Number of generics override needed B4 approval of Category and rejected Drug covered in category Grandfathering Overrides Scriptwise Message 2 Antihypertensives - brand ARBs Cozaar (Losartan) Hyzaar (Losartan Hydrochlorothiazide)
Teveten HCT (Eprosartan/Hydrochlorothiazide)
· Exforge · Valturna 3 niacin containing products- not covered AT ALL · Advicor brand Antihistamine Eye Drops brand Migraine (Triptans) Medications 〈 Relpax 6 Enlarged prostate A Step Therapy Category B (only after Category A has be
de) iled): 6B Enlarged prostate B Step Therapy Category B (only after Category A has
all brands in the category (rapaflo, uroxatral)
7 alzheimers Step Therapy Category B (only after Category A has b incontinence Step Therapy Category B (only after 2 of Category A has been tried and failed): vesicare Lantus/levemir Step Therapy Category B (only after 2 of Category A has been tried and failed): Lantus anti inflammatory/nsaid eye drops Step Therapy Category B (only after 2 of Category A has been tried and failed): Nevanac Opthalmic Prostaglandins etc… Step Therapy Category B (only after 3 of Category A has been tried and failed): Lumigan Use Xalataan PA 866-718-2375 Use Xalataan PA 866-718-2375 Use Cosopt PA 866-718-2375 Use trusopt PA 866-718-2375 Use timolol PA 866-718-2375 Use alphagan P0.15% PA 866-718-2375 sleep aids/insomnia Step Therapy Category B PA required for approvalAmbien (Zolpidem) Edluar Diabetes Step Therapy Category B (only after 2 of Category A has been tried and failed)one of which must be metformin: byetta
sulfonylureas (glyburide, tolazamide, glimepiride, Glipizide,
asthma Step Therapy Category B (only after 1of Category A has been tried and failed): Combivent
albuterol inhaler (proventil/proair/ventolin)
Step Therapy Category B (only after all of Category l en tried and failed): all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi all generic Fenofibrates under this gpi Neuropathic pain (lyrica) gabapentin Step Therapy Category B (only after all of Category A e tried and failed): Nortriptylline Desipramine Carbamazepine Osteoporosis Step Therapy Category B (only after one of Category A has been tried and failed): fosamax (Alendronate) Boniva (Ibandronate) 3. Antihistamines - Non-Sedating- UPDATE NO ANTIHISTAMINES TO BE PAID- FULL COST OF DRUG SHOULD BE MEMBERS COPAY 〈 OTC Loratadine
〈 Generic Fexofenadine - termed 5/30/11
〈 OTC Allegra (Fexofenadine) - Effective 5/31/11
〈 Brand Allegra (not a protocol for Xyzal) - termed 5/30/11
Step Therapy Category C (only after Category B has been tried and failed):
〈 Fexofenadine (effective 12/1/09) - (termed 5/30/11)
〈 OTC Allegra-D/Fexofenadine-D (effective 5/31/11)
Step Therapy Category B (only after Category A has been tried and failed):
〈 Allegra-D (effective 12/1/09) - (termed 5/30/11)
〈 Allegra-D (effective 12/1/09)- (termed 5/30/11)
〈 Allegra-D (effective 12/1/09)- (termed 5/30/11)
〈 Allegra-D (effective 12/1/09)- (termed 5/30/11)
NO PPIS TO BE PAID- FULL COST OF DRUG SHOULD BE MEMBERS COPAY 1. Proton Pump Inhibitors- COPAY= COST OF DRUG
Operators advised to ‘spice up’ their menus Santa Maria and Allegra Strategies announce new research encouraging operators to respond to consumer demand for spicier menu options At a recent event, Santa Maria has announced new research in association with Allegra Strategies that shows that consumers are looking to eat spicier foods when eating out of The research calls on operat
Rabbi Edward Levi Nydle (Levi bar Ido) B’nai Avraham In recent months there has arisen much controversy over “head-coverings” or the kippah for men in Messianic Congregations. Many from Ephraim claim it is only tradition dictated by the Talmud or Jewish tradition, while others, including this rabbi, believe that it is permitted, if not commanded by Yahweh for men to be cover