Select Drug Program® Formulary updates

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Select Drug Program^® Formulary updates

March 1, 2012

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The Select Drug Program Formulary 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
Amethia Lo, Camrese Lo	LoSeasonique^TM	11. Female, Hormone Replacement, Birth Control	December 12, 2011
atorvastastin/amlodipine	Caduet^®	4. Heart, Blood Pressure, & Cholesterol	November 12, 2011
eprosartan	Teveten^®	4. Heart, Blood Pressure, & Cholesterol	December 23, 2011
flucytosine	Ancobon^®	1. Antibiotics & Other Drugs Used for Infection	November 4, 2011
lamivudine	Epivir^®	1. Antibiotics & Other Drugs Used for Infection	December 12, 2011
lamivudine/zidovudine	Combivir^®	1. Antibiotics & Other Drugs Used for Infection	December 30, 2011
methylphenidate ER	Ritalin LA^®	3. Pain, Nervous System, & Psych	December 23, 2011
morphine extended-release	Kadian^®	3. Pain, Nervous System, & Psych	November 11, 2011
olanzapine	Zyprexa^®	3. Pain, Nervous System, & Psych	October 21, 2011
olanzapine ODT	Zyprexa Zydis^®	3. Pain, Nervous System, & Psych	October 21, 2011
tramadol ER	Ryzolt^®	3. Pain, Nervous System, & Psych	December 23, 2011
trimipramine	Surmontil^®	3. Pain, Nervous System, & Psych	November 18, 2011

Brand additions

These brand drugs were added to the formulary as of the date indicated below and are covered at the appropriate brand formulary level of cost-sharing:

Brand drug	Formulary chapter	Effective date
Complera^TM	1. Antibiotics & Other Drugs Used for Infection	January 1, 2012
Lotemax^® opthalmic ointment	12. Eye Medications	January 1, 2012
Tamiflu^® 6mg/ml suspension	1. Antibiotics & Other Drugs Used for Infection	January 1, 2012

Brand deletions

Effective April 1, 2012, these brand drugs will be covered at the appropriate non-formulary level of cost-sharing:

Brand drug	Generic drug	Formulary chapter
Combivir^®	lamivudine/zidovudine	1. Antibiotics & Other Drugs Used for Infection
Epivir^®	lamivudine	1. Antibiotics & Other Drugs Used for Infection
Zyprexa^®	olanzapine	3. Pain, Nervous System, & Psych
Zyprexa Zydis^®	olanzapine ODT	3. Pain, Nervous System, & Psych