Formulary Updates

May 2012 Formulary Updates

• P.3: Added Viread 150mg, 200mg, 250mg and Powder
• P.13: Added Inlyta with PA
• P.12: Added Erivedge 150mg
• P.17: Added Olanzapine 10mg vial with PA

April 2012 Formulary Updates

• P.72: Added cromolyn 100mg/5ml (generic Gastrocrom)
• P.37: Added clobetasol 0.05% shampoo
• P.50: Added Pegasys Proclick 135mcg/5 with PA and QLL
• P.2: Added lamivudine/zidovudine (generic Combivir)
• P.68: Added brimonidine 1.5/ml ( generic Alphagan P 1.5mg/ml)
• P.21: Added methylphenidate ER 20, 30 and 40 mg capsules (generic Ritalin LA)
• P.14: Added topotecan (generic Hycamtin)

March 2012 Formulary Updates

• P.31: Added Atorvastatin (generic Lipitor)
• P.2: Added Complera
• P.2: Added Lamivudine (generic Epivir) 150mg, 300mg
• P.18: Added Olanzapine (generic Zyprexa)
• P.2: Added Incivek with Prior Authorization
• P.3: Added Victrelis with Prior Authorization
• P.39: Added Ampyra ER 10mg with Prior Authorization
• P.26: Added Buproban 150mg (generic for Zyban)
• P.25: Added Nuedexta with Prior Authorization
• P.50: Added Sylatron
• P.13: Added Jakafi
• P.15: Added Xalkori with prior authorization
• P.15: Added Zelboraf with Prior authorization
• P.47: Added Firazyr with Prior Authorization
• P.47: Added Cinryze with Prior Authorization

July 2011

• P.7: Added Latuda with QLL=68 tabs/34 days
• P.10: Added zolpidem with QLL=30 tabs/30 days
• P.23: Added latanoprost

April 2011

• P.2: Replaced brand Maxipime with generic cefipime
• P.2: Added meropenem
• P.4: Replaced brand Arimidex with generic anastrazole
• P.5: Added gemcitabine
• P.9: Added Dilantin 30 mg extended-release
• P.9: Added phenytoin 100 mg, 200 mg, 300 mg extended-release dosage strengths
• P.11: Added losartan
• P.13: Added losartan HCT
• P.14: Replaced brand Dovonex topical scalp solution, ointment with generic calcipotriene topical scalp solution, ointment. Brand Dovonex cream still covered.
• P.17: Added Gilenya which requires PA and QLL=34 capsules/34 days
• P.21: Added enoxaparin
• P.24: Added zafirlukast