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 abacavir sulfate Ziagen^? 1. Antibiotics & Other Drugs Used for Infection June 1, 2012 carbidopa/levodopa/ entacapone Stalevo^? 3. Pain, Nervous System, & Psych April 6, 2012 clopidogrel Plavix^? 4. Heart, Blood Pressure, & Cholesterol May 18, 2012 fluvastatin sodium Lescol^? 4. Heart, Blood Pressure, & Cholesterol April 13, 2012 irbesartan Avapro^? 4. Heart, Blood Pressure, & Cholesterol April 3, 2012 irbesartan/hctz Avalide^? 4. Heart, Blood Pressure, & Cholesterol April 3, 2012 modafinil Provigil^? 3. Pain, Nervous System, & Psych April 4, 2012 nevirapine Viramune^? 1. Antibiotics & Other Drugs Used for Infection May 24, 2012 olanzapine/fluoxetine hcl Symbyax^? 3. Pain, Nervous System, & Psych June 22, 2012 ropinirole Requip XL^? 3. Pain, Nervous System, & Psych May 24, 2012 tinidazole Tindamax^? 1. Antibiotics & Other Drugs Used for Infection May 4, 2012 vancomycin Vancocin^? 1. Antibiotics & Other Drugs Used for Infection April 13, 2012

Brand additions

These brand drugs were added to the formulary and are covered at the appropriate brand formulary level of cost-sharing: Effective July 1, 2012. Brand Drug Formulary chapter Pegasys^? 9. Biotechnology Relpax^? 3. Pain, Nervous System, & Psych Vyvanse^? 3. Pain, Nervous System, & Psych

Brand deletions

These brand drugs will be covered at the appropriate non-formulary level of cost-sharing: Effective October 1, 2012. Brand Drug Generic Drug Formulary chapter Viramune^? nevirapine 1. Antibiotics & Other Drugs Used for Infection Ziagen^? abacavir sulfate 1. Antibiotics & Other Drugs Used for Infection The generic drugs for the above brand drugs are on our formulary and available at the generic formulary level of cost-sharing.

This brand drug will be covered at the appropriate non-formulary level of cost-sharing: Effective October 1, 2012. Brand Drug Formulary therauputic alternative Formulary chapter Treximet^? sumatriptan 3. Pain, Nervous System, & Psych