Related laws and rules

Purpose of the P&T Committee

The Pharmacy and Therapeutics (P&T) Committee was formed to evaluate available evidence regarding the relative safety, efficacy and effectiveness of prescription drugs in a class.

• The Committee is required to make recommendations to state agencies regarding the development of the state’s Preferred Drug List.
• The P&T Committee is a "technical review committee".
• The Committee also serves as the Medicaid Drug Utilization Review (DUR) Board.

P&T Committee goals

• To consider and make recommendations on drug classes based on independent evidence-based reviews. Reviews of drug classes shall be based on the evidence of safety, efficacy, and effectiveness available at the time of the review.
• The Oregon Health & Science University, Evidence-Based Practice Center is contracted by the Health Care Authority to conduct the evidence-based reviews and make its findings available for the P&T Committee.
• Recommendations by the P&T Committee will be solely based on available evidence, not on cost considerations. The cost analysis will be performed after the meeting and does not include the P&T Committee.

P&T member selection

To meet federal Centers for Medicare and Medicaid Services (CMS) requirements, the P&T Committee also fulfills the role of the Drug Utilization Review (DUR) Board. The committee must consist of at least 31% but no more than 51% pharmacists or physicians.

Members must be actively practicing in their area of clinical expertise and must have knowledge and expertise in one of the following:

• Clinically appropriate prescribing of covered outpatient drugs
• Clinically appropriate dispensing and monitoring of covered outpatient drugs
• Drug use review
• Medical quality assurance
• Disease state management

Members cannot currently or within the previous 18 months be employed by:

• A pharmaceutical manufacturer
• A pharmacy benefits management company
• Any agency administering state purchased health care programs

The members main practice focus is outpatient care. Specialties represented on the committee include:

• Family practice
• Internal medicine
• Behavioral health

Members must have experience in:

• Evidence-based medicine
• Serving on a pharmacy and therapeutics committee strongly preferred

Committee membership is representative of programs' geographic distribution.

Members who are active in professional societies are preferred.

P&T Committee meetings

• The P&T Committee will meet at least quarterly. The meetings will comply with the Open Public Meetings Act. Every meeting is recorded.
• The attendance of six members of the committee represents a quorum. The P&T Committee will make a motion on each drug class reviewed. The motion can be made by any member of the committee. Another member of the committee is required to second the motion for it to be voted on. A majority vote passes the motion.