Thursday, May 18, 2006

In open hearing

I attended a hearing of the Pharmaceutical and Therapeutics Committee for Texas Medicaid and CHIP yesterday. Long day, crammed hearing room, lotsa big words. At issue were the drugs that would be included on the preferred drug list for Medicaid and CHIP.

My two cents were directed toward the situation with statins. Protease inhibitors and statins don't get along well. So far, the only two statins deemed safe enough to treat dyslipidemia in combination with PIs are pravastatin and atorvastatin (the later with caution). Neither of these medications is on the PDL.

Like I know all this stuff. Of course, someone pointed it out to me. And they provided me with authoritative research studies to make sure that I understood the point.

As an organization, Texas AIDS Network doesn't endorse specific medications. Our work has been to make all FDA-approved medications available to as many Texans as possible. However, we do love to hammer away at prior authorization requirements when they get in the way of HIV therapy, so this was an opportunity to do so.

What nobody told me was that one of the companies with a newer statin thinks its drug will work well in combination with PIs. (That would be rosuvastatin.) And, of course, the company's guy had to point out that I had erred in my testimony.

I hate when that happens.

Needless to say, I have since been burning up the search engines, trying to find out more about rosuvastatin and HIV. Clearly, the research on the use of rosuvastatin in combination with PIs is underway--and I so stepped on their toes.

I did do some further search for information before the hearing, not being a complete doofus. What I turned up essentially said that the current guidelines accept pravastatin and atorvastatin (with caution) and not other statins for use in treating dyslipidemia for HIV patients. What it didn't turn up, because I used the wrong search terms to turn it up, was that rosuvastatin shows promise and may be a candidate for addition to the guidelines.

Lesson learned? It's disconcerting when your cardiologist shows up at a hearing where you will testify, but not nearly as embarassing as when your gynecologist does. ;)

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