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Generic name (TRADE NAME): Alendronate 5mg, 10mg, 35mg, 40mg, 70mg
BRAND Generic Product: Generic
Effective Date: 2.8.08
Nature of Change: Addition
Comments:
- First generic for FOSAMAX
- Tier 1
- **QL apply
Generic name (TRADE NAME): Aliskiren, 150mg, 300mg (TEKTURNA)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
- Indication: Treatment of hypertension
- Unique mechanism of action
- Long term safety and efficacy unknown
Generic name (TRADE NAME): Amlodipine/valsartan, 5/160, 10/160, 5/320,10mg/320mg (EXFORGE)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
- Indication: Treatment of hypertension, alone or as a supplement
- NOT INDICATED for initial therapy
Generic name (TRADE NAME): Brimonidine/timolol opth sol’n 0.2%, 0.5% (COMBIGEN)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
- Indication: reduction of elevated intraocular pressure or ocular HTN who require adjunctive or replacement therapy
Generic name (TRADE NAME): Carbidopa/levodopa/entacapone 12.5/50/200, 25/100/200, 37.5/150/200 (STALEVO)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
- Indication: combination product for the treatment of Parkinson’s disease
Generic name (TRADE NAME): carvedilol tabs (3.125 mg, 6.25 mg, 12.5 mg, 25 mg)
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for COREG
- Tier 1
Generic name (TRADE NAME): Cefuroxime axetil for susp. 125mg/5ml, 250mg/5ml
BRAND Generic Product: Generic
Effective Date: 2.10.08
Nature of Change: Addition
Comments:
- First generic for CEFTIN
- Tier 1
Generic name (TRADE NAME): ciclopirox soln, 8%
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for PENLAC NAIL LACQUER
- Tier 1
Generic name (TRADE NAME): Clarithromycin for susp. 125mg/5ml, 250mg/5ml
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for BIAXIN
- Tier 1
Generic name (TRADE NAME): Collagenase, 250 units/gm (SANTYL)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
- Indication: debriding chronic dermal ulcers and severely burned areas
Generic name (TRADE NAME): estradiol gel, 0.1% (DIVIGEL)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): Flunisolide Nasal Spray, 25mcg, 29mcg
BRAND Generic Product: Generic
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): fomepizole inj, 1 g/mL
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for ANTIZOL
- Tier 4
Generic name (TRADE NAME): Hydrocodone/guaifenesin syrup (2.5-200/5ml, 5-100/5ml (HYCOTUSS)
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Removal
Comments:
- FDA will be pulling some unapproved hydrocodone cough suppressants from the market
- HYCODAN, TUSSIONEX remain
Generic name (TRADE NAME): ibandronate inj, 3 mg/3 mL (BONIVA)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): Malathion lot’n, 0.5% (OVIDE)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): Maraviroc tabs, 150mg, 300mg (SELZENTRY)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): methylergonovine tabs, 0.2 mg (METHERGINE)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): ofloxacin otic soln, 0.3%
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for FLOXIN OTIC
- Tier 1
Generic name (TRADE NAME): olopatadine ophth soln, 0.1% (PATANOL)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): oxcarbazepine tabs, 150 mg, 300 mg, 600 mg
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for TRILEPTAL
- Tier 1
Generic name (TRADE NAME): Pentazocine/APAP
BRAND Generic Product: Generic
Effective Date: When Administratively Feasible
Nature of Change: Removal
Comments:
- Pentazocine use is associated with increased confusion and hallucinations, especially in the elderly
Generic name (TRADE NAME): pramlintide inj, 1000 mcg/mL (SYMLINPEN 60, SYMLINPEN 120)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): quetiapine ER tabs (24hr), 200 mg, 300 mg, 400 mg (SEROQUEL XR)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): raltegravir tabs, 400 mg (ISENTRESS)
BRAND Generic Product: BRAND
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): ramipril caps, 2.5 mg, 5 mg, 10 mg
BRAND Generic Product: Generic
Effective Date: 1.1.08
Nature of Change: Addition
Comments:
- First generic for ALTACE
- Tier 1
Generic name (TRADE NAME): Rivastigmine Patch 4.6mg, 9.5mg/24hr(EXELON)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
Generic name (TRADE NAME): Rotigotime Patch, 2mg, 4mg, 6mg/24hr (NEUPRO)
BRAND Generic Product: BRAND
Effective Date: 3.1.08
Nature of Change: Addition
Comments:
- Indication: alternative route of administration for the treatment of Parkinson’s Disease
Generic name (TRADE NAME): oxycodone ER tabs (12hr), 15 mg, 30mg, 60 mg (OXYCONTIN)
BRAND Generic Product: BRAND
Effective Date: 1.20.08
Nature of Change: Addition
Comments:
- Additional strengths
- Tier 2
- **QL apply
*ST = Step Therapy, **QL = quantity limits, PA = Prior authorization
For a comprehensive review of all recent Medicare Part D Ideal formulary changes at Prime Therapeutics please refer to: a) https://www.myrxassistant.com, b) click on "Find Drugs" and c) follow directions to corresponding health plan.
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