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:
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calcitriol ointment
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Vectical? ointment
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5. Skin Medications
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March 2, 2012
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clobetasol propionate shampoo,
lotion
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Clobex? shampoo, lotion
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5. Skin Medications
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January 6, 2012
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escitalopram oxalate
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Lexapro?
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3. Pain, Nervous System, &
Psych
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March 1, 2012
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fluticasone propionate lotion
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Cutivate? lotion
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5. Skin Medications
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March 30, 2012
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ibandronate
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Boniva?
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10. Bone, Joint, & Muscle
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March 22, 2012
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quetiapine fumarate
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Seroquel?
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3. Pain, Nervous System, &
Psych
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March 30, 2012
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ziprasidone
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Geodon?
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3. Pain, Nervous System, &
Psych
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March 6, 2012
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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:
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BydureonTM
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7. Diabetes, Thyroid, Steroids,
& Other Misc Hormones
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March 2, 2012
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Janumet XR?
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7. Diabetes, Thyroid,
Steroids, & Other Misc Hormones
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February 10, 2012
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Brand deletions
Effective July 1, 2012, these brand drugs will be covered at the appropriate
non-formulary level of cost-sharing:
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|
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Clobex? shampoo, lotion
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clobetasol propionate shampoo,
lotion
|
5. Skin Medications
|
Geodon?
|
ziprasidone
|
3. Pain, Nervous System, &
Psych
|
Lexapro?
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escitalopram oxalate
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3. Pain, Nervous System, &
Psych
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Seroquel?
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quetiapine fumarate
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3. Pain, Nervous System, &
Psych
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Vectical? ointment
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calcitriol ointment
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5. Skin Medications
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The generic drugs for the above brand drugs are on our formulary and available
at the generic formulary level of cost-sharing.