coming to San Antonio to meet in person with consumers. Ms. Sanor added that they and Shelley Lucas also traveled to Fort Worth, Dallas, and Houston. Nancy Miertschin asked a question regarding the number variance in July and August. Laura Ruiz, THMP data manager, replied that the numbers were low because the October recertification process is ongoing, and Ms. Sanor added that the Program switched to birth month recertification in June, therefore the method of counting recertifications changed. Mr. Rosas asked about the timing of all recertifications. Ms. Sanor replied that the State Pharmacy Assistance Program (SPAP) and Texas Insurance Assistance Program (TIAP) will begin birth month recertifications in next January. A member of the audience asked if the September numbers will reflect the effect of Hurricane Harvey, to which Ms. Sanor replied that it will, however those numbers have not been completed yet. 

  8. Rena Manning from the Epidemiology and Surveillance Branch presented on the HIV Treatment Cascade and Outcomes Among People Living With HIV. Bruce Turner asked if the information included Medicare data, and Ms. Manning replied that they were not able to get Medicare or Veterans’ Administration data for office visits, however they do receive data from EHARS. Mr. Rosas asked how much of the data is from the ARIES system, due to its instability. Ms. Manning explained that a large amount was from ARIES, however the data is from the previous year, which minimizes the effect of delayed data. Mr. Rosas asked about the inclusion of Latina women in the priority populations. Ms. Manning responded that that information was not part of the state plan when tracked. Dr. Vanek requested an expansion of the ‘all others’ category. Ms. Miertschin asked about the raw numbers of people on ADAP versus Ryan White and ADAP. Ms. Manning explained the crossover of categories.

  9. The Action Item to add additional HCV medications to the ADAP formulary was discussed but could not be voted on. Ms. Zumbrun explained that that the Commissioner was highly interested in expanding the HCV Pilot. A memo regarding the expansion was sent to the Commissioner to test feasibility, and he approved the addition of the medications Daklinza, Epclusa, Harvoni, Mavyret, Olysio, Sovaldi, Technivie, and Vosevi to the ADAP formulary, and an expansion to $3 million. Dr. Vanek asked how much of the original $1 million budgeted for the pilot was spent, and Ms. Hills replied that approximately $200,000 remained at the end of the fiscal year. There was discussion over whether the Committee recommended the $1 million cap on the pilot program, and whether the pilot needed to be reapproved annually by the Mr. Turner. Ms. Sanor looked up the meeting minutes which discussed the establishment of the pilot, and relayed that there was no renewal specified. Ms. Zumbrun reminded the Committee that their role was to advise and make recommendations, and that the Commissioner ultimately decides. The Commissioner is very interested in this subject, especially now that there is a cure for HCV. There was further discussion regarding the medications proposed for approval.

  10. The discussion of the Medication Advisory Committee role was held for return to the agenda at the next meeting. Ms. Zumbrun reminded Committee members that THMP has put medications on the formulary between Committee meetings in the past, but that we do want input from the Committee regarding demand and usage of the medications. Ms. Miertschin requested at least two days’ notice that medications were being added to the ADAP formulary. Mr. Rocha reminded members to take and review the packet consisting of the Texas Administrative Code and Texas Health and Safety Code regarding the Medication Advisory Committee.

  11. The next meeting was scheduled for December 8, 2017, due to the need for approval of several items. An RSVP will be requested from all members for the meeting date.

  12. A question was asked in public comments regarding the applications for Committee membership. Ms. Sanor replied that the applications were currently in review and would be forwarded to the Commissioner for approval after the review period ended.

  13. The meeting was adjourned at 2:10 pm.

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

Last updated June 11, 2020