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AIDS DRUG ASSISTANCE PROGRAM (ADAP)

MEDICAL ADVISORY COMMITTEE (MAC)

MAC Meeting Notes - July 15, 2020 

1. Welcome, Rollcall, and Introduction

I. Welcome
Meeting opened by Sandra Robinson, ADAP Branch Chief
II. Rollcall  
MAC Members in Attendance
Craig Ballard
Stephen O’Brien
Wilbert Jordan
Michelle David Lewis
Laveeza Bhatti
Danny Toub
Lucas Hill
David Grelotti

MAC Members not in Attendance
Jennifer Yoon

Magellan Representatives in Attendance
Kristen Haloski
Jason Eugenio
Nicole Quackenbush

Magellan Representatives not in Attendance
N/A 
 
CDPH/Office of AIDS staff in Attendance
Philip Peters
Sandra Robinson
Cynthia Reed-Aguayo

CDPH/Office of AIDS staff not in Attendance
Marisa Ramos 

III. Bagley-Keene Process Introduction
ADAP will conduct public meetings as required by the Bagley-Keene Open Meeting Act. Due to coronavirus restrictions, meetings will be held via teleconference until social distancing requirements are lifted.

ADAP will provide a conference call number with an AT&T operator to ensure members of the public are able to provide comment on agenda topics. Individuals calling in will have up to one minute to provide comment per topic.

Nomination of MAC Vice Chair
The Vice Chair selected during the meeting will serve as Vice Chair through February 1, 2022.

Nominations 
During the first round of nominations, Michelle Sherman nominated Craig Ballard. The nomination was declined by Craig Ballard.
During the second round of nomination, Craig Ballard nominated Michelle Sherman who accepted the nomination. No other nominations submitted.

Vote
The vote was unanimous electing Michelle Sherman as the Vice Chair

2. ADAP / MAC Updates

I. MAC Recruitment Updates
Philp Peters, OA Medical Officer, announced that revised ADAP MAC membership application documents were approved in April 2020. Membership information can be viewed on the ADAP Medical Advisory Committee webpage at: https://www.cdph.ca.gov/Programs/CID/DOA/Pages/OA_ADAP_MAC_Medical_Advisory_Committee.aspx

II. Introduction of New Members
Philip Peters introduced new ADAP MAC members:
Dr. Lucas Hill, Lead Pharmacist, Owen Clinic in San Diego and 
Dr. David Grelotti, Associate Professor of Psychiatry and HIV Psychiatrist, UC San Diego.

3. New Antiretroviral (ARV) Medications

I. Cabotegravir (Cabenuva)
The discussion included two cabotegravir medications that are to be in sequence for the treatment of HIV infection and thus were voted on together.

Oral cabotegravir is to be taken once daily, in combination with oral rilpivirine (Edurant™), to ensure adverse reactions do not occur prior to the start of treatment with the long-acting injections of these medications. Cabenuva is a combination medication which contains cabotegravir extended release injectable suspension and rilpivirine extended release injectable suspension. Cabenuva is administered with a monthly injection.

MAC members in attendance unanimously voted to recommend the addition of both cabotegravir and Cabenuva to the ADAP formulary pending approval from the U.S. Food and Drug Administration (FDA).

II. Fostemsavir
On July 2, 2020, the FDA approved fostemsavir (Rukobia) as a first in class, twice daily oral HIV attachment inhibitor for treatment in HIV infected persons who have not been successfully treated with other therapies due to resistance, intolerance or safety considerations.

MAC members in attendance unanimously voted to recommend the addition of fostemsavir to the ADAP formulary.

4. Opportunistic Infection Treatments

I. Amoxicillin Clavulanate (Augmentin®)
Community-Acquired Pneumonia is an opportunistic infection among people living with HIV. U.S. Department of Health and Human Services (DHHS) opportunistic infection treatment Guidelines recommend high-dose amoxicillin or amoxicillin-clavulanate for the treatment of community-acquired pneumonia. Noting that amoxicillin is already on the formulary, during the call, the MAC discussed that it would be beneficial to add amoxicillin-clavulanate to the formulary.

5. Magellan Presentation

I. Formulary Review
Kristen Haloski conducted a presentation for the ADAP MAC on Major Depressive Disorder Medications and Anxiety Disorder Medications. Due to time constraints, the presentation on Chronic Obstructive Pulmonary Disease (COPD) Medications which was listed on the agenda will be presented during the October 2020 meeting.

6. Close of meeting 

I. Announcement of Future Meeting
Sandra Robinson announced the remaining 2020 ADAP MAC meeting date as Wednesday October 21, 2020 and announced that the December 16, 2020 as listed in posted agenda was an error actual meeting date is January 20, 2021.

II. Posting of Meeting Notes
Meeting notes will be posted on the ADAP MAC web page by August 3rd.

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