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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


ADAP MM 2020-18
May 29, 2020


TO:
ADAP ENROLLMENT WORKERS

SUBJECT:
ADDITION OF TESAMORELIN FOR INJECTION (EGRIFTA SV™) TO THE ADAP FORMULARY

​ADAP MANAGEMENT MEMO 2020-18: ADDITION OF TESAMORELIN FOR INJECTION (EGRIFTA SV™) TO THE ADAP FORMULARY


Effective May 26, 2020, tesamorelin for injection (Egrifta SV™) has been added to the ADAP formulary. Egrifta SV™ received U.S. Food and Drug Administration (FDA) approval on November 5, 2018 as a single-vial formulation. Egrifta SV™ is a growth hormone-releasing factor (GHRF) analog indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. Lipodystrophy is defined as an abnormal distribution of fat tissue and can contribute to the development of fatty liver, dyslipidemia, and insulin resistance. Lipodystrophy in people living with HIV is often caused by exposure to certain older antiretroviral medications.

ADAP management requests that you share this information with your clinical leadership team and local prescribers. The ADAP drug formulary has been updated to reflect the addition of Egrifta SV™. Access to the updated formulary is available at the following URL: https://cdph.magellanrx.com/member/documents.

If you have any questions regarding the addition of these medications to the ADAP formulary, please contact Cynthia Reed-Aguayo, ADAP Specialist, at (916) 449-5791.


Thank you,

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Sandra Robinson, MBA

ADAP Branch Chief

California Department of Public Health


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