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
cevimeline hcl
	Evoxac
?
		16. Diagnostics & Miscellaneous Agents
			October 12, 2012
entacapone
	Comtan
?
		3. Pain, Nervous System, & Psych
			September 28, 2012
mb hydrogel
	Aurstat
TM
		5. Skin Medications
			October 12, 2012
methylphenidate hcl
	Metadate CD
?
		3. Pain, Nervous System, & Psych
			September 28, 2012
tiagabine hcl
	Gabitril
?
		3. Pain, Nervous System, & Psych
			October 26, 2012
trospium chloride
	Sanctura XR
?
		14. Urinary & Prostate Meds
			October 19, 2012
valsartan/hydrochlorothiazide
	Diovan HCT
?
		4. Heart, Blood Pressure, & Cholesterol
			September 28, 2012
			
			
			
Brand additions
These brand drugs were added 
to the formulary and are covered at the appropriate brand formulary level of 
cost-sharing:
			
Generic drug
	Formulary chapter
		Effective date
Stribild
TM
	1. Antibiotics & Other Drugs Used for Infection
		August 30, 2012
Vytorin
?
	4. Heart, Blood Pressure, & Cholesterol
		January 1, 2012
		
		
		
Brand deletions
These brand drugs will be 
covered at the appropriate non-formulary level of cost-sharing: 
 Effective 
April 1, 2013.
		
Generic drug
	Formulary chapter
		Effective date
Diovan HCT
?
	valsartan/hydrochlorothiazide
		4. Heart, Blood Pressure, & Cholesterol
Levaquin
?
	levofloxacin
		1. Antibiotics & Other Drugs Used for Infection
Nardil
?
	phenelzine sulfate
		3. Pain, Nervous System, & Psych
Neurontin Solution
?
	gabapentin solution
		3. Pain, Nervous System, & Psych
Vfend
?
	voriconazole
		1. Antibiotics & Other Drugs Used for Infection
Xalatan
?
	latanoprost
		12. Eye Medications
		
		The generic drugs for the above brand drugs are on our formulary and available 
at the generic formulary level of cost-sharing.