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Select Drug Program® Formulary updates

May 31, 2012

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

calcitriol ointment

Vectical? ointment

5. Skin Medications

March 2, 2012

clobetasol propionate shampoo, lotion

Clobex? shampoo, lotion

5. Skin Medications

January 6, 2012

escitalopram oxalate

Lexapro?

3. Pain, Nervous System, & Psych

March 1, 2012

fluticasone propionate lotion

Cutivate? lotion

5. Skin Medications

March 30, 2012

ibandronate

Boniva?

10. Bone, Joint, & Muscle

March 22, 2012

quetiapine fumarate

Seroquel?

3. Pain, Nervous System, & Psych

March 30, 2012

ziprasidone

Geodon?

3. Pain, Nervous System, & Psych

March 6, 2012

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

BydureonTM

7. Diabetes, Thyroid, Steroids, & Other Misc Hormones

March 2, 2012

Janumet XR?

7. Diabetes, Thyroid, Steroids, & Other Misc Hormones

February 10, 2012

Brand deletions

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

Brand drug

Generic drug

Formulary chapter

Clobex? shampoo, lotion

clobetasol propionate shampoo, lotion

5. Skin Medications

Geodon?

ziprasidone

3. Pain, Nervous System, & Psych

Lexapro?

escitalopram oxalate

3. Pain, Nervous System, & Psych

Seroquel?

quetiapine fumarate

3. Pain, Nervous System, & Psych

Vectical? ointment

calcitriol ointment

5. Skin Medications

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

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