News

Quarterly Pharmacy Changes for July

Quarterly pharmacy changes that are effective July 1, 2009 are noted below:

Drug Name	Indication	Description of Change (by Formulary Type)	Generic Alternatives	Lower Tier Alternatives

Akten	Anesthesia during ophthalmic procedures	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	n/a	n/a
Alvesco	Asthma	New Medication Commercial-Tier 3 Generics Plus- Non-Formulary Medicare- Tier 3 Medicaid – Non-Formulary	n/a	Asmanex Flovent
Ambien CR	Insomnia	Increase Quantity Limit #30/30 days, up from #21/30 days	Zolpidem	n/a
Brovana	COPD	Remove PA		Foradil Serevent
Cesamet	Nausea	Remove Quantity Limit	Ondansetron	n/a
Cialis (2.5mg daily dose)	Erectile Dysfunction	Add Quantity Limit #4/30 days (from #30/30)	n/a	Viagra
Cinryze	Hereditary angioedema	New Medication Added as a medical benefit. Should be added to Medicare under Part B. If CMS determines the drug is covered under Part D, it will be 4^th tier	n/a	n/a
Combigan	Glaucoma	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	Timolol Brimonidine	n/a
Depo Provera	Contraceptive	New Pharmacy Benefit Commercial-Tier 3 Generics Plus- Non-Formulary Medicare- Tier 3 Medicaid – Formulary	n/a	n/a
Desoxyn	ADHD	Remove PA	n/a	n/a
Durezol	Pain and inflammation of the eye after surgery	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	Dexamethasone Prenisolone	n/a
Emsam	Depression	Remove PA	Selegiline	n/a
Fusilev	Antidote	New Medication Added as a medical benefit. Should be added to Medicare under Part B. If CMS determines the drug is covered under Part D, it will be 4^th tier	Leucovorin	n/a
Gelnique Gel	Urinary incontinence	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	Oxybutynin, XL	Detrol LA
Keppra (regular, not XR)	Seizures	Remove PA Commercial-Tier 1 Generics Plus- Tier 1 Medicare- Tier 1 Medicaid –Formulary Keppra XR: Step-edit through generic Keppra	n/a	n/a
Latisse	Eye lash growth	Excluded: Cosmetic Use	n/a	n/a
Lunesta	Insomnia	Increase Quantity Limit 1mg strength, #60/30 days (up from #30/30 days)	Zolpidem	n/a
Marinol	Nausea, appetite stimulant	Remove Quantity Limit	n/a	n/a
Mozobil	Stem cell transplants	New Medication Added as a medical benefit. Should be added to Medicare under Part B. If CMS determines the drug is covered under Part D, it will be 4^th tier	n/a	n/a
Paxil CR	Depression	Remove Step-Edit	Paroxetine	n/a
Perforomist	COPD	Remove PA		Foradil Serevent
Pristiq	Depression	Change Step-Edit Criteria Commercial-Tier 3, SE through 2 SSRIs or 1 SSRI and Effexor XR Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	n/a	Effexor XR
Promacta	Low platelets	New Medication Commercial-Tier 3 Generics Plus- Non-Formulary Medicare- Tier 4 Medicaid – Non-Formulary	n/a	n/a
Rapaflo	Benign Prostatic Hyperplasia	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Tier 3 Medicaid – Non-Formulary	Terazosin	Flomax
Requip XL	Parkinsons Disease	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Tier 2 Medicaid – Non-Formulary	Ropinirole	n/a
Ryzolt	Pain	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	Tramadol	n/a
Sanctura SR	Urinary incontinence	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	Oxybutynin, XL	Detrol LA
Savella	Fibromyalgia	New Medication Commercial-Tier 4, SE through Effexor XR Generics Plus- Non-Formulary Medicare- Non-formulary Medicaid- Non-formulary	n/a	Effexor Xr
Temazepam	Insomnia	Increase Quantity Limit 7.5mg and 15mg, #60/30 days (up from #30/30 days)	n/a	n/a
Toviaz	Urinary incontinence	New Medication Commercial-Tier 4 Generics Plus- Non-Formulary Medicare- Non-Formulary Medicaid – Non-Formulary	Oxybutynin, XL	Detrol LA
Triazolam	Insomnia	Increase Quantity Limit 0.125mg, #60/30 days (up from #30/30 days)
Zolpidem	Insomnia	Increase Quantity Limit 5mg strength, #60/30 days (up from #30/30 days)	n/a	n/a
Zetia	High cholesterol	Remove PA, Tier Change Commercial- Tier 3 (up from Tier 2) Generics Plus- Tier 3 (no change) Medicare- Tier 2 (no change) Medicaid- Non-formulary (changed from formulary)	n/a	n/a
Zomig	Migraine headaches	Add Quantity Limit #6 bottles/30 days	Sumatriptan	Relpax

* For groups without a four-tier pharmacy plan, drugs listed as moving to Tier 4 will remain at Tier 3.

If you have questions or comments regarding these changes, please contact your Account Executive.