Drug Name

Indication

Description of Change (by Formulary Type)

Generic Alternatives

Lower Tier Alternatives

Approximate Monthly Cost Difference

Accretropin

Norditropin

Omnitrope

Growth hormone deficiency

New Medication

Commercial-Tier 3, with Prior Auth

Generics Plus- Non-Formulary

Medicare-  Tier 4

Medicaid – Non-Formulary

n/a

Tev-Tropin

$667

Aloxi

Prevent nausea from chemotherapy

New Medication

Commercial-Tier 4, Qty limit #12 per 30 days

Generics Plus- Non-Formulary

Medicare-  Tier 3 (may have Qty limits)

Medicaid – Non-Formulary

Ondansetron

Granisetron

n/a

Price not yet available

Avastin

Cancer, Macular Degeneration

Prior Authorization Update

Added an approved indication for Age-related Macular Degeneration (medical benefit PA drug)

n/a

n/a

n/a

Lucentis

Macular Degeneration

Prior Authorization Update

Prior Authorization removed (medical benefit drug)

n/a

n/a

n/a

Magugen

Macular Degeneration

Prior Authorization Update

Prior Authorization removed (medical benefit drug)

n/a

n/a

n/a

Nplate

Treats low platelets in a blood disorder called ITP (Idiopathic Thrombocytopenic Purpura)

New Medication

Added as a medical benefit.  Pending CMS confirmation, it will be added to Medicare Part B.  If added to Medicare Part D, it will be Tier 4

n/a

n/a

n/a

Supprelin LA

Early onset of puberty in children

New Medication

Added as a medical benefit.  Restricted to Pediatric Endocrinologist prescribing only.  No prior authorization needed.

n/a

n/a

n/a

Treximet

Migraine Headaches

Quantity Limits

Commercial-Tier 4, Qty limit #9 per 30 days; Step-edit through sumatriptan

Generics Plus- Non-Formulary

Medicare-  Non-Formulary

Medicaid – Non-Formulary

Sumatriptan

Relpax

n/a