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Drug Utilization Review

The primary objectives of Drug Utilization Review (DUR) are to improve the quality of health care for Medicaid members and to assist in containing health care costs.   In order to achieve these goals, prescription claims must be reviewed both prospectively and retrospectively.   Findings of the reviews are communicated to both prescribers and pharmacists to assure that medications provided are appropriate, medically necessary, and not likely to result in adverse medical effects.    Drug Utilization Review is mandated by the Omnibus Budget Reconciliation Act of 1990 (OBRA ’90), an amendment to the Social Security Act.

Calendar, Agendas and Minutes

All meetings are held from 4-6 pm in the Lower Level Conference Room of the DHHR Building at 350 Capitol Street, Charleston, WV.  

Contact:  Brian M. Thompson, MS, PharmD
Drug Utilization Review Coordinator

2014 Meetings       
November 19, 2014  Agenda  Minutes Attachment A - PDL Changes
Attachment B - PA Criteria
Attachment C - DUR Quarterly Report
Attachment D - RDTP Quarterly Report
Attachment E - HID Quarterly Report
September 17, 2014 Agenda Minutes Attachment A - PDL Changes
Attachment B - PA Criteria
Attachment C - DUR Quarterly Report
Attachment D - RDTP Quarterly Report
May 21, 2014  Agenda   Minutes Attachment A - PDL Changes
Attachment B - Xerox Reports
Attachment C - Quarterly DUR Report
Attachment D - RDTP Quarterly Report
February 19, 2014 Agenda Minutes PDL Changes
DUR Presentation
2013 Meetings       
November 20, 2013   Agenda Minutes  Attachment A - Ketoconazole
Attachment B - Chantix
Attachment C - Osphena
Attachment D - Rational Drug Therapy Program Presentation
September 18, 2013  Agenda Minutes Amitiza
May 15, 2013  Agenda Minutes  Asthma Proposal
Polypharmacy Proposal
Molina Report
RDTP Presentation
February 20, 2013  Agenda Minutes Bipolar Proposal
Bipolar Letter
Diabetes Numbers
Mental Health News Letter
Lock-In Outcome FFY 2012
Mail Merge Approval - Crestor PDL Provider Letter
2012 Meetings      
November 28, 2012   Agenda  Minutes Anticonvulsant Drug Use Evaluation
Gastrointestinal Agents DUE Proposal
Gastrointestinal Agents DUE Letter
Rational Drug Therapy Program
Lidoderm Utilization April 2006 - March 2010
September 19, 2012   Agenda  Minutes Attachment A -  Analgesics, Narcotics
Attachment B 
Attachment C -  PDL w/PA Criteria
Attachment D -  Lyrica
Attachment E -  Step Therapy Proposal
Attachment F -  Venlafaxine Member Dosage
Attachment G -  DUR Presentation
Attachment H -  Benzodiazepine Anxiolytic
Attachment I   -  DUR Presentation
Attachment J  -  Summary Report
 May 23, 2012  Agenda  Minutes Attachment A - Incivek
Attachment B - Victrelis
Attachment C - Makena Statement
Attachment D - PT Meeting Changes Summary
Attachment E - Oral Oncology Agents
Attachment F - Kayldeco
Attachment G - Kuvan
Attachment H - Increlex
 February 15, 2012  Agenda  Minutes Attachment A - PDL Changes
Attachment G - RDTP
Attachment H - ACS
Attachment I - Molina 
 2011 Meetings      
 November 16, 2011



Attachment - ACS
Attachment - RDTP
Attachment A - Dificid
Attachment B - Humira - Enbrel
Attachment C - Incivek
Attachment D - Victrelis
Attachment E - Gralise
Attachment F - 2012 DUR Meetings 
 September 21, 2011  Agenda  Minutes Attachment A - RDTP Report
Attachment C - Atypical Antipsychotics
Attachment D - Letter
 May 25, 2011  Agenda   Minutes Adults Stimulants
Atypicals - Children under 6 yrs.
Makena Statement
Otic Edge Drops
Sprycel Updates
WV Fibromyalgia Letter
WV Fibromyalgia  Proposal
WV Narc Prescriber Letter
WV PDL DUR Review 
 March 2, 2011  Agenda  Minutes Carbaglu
Cough/Cold Meds
PDL Changes
DUR Presentation
Multiple Drug Therapy
DUR Archived Agendas and Meetings
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