Chronic Illness Benefit medicine list (formulary)

Transcription

1 Chronic Illness Benefit medicine list (formulary) Who we are Remedi Medical Aid Scheme (referred to as 'the Scheme"), registration number 1430, is a non-profit organisation, registered with the Council for Medical Schemes. Discovery Health (Pty) Ltd (referred to as "the Administrator"), is a separate company who is registered as an authorised financial services provider (registration number 1997/013480/07), administers Remedi Medical Aid Scheme. Important information you need to know We may change the information contained in this document from time to time. We will communicate any changes to the way we pay medicines when we make these changes. The Chronic Illness Benefit (CIB) is managed by the Remedi Medical Aid Scheme Rules. The use of the benefits and programmes linked with the Chronic Illness Benefit are subject to specific s and rules. Members must make sure that they know these rules and s. Any instructions or advice on medicines and the management of the member s are intended to add to, and not replace, the knowledge, expertise, skill and judgement of the member s doctor, pharmacist or other healthcare professional. Remedi Medical Aid Scheme and Discovery Health (Pty) Ltd reserve the right to change the benefit at any time. Contact us You can call us on or visit for more information.

2 Explanation of terms Benefit year A benefit year refers to the benefits a member is entitled to during a calendar year, that is to say 1 January to 31 December. This medicine list (formulary) and Chronic Drug Amounts are applicable for 2019 only. Chronic Drug Amount (CDA) The CDA is a monthly amount we pay up to for a medicine class. This applies to medicine that is not listed on the medicine list (formulary). The Chronic Drug Amount includes VAT and the dispensing fee. Prescribed s (PMB s) These are s which all medical schemes are required to cover by the Council for Medical Schemes for any setting according to clinical guidelines. Chronic Disease List (CDL) A defined list of chronic s we cover according to the Prescribed s. Medicine class This describes medicines that have similar chemical structures or similar therapeutic effects. Active ingredient This is the main substance in a medicine that is responsible for the clinical action on a human body. Page 2 of 21 01/2019

3 Chronic Illness Benefit 2019 The Prescribed s (PMB) medicine list (for all plan types) The PMB medicine list applies to all Remedi Medical Aid Scheme s for the 2019 benefit year. The CDA (Chronic Drug Amount) does not apply to the Standard. Addison s disease R200 R200 Systemic Corticosteroids: Hydrocortisone Covocort 10mg Hydrocortisone R130 R130 Systemic Corticosteroids: Fludrocortisone Florinef acetate 0.1mg Mineralocorticoids Asthma R190 R190 Adrenergics: Formoterol Foratec HFA 120 dose 12mcg/1dose Long acting - Formoterol R355 R485 Adrenergics: Salmeterol Serevent accuhaler 60 dose 50mcg Long acting - Salmeterol Serevent CFC free 120 dose 25mcg R40 R40 Adrenergics: Salbutamol Asthavent ecohaler 200 dose 100mcg Short acting - Salbutamol Venteze CFC free 200 dose 100mcg R250 R275 Anti-asthmatics: Montelukast Lumont 4mg; Leukotriene receptor antagonists Monteflo 4mg; Montelukast Biotech 10mg Montelukast chew Biotech 4mg; Sintair 4mg; Topraz 4mg; R100 R155 Anti-asthmatics: Systemic xanthines Theophylline Sandoz Theophylline anhydrous 200mg; 300mg R320 R320 Formoterol and Formoterol and Symbicord turbohaler 160/4.5mcg; 320/9mcg Budesonide Budesonide 60 dose Vannair 120 dose 80/4.5mcg; 160/4.5mcg R355 R355 Formoterol and Formoterol and Dulera 120 dose 100/5mcg; 200/5mcg Mometasone Mometasone R250 R250 Inhaled anticholinergics: Ipratropium bromide Atrovent HFA 200 dose 20mcg Ipratropium bromide Ipvent HFA 200 dose 40mcg/1dose R245 R305 Inhaled Glucocorticoids Beclomethasone Beceze CFC free 200 dose 100mcg Beclate 200 dose 100mcg; 200mcg Budesonide Budeflam HFA 300 dose 100mcg; 200mcg Pulmicort turbuhaler 200 dose 100mcg; 200mcg Ciclesonide Ciclovent 60 dose 80mcg; 160mcg Fluticasone Flixotide CFC free 50mcg; 125mcg; 250mcg 120 dose Mometasone Asmanex twisthaler 30 dose 200mcg/1dose; 400mcg/1dose Asmanex twisthaler 60 dose 200mcg/1dose; 400mcg/1dose R100 R100 Nasal Corticosteroids Beclomethasone Beclate aquanase 150 dose 50mcg Clenil aqueous 200 dose 50mcg Fluticasone Flomist 120 dose 50mcg Flonase 120 dose 50mcg Page 3 of 21 01/2019

4 Asthma R355 R355 Salmeterol and Fluticasone Bipolar mood disorder Salmeterol and Fluticasone Foxair accuhaler 60 dose 50/100; 50/250 Foxair accuhaler 60 dose 50/500 Sereflo HFA 120 dose 25/50; 25/125; 25/250 Sereflo HFA synchrobreathe 120 dose 25/50; 25/125; 25/250 R350 R350 Surgical item Inhaler device Dp haler device Spacer Glaxohaler R15 R15 Systemic Corticosteroids: Prednisone Be-Tabs Prednisone Prednisone Panafcort Trolic R120 R160 Anti-depressants: Citalopram Adco-Talomil SSRI s Arrow Citalopram Cilate Escitalopram Accord Escitalopram 10mg; Marprem Zitolex 10mg; Fluoxetine Deprozan Fluoxetine Actor Prolax Ranflocs Zydus-Fluoxetine Sertraline Dyna Sertraline 50mg; 100mg Serdep 50mg; 100mg Serlife 50mg; 100mg R290 R385 Anti-epileptics: Carbamazepine Degranol 200mg Carboxamide derivatives Tegretol CR 200mg; 400mg Zeptol 200mg R490 R490 Anti-epileptics: Valproic acid Convulex 150mg Fatty acid derivatives Convulex syrup 250mg/5ml Epilim crushable 100mg Epilim sugar-free syrup 200mg/5ml Epilizine CR 200mg; 300mg; 500mg Eprolep CR 200mg; 300mg; 500mg Navalpro CR 200mg; 300mg; 500mg Valeptic CR 300mg; 500mg R325 R415 Anti-epileptics: Lamotrigine Dyna-Lamotrigine 2; 50mg; 100mg; 200mg Other agents Epitec 2; 50mg; 100mg; 200mg Girotec 50mg; 100mg; 200mg Lamidus 50mg Lamitor 2; 50mg; 100mg; 200mg R615 R945 Anti-psychotics: Clozapine Aspen Clozapine 2; 100mg Clozapine Cloment 2; 100mg R345 R345 Anti-psychotics: Lithium Camcolit 250mg; 400mg Lithium R600 R600 Anti-psychotics: Olanzapine Olawin Olanzapine Olawin oradispersible Olexar Prexolan Prexolan ODT Redilanz Zylena R400 R400 Anti-psychotics: Chlorpromazine Largactil 2; 100mg Phenothiazines with aliphatic side-chain R295 R295 Anti-psychotics: Quetiapine Dopaquel 2; 100mg; 200mg; 300mg Quetiapine Mylan Quetiapine 2; 100mg; 200mg; 300mg Page 4 of 21 01/2019

5 Bipolar mood disorder Bronchiectasis R40 R40 Adrenergics: Short acting - Salbutamol Cardiac failure R100 R115 ACE inhibitors and diuretics R295 R295 Anti-psychotics: Quetiapine Psyquet 2; 100mg; 200mg; 300mg Quetiapine Quetiapine Biotech 300mg Serez 2; 100mg; 200mg; 300mg Spec Quetiapine 2; 300mg R515 R650 Anti-psychotics: Flupenthixol Fluanxol 0.; 1mg Thioxanthene derivatives Fluanxol depot 1ml Zuclopenthixol Clopixol 2mg; 10mg Clopixol depot 200mg R350 R505 Other anti-psychotics Aripiprazole Arizofy ; 1 Risperidone Risnia 0.; 1mg; 2mg; 3mg Rispevon 1mg; 2mg; 3mg; 4mg Rispide 0.; 1mg; 2mg Zoxadon 0.; 1mg; 2mg; 3mg; 4mg Salbutamol Asthavent ecohaler 200 dose 100mcg Venteze CFC free 200 dose 100mcg R250 R250 Inhaled anticholinergics: Ipratropium bromide Atrovent HFA 200 dose 20mcg Ipratropium bromide Ipvent HFA 200 dose 40mcg/1dose R15 R15 Systemic Corticosteroids: Prednisone Be-Tabs Prednisone Prednisone Panafcort Trolic Enalapril and diuretics Enap co 20/12. Pharmapress co 20/12. Lisinopril and diuretics Adco-Zetomax co 10/12.; 20/12. Lisoretic 10/12.; 20/12. Lisozide 10/12.; 20/12. Zestoretic 10/12.; 20/12. Perindopril and Bioprexum Plus 10/2. diuretics Ciplasyl Plus 4/1.2 Pearinda Plus 4/1.2 Perindopril co Unicorn 4/1.2 Prexum Plus 5/1.2 Vectoryl Plus 4/1.2 R85 R100 ACE inhibitors: Captopril Adco-Captomax 2; 50mg Plain Bio-Captopril 2 Mylan Captopril 2; 50mg Enalapril Alapren ; Enalapril Biotech ; Enalapril Unicorn 10mg; Hypace Lisinopril Austell-Lisinopril 10mg; Sinopren ; Perindopril Ciplasyl 4mg Pearinda Perindopril Unicorn Prexum Ran-Perindopril 4mg Spec-Perindopril Vectoryl 8mg Quinapril Accumax 10mg; Page 5 of 21 01/2019

6 Cardiac failure R230 R260 Alpha and Beta blocking agents R120 R120 Angiotensin II antagonists: Combinations R85 R120 Angiotensin II antagonists: Plain R100 R100 Arteriolar smooth muscle Hydrazinophthalazine derivatives R75 R85 Beta blocking Selective Carvedilol Aspen Carvedilol 6.2; 12.; 2 Carloc 6.2; 12.; 2 Carvetrend 6.2; 12.; 2 Vediblok 6.2; 12.; 2 Losartan and diuretics Losaar Plus 50/12.; 100/2 Losartan co Unicorn 50/12.; 100/2 Netrasol co 50/12.; 100/2 Zartan co 100/2 Valsartan and diuretics Dynaval co 80/12.; 160/12.; 160/2 Irbesartan Jubitan 150mg; 300mg Losartan Ciplazar 100mg Zartan 100mg Hydralazine Hyperphen 10mg; 50mg Sandoz Hydralazine Bisoprolol Adco-Bisocor Betacor Bilocor Bislo Bisoprolol Unichem Bisoprolol Unicorn Bisozyd Mylan Bisoprolol R25 R25 Cardiac glycosides: Digoxin Lanoxin 0.062; 0.2 Digoxin Lanoxin paediatric/geriatric syrup 0.0/1ml R20 R40 High-ceiling diuretics Furosemide Dino-Retic Furobe Mylan Furosemide R15 R15 Low-ceiling diuretics: Hydrochlorothiazide Hexazide 2 Thiazides, plain Ridaq 12. R25 R25 Low-ceiling diuretics: Indapamide Cipla-Indapamide 2. excluding Thiazides Daptril 2. Mylan Indapamide 2. R120 R120 Potassium sparing agents Spironolactone Aldactone 2 Sandoz Spironolactone 2 Spiractin 2 R105 R105 Potassium supplements Potassium chloride Plenish K 600mg Slow-K 600mg Ultipot 600mg R195 R195 Vasodilators in cardiac Isosorbide dinitrate Isordil 30mg disease: Sandoz Isosorbide dinitrate Organic nitrates Isosorbide mononitrate Elantan LA 50mg Ismo Monicor SR 60mg R100 R100 Influenza vaccines Influenza, purified antigen Influvac 0.5ml Vaxigrip single dose 0.5ml pre-filled R175 R175 Pneumococcus vaccines Pneumococcus, purified polysaccharides antigen Pneumovax vaccine Enalapril and diuretics Enap co 20/12. Pharmapress co 20/12. Lisinopril and diuretics Adco-Zetomax co 10/12.; 20/12. Lisoretic 10/12.; 20/12. Lisozide 10/12.; 20/12. Zestoretic 10/12.; 20/12. Perindopril and Bioprexum Plus 10/2. diuretics Cardiomyopathy R100 R115 ACE inhibitors and diuretics 2 Page 6 of 21 01/2019

7 Cardiomyopathy R100 R115 ACE inhibitors and Perindopril and Ciplasyl Plus 4/1.2 diuretics diuretics Pearinda Plus 4/1.2 Perindopril co Unicorn 4/1.2 Prexum Plus 5/1.2 Vectoryl Plus 4/1.2 R85 R100 ACE inhibitors: Captopril Adco-Captomax 2; 50mg Plain Bio-Captopril 2 Mylan Captopril 2; 50mg Enalapril Alapren ; Enalapril Biotech ; Enalapril Unicorn 10mg; Hypace Lisinopril Austell-Lisinopril 10mg; Sinopren ; Perindopril Ciplasyl 4mg Pearinda Perindopril Unicorn Prexum Ran-Perindopril 4mg Spec-Perindopril Vectoryl 8mg Quinapril Accumax 10mg; R230 R260 Alpha and Beta blocking Carvedilol Aspen Carvedilol 6.2; 12.; 2 agents Carloc 6.2; 12.; 2 Carvetrend 6.2; 12.; 2 Vediblok 6.2; 12.; 2 R120 R120 Angiotensin II antagonists: Losartan and diuretics Losaar Plus 50/12.; 100/2 Combinations Losartan co Unicorn 50/12.; 100/2 Netrasol co 50/12.; 100/2 Zartan co 100/2 Valsartan and diuretics Dynaval co 80/12.; 160/12.; 160/2 R85 R120 Angiotensin II antagonists: Irbesartan Jubitan 150mg; 300mg Plain Losartan Ciplazar 100mg Zartan 100mg R85 R85 Anti-thrombotic Warfarin Cipla-Warfarin Vitamin K antagonists R100 R100 Arteriolar smooth muscle Hydralazine Hyperphen 10mg; 50mg Sandoz Hydralazine 2 Hydrazinophthalazine derivatives R30 R35 Aspirin Acetylsalicylic acid Myoprin 100mg R75 R85 Beta blocking Bisoprolol Adco-Bisocor Selective Betacor Bilocor Bislo Bisoprolol Unichem Bisoprolol Unicorn Page 7 of 21 01/2019

8 Cardiomyopathy R75 R85 Beta blocking Bisoprolol Bisozyd Selective Mylan Bisoprolol R25 R25 Cardiac glycosides: Digoxin Lanoxin 0.062; 0.2 Digoxin Lanoxin paediatric/geriatric syrup 0.0/1ml R20 R40 High-ceiling diuretics Furosemide Dino-Retic Furobe Mylan Furosemide R15 R15 Low-ceiling diuretics: Hydrochlorothiazide Hexazide 2 Thiazides, plain Ridaq 12. R25 R25 Low-ceiling diuretics: Indapamide Cipla-Indapamide 2. excluding Thiazides Daptril 2. Mylan Indapamide 2. R120 R120 Potassium sparing agents Spironolactone Aldactone 2 Sandoz Spironolactone 2 Spiractin 2 R105 R105 Potassium supplements Potassium chloride Plenish K 600mg Slow-K 600mg Ultipot 600mg R195 R195 Vasodilators in cardiac Isosorbide dinitrate Isordil 30mg disease: Sandoz Isosorbide dinitrate Organic nitrates Isosorbide mononitrate Elantan LA 50mg Ismo Monicor SR 60mg R100 R100 Influenza vaccines Influenza, purified antigen Influvac 0.5ml Vaxigrip single dose 0.5ml pre-filled R175 R175 Pneumococcus vaccines Pneumococcus, purified Pneumovax vaccine polysaccharides antigen Chronic obstructive R190 R190 Adrenergics: Formoterol Foratec HFA 120 dose 12mcg/1dose pulmonary disease (COPD) R40 R40 Long acting - Formoterol Adrenergics: Salbutamol Asthavent ecohaler 200 dose 100mcg Short acting - Salbutamol Venteze CFC free 200 dose 100mcg R410 R410 Adrenergics: Indacaterol Onbrez breezhaler 150mcg Ultra long acting - Indacaterol R100 R155 Anti-asthmatics: Systemic xanthines Theophylline Sandoz Theophylline anhydrous 200mg; 300mg R320 R320 Formoterol and Budesonide R355 R355 Formoterol and Mometasone R545 R545 Glycopyrronium bromide and Indacaterol R430 R430 Inhaled anticholinergics: Glycopyrronium bromide R250 R250 Inhaled anticholinergics: Ipratropium bromide R525 R525 Inhaled anticholinergics: Tiotropium bromide R205 R205 Salbutamol and Ipratropium bromide R355 R355 Salmeterol and Fluticasone R793 R793 Surgical item: Oxygen concentrator Formoterol and Symbicord turbohaler 160/4.5mcg; 320/9mcg Budesonide 60 dose Vannair 120 dose 80/4.5mcg; 160/4.5mcg Formoterol and Dulera 120 dose 100/5mcg; 200/5mcg Mometasone Glycopyrronium Ultibro breezhaler (30 caps & inhaler) bromide and Indacaterol Glycopyrronium Seebri breezhaler (30 caps & inhaler) bromide Ipratropium bromide Atrovent HFA 200 dose 20mcg Ipvent HFA 200 dose 40mcg/1dose Tiotropium bromide Forvent (refill) 18mcg Salbutamol and Ipratropium bromide Salmeterol and Fluticasone Oxygen Duolin HFA 200 dose Foxair accuhaler 60 dose 50/100; 50/250 Foxair accuhaler 60 dose 50/500 Sereflo HFA 120 dose 25/50; 25/125; 25/250 Sereflo HFA synchrobreathe 120 dose 25/50; 25/125; 25/250 Oxygen concentrator rental Page 8 of 21 01/2019

9 Chronic obstructive pulmonary disease (COPD) Chronic renal disease R15 R15 Systemic Corticosteroids: Prednisone Be-Tabs Prednisone Prednisone Panafcort Trolic R100 R100 Influenza vaccines Influenza, purified antigen Influvac 0.5ml Vaxigrip single dose 0.5ml pre-filled R100 R115 ACE inhibitors and Enalapril and diuretics Enap co 20/12. diuretics Pharmapress co 20/12. Lisinopril and diuretics Adco-Zetomax co 10/12.; 20/12. Lisoretic 10/12.; 20/12. Lisozide 10/12.; 20/12. Zestoretic 10/12.; 20/12. Perindopril and Bioprexum Plus 10/2. diuretics Ciplasyl Plus 4/1.2 Pearinda Plus 4/1.2 Perindopril co Unicorn 4/1.2 Prexum Plus 5/1.2 Vectoryl Plus 4/1.2 R85 R100 ACE inhibitors: Captopril Adco-Captomax 2; 50mg Plain Bio-Captopril 2 Mylan Captopril 2; 50mg Enalapril Alapren ; Enalapril Biotech ; Enalapril Unicorn 10mg; Hypace Lisinopril Austell-Lisinopril 10mg; Sinopren ; Perindopril Ciplasyl 4mg Pearinda Perindopril Unicorn Prexum Ran-Perindopril 4mg Spec-Perindopril Vectoryl 8mg Quinapril Accumax 10mg; R120 R120 Angiotensin II antagonists: Losartan and diuretics Losaar Plus 50/12.; 100/2 Combinations Losartan co Unicorn 50/12.; 100/2 Netrasol co 50/12.; 100/2 Zartan co 100/2 Valsartan and diuretics Dynaval co 80/12.; 160/12.; 160/2 R85 R120 Angiotensin II antagonists: Irbesartan Jubitan 150mg; 300mg Plain Losartan Ciplazar 100mg Zartan 100mg R300 R300 Calcium supplements Calcium carbonate B-cal R5 R5 Folic acid and derivatives Folic acid Be-Tabs Folic acid Folic acid 0.; Gulf Folic acid Page 9 of 21 01/2019

10 Chronic renal disease Coronary artery disease R250 R250 Hepatitis B vaccine Hepatitis B, purified antigen R45 R45 Iron in combination with Ferrous fumarate folic acid R535 R535 Iron, parenteral Iron, parenteral preparations preparations Euvax b vial 1ml Heberbio hbv sgl dose 1ml adult Pregamal 20mcg/1ml 20mcg/1ml Cosmofer ampoule 2ml 50mg/1ml Equifer ampoule 5ml 100mg/5ml Rautevene ampoule 5ml 100mg/5ml Sucrofer 5ml /1ml R3 340 R3 340 Other anti-anaemic Darbepoetin Alfa Aranesp pre-filled syringe 0.4ml 10mcg/0.4ml preparations Aranesp pre-filled syringe 0.5ml 20mcg/0.5ml Aranesp pre-filled syringe 0.3ml 30mcg/0.3ml Aranesp pre-filled syringe 0.4ml 40mcg/0.4ml Aranesp pre-filled syringe 0.5ml 50mcg/0.5ml Aranesp pre-filled syringe 0.3ml 60mcg/0.3ml Erythropoietin Eprex pre-fill 2000U/0.5ml Eprex pre-fill 4000U/0.4ml Recormon pre-filled syringe 500U/0.3ml Recormon pre-filled syringe 2000U/0.3ml Recormon pre-filled syringe 4000U/0.3ml Repotin ampoule 1ml 2000U Repotin ampoule 1ml 4000U Methoxy polyethylene Mircera pre-filled syringe 0.3ml 30mcg/0.3ml glycol-epoetin beta Mircera pre-filled syringe 0.3ml 50mcg/0.3ml Mircera pre-filled syringe 0.3ml 75mcg/0.3ml Mircera pre-filled syringe 0.3ml 100mcg/0.3ml Mircera pre-filled syringe 0.3ml 120mcg/0.3ml Mircera pre-filled syringe 0.3ml 150mcg/0.3ml Mircera pre-filled syringe 0.3ml 200mcg/0.3ml Mircera pre-filled syringe 0.3ml 250mcg/0.3ml R400 R400 Vitamin D and analogues Alfacalcidol One alpha 0.25mcg; 1mcg R230 R230 Anti-thrombotic Clopidogrel Clopidogrel 75 Biotech 7 Clopidogrel Closolve 7 Pharma Dynamics Clopidogrel 7 Plagrol 7 R30 R35 Aspirin Acetylsalicylic acid Myoprin 100mg R85 R200 Beta blocking Propranolol Inderal 10mg Non-selective Indoblok 10mg; Purbloka R75 R85 Beta blocking Atenolol B-Block 100mg Selective Tenopress 50mg; 100mg Zetenol 50mg; 100mg R230 R320 Selective calcium channel Diltiazem Adco-Zildem 60mg blockers with direct Adco-Zildem SR 180mg; 2 cardiac effects Verapamil Vasomil ; 80mg Verahexal SR 2 R100 R130 Selective calcium channel Amlodipine Amlodipine Unicorn blockers with mainly Amtas vascular effects Austell-Amlodipine Ciplavasc Gulf Amlodipine Lomanor Pendine Pharma Dynamics Amlodipine besylate Felodipine Felodipine-Hexal R195 R195 Vasodilators in cardiac disease: Organic nitrates Plendil 2.; Nifedipine Cipalat Retard Isosorbide dinitrate Isordil 30mg Sandoz Isosorbide dinitrate Isosorbide mononitrate Elantan LA 50mg Page 10 of 21 01/2019

11 Coronary artery disease R195 R195 Vasodilators in cardiac disease: Organic nitrates Isosorbide mononitrate Ismo Monicor SR Crohn s disease R5 R5 Folic acid and derivatives Folic acid Be-Tabs Folic acid Folic acid 0.; Gulf Folic acid R810 R810 Intestinal antiinflammatories: Mesalazine Asacol 400mg; 800mg Mezavant 1200mg Aminosalicylic acid and Pentasa 500mg; 1000mg similar agents Salofalk 1000mg Olsalazine Dipentum 250mg Sulfasalazine Salazopyrin 500mg Salazopyrin EN 500mg R1 940 R1 940 Intestinal antiinflammatories: Budesonide Entocord enema Corticosteroids R775 R775 Other immunosuppressive Azathioprine Azamun 50mg Azathioprine Azathioprine PCH 50mg R110 R110 Other immunosuppressive Methotrexate R15 R15 Systemic Corticosteroids: Prednisone Diabetes insipidus R1 450 R1 700 Posterior pituitary hormones: Vasopressin and analogues Diabetes mellitus Type 1 60mg Methotrexate Abitrexate 2. Methotrexate 2. Prednisone Be-Tabs Prednisone Panafcort Trolic Desmopressin Ddavp 0.1mg; 0.2mg Ddavp nasal spray 5ml 0.1mg/1ml ***Please note an overall monthly limit applies to Insulins across the different Insulin classes*** The overall monthly limit for the is R700. The overall monthly limit for the is R720. R460 R530 Anti-diabetic Insulin Glulisine Apidra - cartridge 3ml Fast-acting Insulins Insulin Human Biosulin r - cartridge 3ml Humulin r - cartridge 3ml; vial 10ml Insulin Lispro Humalog - cartridge 3ml; kwikpen 3ml; vial 10ml R700 R720 Anti-diabetic Intermediate-acting or Insulin Aspart Novomix 30 - flexpen 3ml long-acting combined with fast-acting Insulins (Biphasic) Insulin Human Actraphane hm(ge) - vial 10ml Biosulin cartridge 3ml Humulin 30/70 - cartridge 3ml; kwikpen 3ml; vial 10ml Insulin Lispro Humalog mix 25 - cartridge 3ml; vial 10ml Humalog mix 25 - kwikpen 3ml Humalog mix 50 - cartridge 3ml Humalog mix 50 - kwikpen 3ml R435 R465 Anti-diabetic Intermediate-acting Insulins Insulin Human Biosulin l - cartridge 3ml Biosulin n - cartridge 3ml Humulin n - cartridge 3ml; kwikpen 3ml; vial 10ml R460 R555 Anti-diabetic Long-acting Insulins Insulin Detemir Levemir - prefilled cartridge 3ml Insulin Glargine Basaglar - cartridge 3ml Basaglar - pre-filled pen 3ml Optisulin - cartridge 3ml Optisulin - pen 3ml Toujeo pen 1.5ml R30 R35 Aspirin Acetylsalicylic acid Myoprin 100mg Page 11 of 21 01/2019

12 Diabetes mellitus Type 1 Diabetes mellitus Type 2 R200 R280 Blood glucose monitoring agents Glucose strips Accu chek instant strips Caresens n glucose test strips 29g Freestyle strip optium glucose test Strips accu check glucose active Test fora diamond blood glucose strip Test glucocheck Test strip blood glucose clicks bionime gs550 Test strip glucose easymax Test strip glucose on call plus ez Test strip onetouch select Test strip onetouch select plus R350 R350 Surgical item Lancets Lancet 50s Lancet blood collection needle loris Lancet fora collection needle sterile 30g Lancets fora tender needle sterile 33g Lancet oncall glucose Lancet solus v2 Lancet unilet sterile 4cm x 6cm x 7.5cm 28g Lancet unilet sterile 28g Needles Droplet pen needle 10mm 29g Droplet pen needle 12mm 29g Droplet pen needle 6mm 31g Droplet pen needle 8mm 31g Droplet pen needle 6mm 32g Needle insulin pen bd microfine 30g 8mm Needle insulin pen bd microfine 31g 5mm Needle insulin pen bd microfine tw 32g 4mm Needle novofine Syringes Needle accufine insulin pen 8mm 30g Syringe insulin 1.0ml with 27g needle Syringe insulin bd microfine 0.3ml 30g 8mm demi Syringe insulin bd microfine 1ml 30g 8mm Syringe insulin bd microfine 1ml 9g 12.7mm R65 R65 Anti-diabetic Metformin Accord Metformin 500mg; 850mg Biguanides Apex-Metformin 500mg Austell-Metformin 500mg; 850mg Bigsens 500mg; 850mg; 1000mg Diaphage 500mg; 850mg; 1000mg Gluconorm 500mg; 850mg Metchek 500mg; 850mg Metformin Alkem 500mg Mylan Metformin 500mg; 850mg; 1000mg Romidab 500mg; 850mg; 1000mg Sandoz Metformin 500mg ***Please note an overall monthly limit applies to Insulins across the different Insulin classes*** The overall monthly limit for the is R700. The overall monthly limit for the is R720. R460 R530 Anti-diabetic Insulin Glulisine Apidra - cartridge 3ml Fast-acting Insulins Insulin Human Biosulin r - cartridge 3ml Humulin r - cartridge 3ml; vial 10ml Insulin Lispro Humalog - cartridge 3ml; kwikpen 3ml; vial 10ml Page 12 of 21 01/2019

13 Diabetes mellitus Type 2 R700 R720 Anti-diabetic Intermediate-acting or Insulin Aspart Novomix 30 - flexpen 3ml long-acting combined with fast-acting Insulins (Biphasic) Insulin Human Actraphane hm(ge) - vial 10ml Biosulin cartridge 3ml Humulin 30/70 - cartridge 3ml; kwikpen 3ml; vial 10ml Insulin Lispro Humalog mix 25 - cartridge 3ml; vial 10ml Humalog mix 25 - kwikpen 3ml Humalog mix 50 - cartridge 3ml Humalog mix 50 - kwikpen 3ml R435 R465 Anti-diabetic Intermediate-acting Insulins Insulin Human Biosulin l - cartridge 3ml Biosulin n - cartridge 3ml Humulin n - cartridge 3ml; kwikpen 3ml; vial 10ml R460 R555 Anti-diabetic Long-acting Insulins Insulin Detemir Levemir - prefilled cartridge 3ml Insulin Glargine Basaglar - cartridge 3ml Basaglar - pre-filled pen 3ml Optisulin - cartridge 3ml Optisulin - pen 3ml Toujeo pen 1.5ml R685 R685 Anti-diabetic Exenatide Byetta disposable pen 1.2ml 5mcg/1dose Other, excluding Insulins: Exenatide 60 dose Byetta disposable pen 2.4ml 10mcg/1dose 60 dose R150 R150 Anti-diabetic Gliclazide Adco-Glucomed 80mg Sulfonamides, urea Austell-Gliclazide 80mg derivatives Diaglucide 80mg Diaglucide MR 60mg Diaglumed 80mg Dyna Gliclazide SR 30mg Gliclazide Unicorn MR 30mg Glygard 80mg Mylan Gliclazide 80mg Sandoz Gliclazide 80mg R200 R215 Anti-diabetic Pioglitazone Accord Pioglitazone 1; 30mg; 4 Thiazolidinediones Cipla-Pioglitazone 1; 30mg R30 R35 Aspirin Acetylsalicylic acid Myoprin 100mg R200 R280 Blood glucose monitoring Glucose strips Accu chek instant strips agents Caresens n glucose test strips 29g Freestyle strip optium glucose test Strips accu check glucose active Test fora diamond blood glucose strip Test glucocheck Test strip blood glucose clicks bionime gs550 Test strip glucose easymax Test strip glucose on call plus ez Test strip onetouch select Test strip onetouch select plus Page 13 of 21 01/2019

14 Diabetes mellitus Type 2 R150 R215 Dipeptidyl peptidase inhibitors: Saxagliptin Saxagliptin Onglyza 2.; R350 R350 Surgical item Lancets Lancet 50s Lancet blood collection needle loris Lancet fora collection needle sterile 30g Lancets fora tender needle sterile 33g Lancet oncall glucose Lancet solus v2 Lancet unilet sterile 4cm x 6cm x 7.5cm 28g Lancet unilet sterile 28g Needles Droplet pen needle 10mm 29g Droplet pen needle 12mm 29g Droplet pen needle 6mm 31g Droplet pen needle 8mm 31g Droplet pen needle 6mm 32g Needle insulin pen bd microfine 30g 8mm Needle insulin pen bd microfine 31g 5mm Needle insulin pen bd microfine tw 32g 4mm Needle novofine Syringes Needle accufine insulin pen 8mm 30g Syringe insulin 1.0ml with 27g needle Syringe insulin bd microfine 0.3ml 30g 8mm demi Syringe insulin bd microfine 1ml 30g 8mm Syringe insulin bd microfine 1ml 9g 12.7mm Dysrhythmia R620 R680 Anti-arrhythmics: Flecainide Tambocor 100mg class Ic Tambocor CR 100mg; 200mg Propafenone Rythmol 150mg; 300mg R475 R475 Anti-arrhythmics: Amiodarone Arycor 100mg; 200mg class III - Amiodarone Bio-Amiodarone 200mg Hexarone 100mg; 200mg R85 R85 Anti-thrombotic Warfarin Cipla-Warfarin Vitamin K antagonists R30 R35 Aspirin Acetylsalicylic acid Myoprin 100mg R85 R200 Beta blocking Propranolol Inderal 10mg Non-selective Indoblok 10mg; Purbloka Sotalol Sotahexal 80mg; 160mg R75 R85 Beta blocking Atenolol B-Block 100mg Selective Tenopress 50mg; 100mg Zetenol 50mg; 100mg R25 R25 Cardiac glycosides: Digoxin Lanoxin 0.062; 0.2 Digoxin Lanoxin paediatric/geriatric syrup 0.0/1ml R230 R320 Selective calcium channel blockers with direct cardiac effects Epilepsy R185 R285 Anti-epileptics: Benzodiazepine derivatives R290 R385 Anti-epileptics: Carboxamide derivatives R490 R490 Anti-epileptics: Fatty acid derivatives Verapamil Vasomil ; 80mg Verahexal SR 2 Clonazepam Clonam 0.; 2mg Rivotril 0.; 2mg Carbamazepine Degranol 200mg Tegretol CR 200mg; 400mg Zeptol 200mg Valproic acid Convulex 150mg Convulex syrup 250mg/5ml Epilim crushable 100mg Epilim sugar-free syrup 200mg/5ml Epilizine CR 200mg; 300mg; 500mg Eprolep CR 200mg; 300mg; 500mg Navalpro CR 200mg; 300mg; 500mg Valeptic CR 300mg; 500mg Page 14 of 21 01/2019

15 Epilepsy R85 R85 Anti-epileptics: Hydantoin derivatives R325 R415 Anti-epileptics: Other agents R30 R30 Anti-epileptics: Barbiturates and derivatives Phenytoin Phenytoin sod 100mg Lamotrigine Dyna-Lamotrigine 2; 50mg; 100mg; 200mg Epitec 2; 50mg; 100mg; 200mg Girotec 50mg; 100mg; 200mg Lamidus 50mg Lamitor 2; 50mg; 100mg; 200mg Topiramate Epitoz 2; 50mg; 100mg Phenobarbital Lethyl 30mg Sedabarb 30mg R5 R5 Folic acid and derivatives Folic acid Be-Tabs Folic acid Folic acid 0.; Gulf Folic acid Glaucoma R230 R230 Anti-glaucoma Dorzolamide Glaucopress 5ml 2% Carbonic anhydrase Trusopt 5ml owi 2% inhibitors R235 R235 Anti-glaucoma Bimatoprost Lumigan 0.01% Prostaglandin analogues Latanoprost Atana 2.5ml 50mcg/1ml Spersatan 2.5ml 50mcg/1ml Xalatan 2.5ml 50mcg/1ml Travoprost Travatan 2.5ml 0.004% R240 R240 Anti-glaucoma Brimonidine Alphagan purite 5ml 1./1ml Sympathomimetics Brimoct 5ml 2mg/1ml R100 R100 Anti-glaucoma Beta blocking Timolol R275 R275 Anti-glaucoma Beta blocking Timolol, combinations Haemophilia R5 R5 Analgesics: Paracetamol Timolol Glaucosan 5ml 0.5% Occumol 5ml 0.5% Timolol, combinations Azarga 5ml Co-Atana 2.5ml Combigan 5ml 2mg/ Cosopt 5ml 0.5% Duotrav 2.5ml Ganfort 3ml Glaumide-co 5ml Glauopt co 5ml Xalacom 2.5ml Paracetamol Adco-Napamol 500mg Adco-Prolief 500mg Cetapon 500mg Painogesic 500mg Tranexamic acid Tranexamic Acid Medwich 500mg R220 R220 Anti-fibrinolytics: Amino acids R R Blood coagulation factors Coagulation factor IX Haemosolvex IX 500U Octanine F vial 30ml 250U; 500U; 1000U Coagulation factor VIII Haemosolvate VIII 300U; 500U; 1000U Octanate vial 5ml 250U Octanate vial 10ml 500U; 1000U R1 450 R1 700 Posterior pituitary Desmopressin Ddavp 0.1mg; 0.2mg hormones: Ddavp nasal spray 5ml 0.1mg/1ml Vasopressin and analogues Hyperlipidaemia R290 R290 Lipid modifying Fibrates R50 R55 Lipid modifying Statins Bezafibrate Bezalip Retard 400mg Dyna-Bezafibrate SR 400mg Sandoz Bezafibrate 400mg Atorvastatin Adco Atorvastatin 10mg; ; Aspavor 10mg; ; ; 80mg Astor 10mg; ; ; 80mg Atolip 10mg; ; ; 80mg Atorvastatin Unicorn 10mg; ; Lestavor 10mg; ; 80mg Lipogen 10mg; ; 80mg Vastor 10mg; ; Simvastatin Adco-Simvastatin 10mg; ; Aspen Simvastatin 10mg; ; Page 15 of 21 01/2019

16 Hyperlipidaemia R50 R55 Lipid modifying Statins Hypertension R200 R200 ACE inhibitors and calcium channel blockers R100 R115 ACE inhibitors and diuretics R85 R100 ACE inhibitors: Plain R230 R260 Alpha and Beta blocking agents R120 R120 Angiotensin II antagonists: Combinations R85 R120 Angiotensin II antagonists: Plain Simvastatin Austell-Simvastatin 10mg; ; Choleste ; Cipla-Simvastatin 10mg; ; Zysim 10mg; Perindopril and Coveram 5/; 10/; 5/10mg; 10/10mg Amlodipine Enalapril and diuretics Enap co 20/12. Pharmapress co 20/12. Lisinopril and diuretics Adco-Zetomax co 10/12.; 20/12. Lisoretic 10/12.; 20/12. Lisozide 10/12.; 20/12. Zestoretic 10/12.; 20/12. Perindopril and Bioprexum Plus 10/2. diuretics Ciplasyl Plus 4/1.2 Pearinda Plus 4/1.2 Perindopril co Unicorn 4/1.2 Prexum Plus 5/1.2 Vectoryl Plus 4/1.2 Captopril Adco-Captomax 2; 50mg Bio-Captopril 2 Mylan Captopril 2; 50mg Enalapril Alapren ; Enalapril Biotech ; Enalapril Unicorn 10mg; Hypace Lisinopril Austell-Lisinopril 10mg; Sinopren ; Perindopril Ciplasyl 4mg Pearinda Perindopril Unicorn Prexum Ran-Perindopril 4mg Spec-Perindopril Vectoryl 8mg Quinapril Accumax 10mg; Carvedilol Aspen Carvedilol 6.2; 12.; 2 Carloc 6.2; 12.; 2 Carvetrend 6.2; 12.; 2 Vediblok 6.2; 12.; 2 Losartan and diuretics Losaar Plus 50/12.; 100/2 Losartan co Unicorn 50/12.; 100/2 Netrasol co 50/12.; 100/2 Zartan co 100/2 Valsartan and diuretics Dynaval co 80/12.; 160/12.; 160/2 Irbesartan Jubitan 150mg; 300mg Losartan Ciplazar 100mg Page 16 of 21 01/2019

17 Hypertension R85 R120 Angiotensin II antagonists: Losartan Zartan 100mg Plain R180 R180 Anti-adrenergic Doxazosin Cardugen 1mg; 4mg Alpha-adrenoreceptor antagonists R170 R170 Anti-adrenergic Methyldopa Hypotone 250mg Methyldopa Mylan Methyldopa 250mg R30 R30 Anti-adrenergic Reserpine Reserpine 0.2 Rauwolfia alkaloids R100 R100 Arteriolar smooth muscle Hydralazine Hyperphen 10mg; 50mg Sandoz Hydralazine 2 Hydrazinophthalazine derivatives R85 R200 Beta blocking Propranolol Inderal 10mg Non-selective Indoblok 10mg; Purbloka R75 R85 Beta blocking Atenolol B-Block 100mg Selective Tenopress 50mg; 100mg Zetenol 50mg; 100mg R20 R40 High-ceiling diuretics Furosemide Dino-Retic Furobe Mylan Furosemide R15 R15 Low-ceiling diuretics: Hydrochlorothiazide Hexazide 2 Thiazides, plain Ridaq 12. R25 R25 Low-ceiling diuretics: Indapamide Cipla-Indapamide 2. excluding Thiazides Daptril 2. Mylan Indapamide 2. R120 R120 Potassium sparing agents Spironolactone Aldactone 2 Sandoz Spironolactone 2 Spiractin 2 R105 R105 Potassium supplements Potassium chloride Plenish K 600mg Slow-K 600mg Ultipot 600mg R230 R320 Selective calcium channel Diltiazem Adco-Zildem 60mg blockers with direct Adco-Zildem SR 180mg; 2 cardiac effects Verapamil Vasomil ; 80mg Verahexal SR 2 R100 R130 Selective calcium channel Amlodipine Amlodipine Unicorn blockers with mainly Amtas vascular effects Austell-Amlodipine Ciplavasc Gulf Amlodipine Lomanor Pendine Pharma Dynamics Amlodipine besylate Felodipine Felodipine-Hexal Plendil 2.; Nifedipine Cipalat Retard Hypothyroidism R45 R45 Thyroid hormones Levothyroxine sodium Euthyrox 25mcg; 50mcg; 100mcg Multiple sclerosis R90 R90 Anti-depressants: Amitriptyline Gulf Amitriptyline 2 Tricyclics Sandoz Amitriptyline 2 Trepiline 10mg R215 R270 Drugs for urinary Oxybutynin Mylan Oxybutynin frequency and incontinence Oxyrest R7 700 R7 700 Interferons Interferon beta-1a Rebif 22 pre-filled syringe 0.5ml 22mcg/0.5ml Rebif 22 rebidose pre-filled pen 0.5ml 22mcg/0.5ml Page 17 of 21 01/2019

18 Multiple sclerosis R7 700 R7 700 Interferons Interferon beta-1a Rebif 44 pre-filled syringe 0.5ml 44mcg/0.5ml Rebif 44 rebidose pre-filled pen 0.5ml 44mcg/0.5ml R1 250 R1 250 Muscle relaxants: Other centrally acting agents R15 R15 Systemic Corticosteroids: Prednisone Baclofen Bio-Baclofen 10mg Teva Baclofen 10mg Prednisone Be-Tabs Prednisone Panafcort Trolic Parkinson's disease R280 R280 Anticholinergic Biperiden Akineton 2mg Tertiary amines R700 R700 Dopamine agonists Pramipexole Mylan Pramipexole 0.12; 0.2; 1mg Pexasp 0.12; 0.2; 1mg Pramex 0.12; 0.2; 1mg Ropinirole Accord Ropinirole 0.2; 0.; 1mg; 2mg; R280 R280 Dopaminergic Amantadine Symadin 100mg Adamantane derivatives R680 R680 Levodopa and Levodopa and Carbilev 25/100mg; 25/250mg decarboxylase inhibitor decarboxylase inhibitor Teva Carbi-Levo 25/100mg; 25/250mg Rheumatoid R65 R65 Anti-inflammatory Diclofenac Adco-Diclofenac 50mg arthritis Acetic acid derivatives and A-Lennon Diclofenac 2; 50mg related substances Diclofenac Biotech 2 Mylan Diclofenac 2; 50mg Panamor AT 50mg Indomethacin Betacin 2 Gulf Indomethacin 2 Methocaps 2 R60 R280 Anti-inflammatory Celecoxib Celecoxib Unicorn 100mg; 200mg Coxibs Coxleon 100mg; 200mg R60 R60 Anti-inflammatory Meloxicam Adco-Meloxicam 1 Oxicams Apex-Meloxicam 7. Flexocam 7. Medoxicam 7. Zydus-Meloxicam 7. Piroxicam Pyrocaps Roxifen R45 R45 Anti-inflammatory Ibuprofen Betaprofen 200mg Propionic acid derivatives Betaprofen FC 400mg Bren 400mg Ibucine 200mg; 400mg Ibunate 200mg Ibusor 200mg Naproxen Mylan Naproxen 250mg Naproscript 250mg R105 R105 Anti-rheumatic Chloroquine Plasmoquine 200mg Chloroquine R5 R5 Folic acid and derivatives Folic acid Be-Tabs Folic acid Folic acid 0.; Gulf Folic acid R810 R810 Intestinal antiinflammatories: Sulfasalazine Salazopyrin 500mg Aminosalicylic acid and similar agents Salazopyrin EN 500mg R775 R775 Other immunosuppressive Azathioprine Azathioprine Azamun 50mg Azathioprine PCH 50mg Page 18 of 21 01/2019

19 Rheumatoid arthritis R110 R110 Other immunosuppressive Methotrexate R15 R15 Systemic Corticosteroids: Prednisone Schizophrenia R120 R160 Anti-depressants: SSRI s Systemic lupus erythematosus (SLE) R290 R385 Anti-epileptics: Carboxamide derivatives R615 R945 Anti-psychotics: Clozapine R600 R600 Anti-psychotics: Olanzapine R400 R400 Anti-psychotics: Phenothiazines with aliphatic side-chain R295 R295 Anti-psychotics: Quetiapine Methotrexate Abitrexate 2. Methotrexate 2. Prednisone Be-Tabs Prednisone Panafcort Trolic Citalopram Adco-Talomil Arrow Citalopram Cilate Escitalopram Accord Escitalopram 10mg; Marprem Zitolex 10mg; Fluoxetine Deprozan Fluoxetine Actor Prolax Ranflocs Zydus-Fluoxetine Sertraline Dyna Sertraline 50mg; 100mg Serdep 50mg; 100mg Serlife 50mg; 100mg Carbamazepine Degranol 200mg Tegretol CR 200mg; 400mg Zeptol 200mg Clozapine Aspen Clozapine 2; 100mg Cloment 2; 100mg Olanzapine Olawin Olawin oradispersible Olexar Prexolan Prexolan ODT Redilanz Zylena Chlorpromazine Largactil 2; 100mg Quetiapine Dopaquel 2; 100mg; 200mg; 300mg Mylan Quetiapine 2; 100mg; 200mg; 300mg Psyquet 2; 100mg; 200mg; 300mg Quetiapine Biotech 300mg Serez 2; 100mg; 200mg; 300mg Spec Quetiapine 2; 300mg R515 R650 Anti-psychotics: Flupenthixol Fluanxol 0.; 1mg Thioxanthene derivatives Fluanxol depot 1ml Zuclopenthixol Clopixol 2mg; 10mg Clopixol depot 200mg R350 R505 Other anti-psychotics Aripiprazole Arizofy ; 1 Risperidone Risnia 0.; 1mg; 2mg; 3mg Rispevon 1mg; 2mg; 3mg; 4mg Rispide 0.; 1mg; 2mg Zoxadon 0.; 1mg; 2mg; 3mg; 4mg R65 R65 Anti-inflammatory Diclofenac Adco-Diclofenac 50mg Acetic acid derivatives and A-Lennon Diclofenac 2; 50mg related substances Diclofenac Biotech 2 Mylan Diclofenac 2; 50mg Panamor AT 50mg Indomethacin Betacin 2 Gulf Indomethacin 2 Methocaps 2 Page 19 of 21 01/2019

20 Systemic lupus erythematosus (SLE) R60 R280 Anti-inflammatory Celecoxib Celecoxib Unicorn 100mg; 200mg Coxibs Coxleon 100mg; 200mg R60 R60 Anti-inflammatory Meloxicam Adco-Meloxicam 1 Oxicams Apex-Meloxicam 7. Flexocam 7. Medoxicam 7. Zydus-Meloxicam 7. Piroxicam Pyrocaps Roxifen R45 R45 Anti-inflammatory Ibuprofen Betaprofen 200mg Propionic acid derivatives Betaprofen FC 400mg Bren 400mg Ibucine 200mg; 400mg Ibunate 200mg Ibusor 200mg Naproxen Mylan Naproxen 250mg Naproscript 250mg R105 R105 Anti-rheumatic Chloroquine Plasmoquine 200mg Chloroquine R85 R85 Anti-thrombotic Warfarin Cipla-Warfarin Vitamin K antagonists R30 R35 Aspirin Acetylsalicylic acid Myoprin 100mg R25 R25 Emolients and Zinc products Zinc ointment bp protectives: Zinc products R5 R5 Folic acid and derivatives Folic acid Be-Tabs Folic acid Folic acid 0.; Gulf Folic acid R775 R775 Other immunosuppressive Azathioprine Azamun 50mg Azathioprine Azathioprine PCH 50mg R110 R110 Other immunosuppressive Methotrexate R15 R15 Systemic Corticosteroids: Prednisone Methotrexate Abitrexate 2. Methotrexate 2. Prednisone Be-Tabs Prednisone Panafcort Trolic R25 R25 Topical Corticosteroids: Betamethasone Repivate cream 0.1% Group III Topivate cream 0.1% Vari-Betamethasone cream 0.1% Ulcerative colitis R5 R5 Folic acid and derivatives Folic acid Be-Tabs Folic acid Folic acid 0.; Gulf Folic acid R810 R810 Intestinal antiinflammatories: Mesalazine Asacol 400mg; 800mg Mezavant 1200mg Aminosalicylic acid and Pentasa 500mg; 1000mg similar agents Salofalk 1000mg Olsalazine Dipentum 250mg Sulfasalazine Salazopyrin 500mg Salazopyrin EN 500mg R1 940 R1 940 Intestinal antiinflammatories: Corticosteroids Budesonide Entocord enema R775 R775 Other immunosuppressive Azathioprine R110 R110 Other immunosuppressive Methotrexate R15 R15 Systemic Corticosteroids: Prednisone Azathioprine Azamun 50mg Azathioprine PCH 50mg Methotrexate Abitrexate 2. Methotrexate 2. Prednisone Be-Tabs Prednisone Panafcort Trolic Page 20 of 21 01/2019

21 Complaints process You may lodge a complaint or query with Remedi Medical Aid Scheme directly on or address a complaint in writing to the Principal Officer at the Scheme s registered address. Should your complaint remain unresolved, you may lodge a formal dispute by following the Remedi Medical Aid Scheme internal disputes process. You may, as a last resort, approach the Council for Medical Schemes for assistance. Council for Medical Schemes Complaints Unit, Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion, 0157 / / complaints@medicalschemes.com / Page 21 of 21 01/2019