August 2022 Policy Memo

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Memo: August 30, 2022

With most of the Hill being on vacation or recess, August was a quiet policy month for Sick Cells. Nevertheless, we have a few important updates to share about our work.

1. Sick Cells prepared advocates for a Tennessee Pharmacy Advisory Committee Meeting on August 11th.

a. One advocate, a SCD expert clinician in Tennessee, provided oral testimony.

b. Sick Cells submitted written testimony.

c. Current formulary placements for SCD therapies are as follows:

Droxia Preferred, Open Access
Hydroxyurea Preferred, Open Access
Endari Non-preferred, Prior Authorization, Step Therapy & Quantity Limits
Oxbryta Non-preferred, Prior Authorization, Step Therapy & Quantity Limits
Siklos Non-preferred, Prior Authorization
Adakveo Not Listed

d. The board did not recommend any changes to the formulary.

2. The August Ambassador Priority Topic Meeting (PTM) focused on the topic of Access & Coverage.

a. Ambassadors reviewed the basics of insurance coverage & common paint points, and how to make an appeal.

3. Sick Cells released the final report for our Medicaid research project

a. Medicaid Access & Landscape Review for Prescription Drugs Treating Sickle Cell Disease

b. Results will be premiered at the 2022 Coverage for SCD Summit on August 31.

Please contact with questions.

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