The Select Drug Program Formulary, which is available for commercial members, is a list of medications approved by the U.S. Food and Drug Administration that were chosen for formulary coverage based on their medical effectiveness, safety, and value. The list changes periodically as the Pharmacy and Therapeutics Committee reviews the formulary to ensure its continued effectiveness. The most recent changes are listed below.

Generic additions

These generic drugs recently became available in the marketplace. When these generic drugs became available, we began covering them at the appropriate generic formulary level of cost-sharing:

Generic drug	Brand drug	Formulary chapter	Effective date
adapalene lotion	Differin® Lotion	5. Skin Medications	April 6, 2015
cefixime susp 100 mg/5 ml and 200 mg/5 ml	Suprax® Susp 100 mg/5 ml and 200 mg/5 ml	1. Antibiotics & Other Drugs Used for Infection	April 27, 2015
dexmethylphenidate hcl er 10 mg	Focalin® XR 10 mg	3. Pain, Nervous System, & Psych	February 9, 2015
doxycycline ir-dr	Oracea®	1. Antibiotics & Other Drugs Used for Infection	April 6, 2015
esomeprazole magnesium*	Nexium®	8. Stomach, Ulcer, & Bowel Meds	February 23, 2015
lamotrigine odt	Lamictal® ODT	3. Pain, Nervous System, & Psych	February 2, 2015
metaxalone 400 mg	N/A	9. Bone, Joint, & Muscle	April 6, 2015
methylphenidate hcl chewable tabs	Methylin® Chewable Tabs	3. Pain, Nervous System, & Psych	March 16, 2015
metoclopramide hcl	Metozolv® ODT	8. Stomach, Ulcer, & Bowel Meds	April 13, 2015
naproxen cr	Naprelan® CR	9. Bone, Joint, & Muscle	March 16, 2015
noreth-ethinyl estradiol/iron	Generess® FE	10. Female, Hormone Replacement, & Birth Control	April 6, 2015
pramipexole er 0.375 mg	Mirapex® ER 0.375 mg	3. Pain, Nervous System, & Psych	April 27, 2015
pramipexole er 0.75 mg and 1.5 mg	Mirapex® ER 0.75 mg and 1.5 mg	3. Pain, Nervous System, & Psych	February 16, 2015
trandolapril-verapamil er	Tarka®	4. Heart, Blood Pressure, & Cholesterol	March 2, 2015
triamcinolone acetonide spray	Kenalog® Spray	5. Skin Medications	April 27, 2015

*Generic requires prior authorization.

Brand deletions

Effective October 1, 2015, these brand drugs will be covered at the appropriate non-formulary level of cost-sharing:

Brand drug	Generic drug	Formulary chapter
Generess® FE	noreth-ethinyl estradiol/iron	10. Female, Hormone Replacement, & Birth Control
Mirapex® ER	pramipexole er	3. Pain, Nervous System, & Psych
Oracea®	doxycycline ir-dr	1. Antibiotics & Other Drugs Used for Infection

The generic drugs for the above brand drugs are on our formulary and available at the generic formulary level of cost-sharing.

Effective October 1, 2015, these brand drugs will be covered at the appropriate non-formulary level of cost-sharing:

Brand drug	Formulary therapeutic alternative	Formulary chapter
Alkeran®	cyclophosphamide	2. Cancer & Organ Transplant Drugs
Epivir® HBV Sol	adefovir, entecavir, lamivudine	1. Antibiotics & Other Drugs Used for Infection
Fareston®	exemestane, letrozole, tamoxifen	2. Cancer & Organ Transplant Drugs
Hexalen®	etoposide, letrozole, tamoxifen	2. Cancer & Organ Transplant Drugs
Kristalose®	lactulose solution	8. Stomach, Ulcer, & Bowel Meds
Myleran®	cyclophosphamide, Gleevec®	2. Cancer & Organ Transplant Drugs
Novoseven® RT	Advate®, Feiba® NF, Hexilate® FS, Recombinate®	4. Heart, Blood Pressure, & Cholesterol
Rixubis®	AlphaNine® SD, BeneFix®, Humate-P®	4. Heart, Blood Pressure, & Cholesterol
Viramune® XR 100 mg	Atripla®, Complera®, nevirapine 200 mg, Sustiva®	1. Antibiotics & Other Drugs Used for Infection
Wilate®	AlphaNine® SD, BeneFix®, Humate-P®	4. Heart, Blood Pressure, & Cholesterol

There are no generic equivalents for the above brand drugs; however, there are formulary therapeutic alternative drugs. These therapeutic alternative drugs are available at the appropriate formulary level of cost-sharing. We encourage you to discuss formulary alternatives with your patients.