Effective 01/01/2010
The Pharmacy and Therapeutics Committee approved the following changes to the Preferred Drug List.

Recently Added Drugs
Androgel – subject to prior authorization Benzac AC gel and wash – generic Byetta – subject to prior authorization Colazal – generic Dovonex Cream and Topical Solution – generic Duetact – step therapy required Hepsera Levemir MetroGel &ndash generic MetroLotion &ndash generic Norflex Tablets – generic Prandin Precose – generic Rebif – prior authorization required Renvela – step therapy required Starlix – generic Sulfucetamide Wash – generic Symlin – prior authorization required Uloric – step therapy required Vectical Zanaflax – generic

No Longer Require Prior Authorization
Bupropion SR Fluconazole Lamotrigine Topiramate Zonisamide

Recently Removed Drugs
Androxy – current users will be grandfathered Avandamet – current users will be grandfathered Avandaryl – current users will be grandfathered Avandia – current users will be grandfathered Azelex – current users will be grandfathered Betaseron – current users will be grandfathered Estraderm – current users will be grandfathered Kineret – current users will be grandfathered Methitest – current users will be grandfathered Prefest – current users will be grandfathered Prosom – current users will be grandfathered Restoril 7.5mg and 22.5mg – current users will be grandfathered RenaGel – discontinued by manufacturer, current users auth'd for Renvela Rozerem – current users will be grandfathered Testim Vivelle Dot – current users will be grandfathered

Effective 04/01/2009
The Pharmacy and Therapeutics Committee approved the following changes to the Preferred Drug List.

Recently Added Drugs
Cymbalta – subject to prior authorization Humira – subject to prior authorization Hycamtin – subject to prior authorization Xenazine – subject to prior authorization

Recently Removed Drugs
Actonel Fosamax Plus D (the individual components are available on the formulary) Humulin products Humalog products

Novolin and Novolog products remain on the Preferred Drug List

Effective 01/15/2009
The Pharmacy and Therapeutics Committee approved the following changes to the Preferred Drug List.

Recently Added Drugs
Kuvan - subject to prior authorization Revlimid - subject to prior authorization

Now Require Prior Auth.
Terbinafine Tablet (Lamisil) - subject to a quantity limits quantity limit of 90 days of medication in 180 days.

Introduction

This Preferred Drug List (PDL) is a compilation of drugs in various therapeutic classes for use in meeting the prescription therapy needs of enrollees in Medicaid and related UnitedHealthcare and AmeriChoice government-funded health care products. These include State Child Health Insurance Programs (SCHIP) and various programs for uninsured adults administered by AmeriChoice and UnitedHealthcare. Some of the medications included in the PDL are not covered for some enrollees. The list applies to prescriptions dispensed at network pharmacies. It does not include inpatient medications or drugs obtained from or administered in a physician’s office.