GINETTE TABS MEDITRIM 480MG. Anti-Histamines Cetirizine dihydrochloride 10mg tab AUSTELL CETIRIZINE 10MG
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- Octavia Preston
- 5 years ago
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1 SCRIPTPHARM RISK MANAGEMENT CHRONIC MEDICINE FORMULARY Nedgroup Traditional, Traditional plus and Platinum non-pmb Formulary CHRONIC CONDITIONS ACNE (Cystic Nodular ONLY) Acne 21 beige tabs: Cyproterone acetate 2mg; ethinylestradiol 0.035mg 7 placebo tabs GINETTE TABS Dermatologist prescription ONLY L70.1 Acne Isotretinoin 10mg ORATANE 10MG Motivation, including history of therapy & patient's weight,. Dermalologist prescription ONLY. Acne Isotretinoin 20mg ORATANE 20MG Sulphonamides and combinations Trimethoprim 80 mg; sulphamethoxazole 400 mg MEDITRIM 480MG Tetracyclines Doxycycline HCl 100mg CYCLIDOX 100MG Tetracyclines Minocycline 100mg CYCLIMYCIN 100MG Tetracyclines Minocycline 50mg CYCLIMYCIN 50MG Tetracyclines Oxytetracycline HCl 250mg OXY 250MG Motivation, including history of therapy & patient's weight,. Dermalologist prescription ONLY. Dermatologist prescription ONLY Dermatologist prescription ONLY. Maximum 30 per month. Dermatologist prescription ONLY. Maximum 60 per month. Dermatologist prescription ONLY. Maximum 60 per month. Dermatologist prescription ONLY. Maximum 60 per month. ALLERGIC RHINITIS (With Asthma / <12 years old) Anti-Histamines Cetirizine dihydrochloride 10mg tab AUSTELL CETIRIZINE 10MG Clinical motivation if prescribed together with Nasal Corticosteroid Spray J30 Anti-Histamines Cetirizine 1mg/ml syrup CETIRIZINE-HEXAL 1MG/1ML Clinical motivation if prescribed together with Nasal Corticosteroid Spray 1
2 SIMAYLA LORATADINE Anti-Histamines Loratadine 10mg tab MG Clinical motivation if prescribed together with Nasal Corticosteroid Spray Anti-Histamines Loratadine 5mg/5ml AP LORATADINE 5MG/5ML Anti-Histamines Desloratadine 5mg DAZIT 5MG TAB Anti-Histamines Desloratadine 2.5mg/5ml NEOCLARITYNE 2.5MG/5ML Clinical motivation if prescribed together with Nasal Corticosteroid Spray Patient must have tried and failed on formulary Loratadine Patient must have tried and failed on formulary Loratadine Glucocorticosteroids Beclomethasone dipropionate 50ug Aqueous CLENIL AQUEOUS NASAL SPRAY Clinical motivation if prescribed together with antihistamine tablets Glucocorticosteroids Fluticasone 50mcg FLONASE Clinical motivation if prescribed together with antihistamine tablets ALZHEIMER'S DISEASE Alzheimer's disease Donepezil HCl 10mg CURLOVON 10MG DONECEPT 10MG prescription G30 Alzheimer's disease Donepezil HCl 5mg CURLOVON 5MG DONECEPT 5MG prescription Alzheimer's disease Galantamine 8mg REMINYL CR 8MG prescription Alzheimer's disease Galantamine 16mg REMINYL CR 16MG prescription Alzheimer's disease Galantamine 24mg REMINYL CR 24MG prescription Alzheimer's disease Rivastigamine 1.5mg EXELON 1.5 MG CAPS prescription 2
3 Alzheimer's disease Rivastigamine 3.0mg EXELON 3.0 MG CAPS Alzheimer's disease Rivastigamine 4.5mg EXELON 4.5 MG CAPS Alzheimer's disease Rivastigamine 6.0mg EXELON 6.0 MG CAPS prescription prescription prescription Alzheimer's disease Memantine HCL 10mg EBIXA 10MG TABS MEMOR 10MG prescription Alzheimer's disease Memantine HCL 10mg/g EBIXA 10MG/G DROPS 50G prescription ANXIETY Others Buspirone HCl 10mg PASRIN 10MG TAB F41 SSRI Fluoxetine 20mg DEPROZAN 20MG NUZAK 20MG ATTENTION DEFICIT DISORDER (ADHD) Only for patients under 18 years of age SSRI Citalopram hydrobromide 20mg ARROW CITALOPRAM TALOMIL 20MG SSRI Paroxetine 20mg SERRAPRESS 20MG XET 20MG Beta-blockers Propranolol 40mg INDOBLOK 40MG TAB Others Methylphenidate HCl 10mg RITALIN 10MG TABS METHYLPHENIDATE HCL- DOUGLAS (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered (If linked to any other Psychiatric conditions) Benzodiazepines will not be considered Paediatrician/Neurologist/Psyc hiatrist prescription. 3
4 F90 Others Methylphenidate HCl 20mg RITALIN LA 20MG CAPS Others Methylphenidate HCl 18mg CONCERTA 18MG Paediatrician/Neurologist/Psyc hiatrist prescription. Motivation, including history of therapy,. Paediatrician/Neurologist/Psyc hiatrist prescription. Others Methylphenidate HCl 27mg CONCERTA 27MG Motivation, including history of therapy,. Paediatrician/Neurologist/Psyc hiatrist prescription. Others Methylphenidate HCl 36mg CONCERTA 36MG Others Methylphenidate HCl 54mg CONCERTA 54MG Motivation, including history of therapy,. Paediatrician/Neurologist/Psyc hiatrist prescription. Motivation, including history of therapy,. Paediatrician/Neurologist/Psyc hiatrist prescription. Behcet's Disease M35.2 Immunosuppressants Azathioprine 50mg AZATHIOPRINE PCH 50MG TABS AZAMUM 50MG TABS Topical Cortico-steroids Hydrocortisone 25g DILUCORT CREAM DILUCORT CREAM Topical Cortico-steroids Hydrocortisone 1g/100g MYLOCORT 1MG/100MG CREAM Topical Cortico-steroids Betamethasone 1mg/g TOPIVATE 1MG/MG CREAM Topical Cortico-steroids Betamethasone 0.1% LENOVATE 0.1% OINT Corticosteroids Hydrocortisone 10mg COVOCORT 10MG Corticosteroids Fludrocortisone, 0.1mg FLORINEF 0.1MG Corticosteroids Prednisone 5mg BE-TABS PREDNISONE 5MG Corticosteroids Hydrocortisone 10mg COVOCORT 10MG Corticosteroids Fludrocortisone, 0.1mg FLORINEF 0.1MG Cytostatic Cyclophosphomide 50mg ENDOXAN 50MG Cytostatic Methotrexate METHOTREXATE 2.5MG Other Chloroquine phosphate PLASMOQUINE 200MG Anti-gout Colchicine 0.5mg LENNON-COLCHICINE 0.5MG Corticosteroid Eye drops Dexamethasone 1mg/ml MAXIDEX 1MG/ML 5ML DROPS MYLOCORT 1MG/100MG OINT BETNOVATE 1MG/MG OINTMENT LENOVATE 0.1% CREAM 4
5 Corticosteroid Eye drops Prednisolone 10mg/ml PRED-FORT 5ML DROPS DEPRESSION, MAJOR F33 Mono-Amine Oxidase Mono-Amine Oxidase Moclobemide 150mg Moclobemide 300mg CLORIX 150MG TAB CLORIX 300MG TAB Citalopram hydrobromide 20mg ARROW CITALOPRAM TALOMIL 20MG 1st Line Agent. Fluoxetine HCI 20mg cap DEPROZAN 20MG NUZAK 20MG 1st Line Agent. Paroxetine 20mg SERRAPRESS 20MG XET 20MG 1st Line Agent. Escitalopram 10mg LEXAMIL 10MG ZITOLEX 10mg 2nd Line Agent. Therapy must be initiated by a Serotonin and Noradrenaline re-uptake Serotonin and Noradrenaline re-uptake Serotonin and Noradrenaline re-uptake Serotonin and Noradrenaline re-uptake Escitalopram 20mg LEXAMIL 20MG ZITOLEX 20MG Sertraline 50mg DYNA-SERTRALINE 50MG SERDEP 50MG TAB Sertraline 100mg DYNA-SERTRALINE 100MG SERDEP100MG TAB Venlafaxine HCL 37.5mg Venlafaxine HCL 37.5mg ODIVEN 37.5MG TABS ADCO VENLAFAXINE XR 37.5MG VENLOR XR 37.5MG Venlafaxine HCL 75mg VENLOR XR 75MG VENLAFAXINE UNICORN XR 75mg Venlafaxine HCL 150mg VENLOR XR 150MG VENLAFAXINE UNICORN XR 150mg Tricyclics Amitriptyline HCI 25mg TREPILINE 25MG TAB Tricyclics Clomipramine HCI 10mg EQUINORM 10MG Tricyclics Clomipramine HCI 25mg CLOMIDEP 25MG Tricyclics Dothiepin HCI 25mg THADEN 25MG CAPS Tricyclics Dothiepin HCI 75mg THADEN 75MG CAPS Tricyclics Imipramine HCI 10mg ETHIPRAMINE 10MG TAB Tricyclics Imipramine HCI 25mg ETHIPRAMINE 25MG TAB GULF AMIRIPTYLINE 25MG 2nd Line Agent. Therapy must be initiated by a 5
6 Other Bupropion 150mg WELLBUTRIN SR 150MG TAB Other Bupropion 300mg WELLBUTRIN XL 300MG TAB Other Mirtazapine 15mg MIRADEP 15MG MYLAN-MIRTAZAPINE 15MG Other Mirtazapine 30mg MIRADEP 30MG MYLAN-MIRTAZAPINE 30MG Anti-epileptics Lamotrigine 25mg DYNA-LAMOTRIGINE 25MG Psych motivation Psych motivation Anti-epileptics Lamotrigine 50mg DYNA-LAMOTRIGINE 50MG LAMIDUS 50MG Anti-epileptics Lamotrigine 100mg DYNA-LAMOTRIGINE 100MG LAMIDUS 100MG Anti-epileptics Lamotrigine 200mg DYNA-LAMOTRIGINE 200MG LAMIDUS 200MG Anti-epileptics Topiramate 25mg ADCO-TOPIRAMATE 25MG EPITOZ 25MG TAB Anti-epileptics Topiramate 50mg ADCO-TOPIRAMATE 50MG EPITOZ 50MG TAB Anti-epileptics Topiramate 100mg ADCO-TOPIRAMATE 100MG EPITOZ 100MG TAB Anti-epileptics Topiramate 100mg ADCO-TOPIRAMATE 200MG Anti-psychotics Risperidone 1mg RISNIA 1MG ZOXADON 1MG Psych motivation Anti-psychotics Risperidone 2mg RISNIA 2MG ZOXADON 2MG Psych motivation Other Agomelatine 25mg VALDOXANE 25MG TAB ECZEMA Emoliients and Lotion Aqueous Cream 400g EPI-MAX JUNIOR L20.9 Emoliients and Lotion Aqueous Cream 500g Epizone A L30.9 Emoliients and Lotion Emulsifying ointment 500g UNG EMULSIFICANS Limited to 400 gram per month Limited to 500 gram per month Limited to 500 gram per month Emoliients and Lotion Emulsifying ointment 500g EPIZONE E Limited to 500g per month Cortico-steroids Hydrocortisone 25g DILUCORT CREAM DILUCORT OINTMENT Cortico-steroids Hydrocortisone 1g/100g MYLOCORT 1GM/100GM MYLOCORT CREAM 1GM/100GM OINT Cortico-steroids Betamethasone 1mg/g TOPIVATE 1MG/GM CREAM BETNOVATE 1MG/GM OINTMENT Cortico-steroids Betamethasone 0.1% LENOVATE 0.1% OINT LENOVATE 0.1% CREAM Cortico-steroids Methylprednisolone 1mg/g ADVANTAN CREAM ADVANTAN OINTMENT Limited to 30g per month Cortico-steroids Methylprednisolone 1mg/g ADVANTAN FATTY OINT Limited to 30g per month 6
7 Anti-Histamines Chlorpheniramine 2mg/5ml SYR ALLERGEX 2MG/5ML SYR Anti-Histamines Chlorpheniramine 4mg ALLERGEX 4mg tablet ALLERHIST 4MG CAP Anti-Histamines Chlorpheniramine 4mg RHINETON 4MG TABS Fungicide Selenium 25mg/ml SELSUN SHAMPOO 2.5% Limited to 100ml per month Topical Cortico-steroids Fluocinolone 0.25mg/g SYNALAR GEL 0.25MG/G Limited to 30g per month Cortico-steroids Betamethason 1mg/g BETNOVATE SCALP Limited to 30ml per month GASTRO- OESOPHAGEAL REFLUX DISEASE Histamine-2 receptor antagonists Cimetidine 200mg CIMLOK 200MG Gastroscopy results - K21 Histamine-2 receptor antagonists Cimetidine 200mg BIO-CIMETIDINE 200MG Gastroscopy results - Histamine-2 receptor antagonists Cimetidine 400mg CIMLOK 400MG Gastroscopy results - Histamine-2 receptor antagonists Cimetidine 400mg BIO-CIMETIDINE 400MG Gastroscopy results - Histamine-2 receptor antagonists Ranitidine HCI 150mg AUSTAC 150MG Gastroscopy results - Histamine-2 receptor antagonists Ranitidine HCI 300mg AUSTAC 300MG Gastroscopy results - Proton pump Lansoprazole 15mg LANCAP 15MG Gastroscopy results - Proton pump Lansoprazole 30mg LANCAP 30MG Gastroscopy results - Proton pump Omeprazole 10mg OMEZ 10MG Proton pump Omeprazole 20mg NOZER 20mg Proton pump Pantoprazole 20mg PANTOCID 20MG PANTOCID 20MG Proton pump Pantoprazole 40mg PANTOCID 40MG PANTOCID 40MG Gastroscopy results - Gastroscopy results - Gastroscopy results - Gastroscopy results - 7
8 GOUT Anti-gout Colchicine 0.5mg LENNON-COLCHICINE 0.5MG Only if associated with Diabetes or Hypertension M10.99 Anti-gout Allopurinol 300mg PURICOS 300MG TABS Only if associated with Diabetes or Hypertension Anti-gout Allopurinol 100mg PURICOS 100MG TABS Only if associated with Diabetes or Hypertension Hyperfunction of Pituitary Gland Hormone Cabergoline 0.5mg DOSTINEX 0.5MG TAB E22.8 Hormone Quinagolide 150mcg NORPROLAC 150MCG TAB Hormone Quinagolide 75mcg NORPROLAC 75MCG TABS Hormone Bromocriptine 2.5mg APO-BROMOCRIPTINE 2.5MG ASPEN BROMOCRIPTINE 2.5MG prescription prescription prescription prescription INSOMNIA Others Zolpidem 10mg ZOLNOXS G47.0 Others Zopiclone 7.5mg ZOPIVANE 7.5MG TAB (If linked to Psychiatric PMB Condition ONLY) (If linked to Psychiatric PMB Condition ONLY) MIGRAINE(Prophylaxis ONLY) Anti-Migraine agents Clonidine HCl 0.025mg MENOGRAINE 0.025MG G43 Beta-receptor blockers Propranolol HCl 10mg INDOBLOK 10MG Beta-receptor blockers Propranolol HCl 40mg INDOBLOK 40MG Tricyclics Amitriptyline HCI 25mg TREPILINE 25MG TAB Tricyclics Imipramine HCI 10mg ETHIPRAMINE 10MG TAB Tricyclics Imipramine HCI 25mg ETHIPRAMINE 25MG TAB GULF AMIRIPTYLINE 25MG Obsessive Compulsive Disorder F42 Citalopram hydrobromide 20mg ARROW CITALOPRAM TALOMIL 20MG Iniated by Fluoxetine HCI 20mg cap DEPROZAN 20MG NUZAK 20MG Iniated by Paroxetine 20mg SERRAPRESS 20MG XET 20MG Iniated by Escitalopram 10mg LEXAMIL 10MG ZITOLEX 10mg Iniated by Escitalopram 20mg LEXAMIL 20MG ZITOLEX 20MG Iniated by Sertraline 50mg DYNA-SERTRALINE 50MG SERDEP 50MG TAB Iniated by 8
9 Sertraline 100mg DYNA-SERTRALINE 100MG SERDEP100MG TAB Iniated by OSTEOARTHRITIS Analgesic and Antipyretics Paracetamol 500mg tab NAPAMOL 500MG TAB M15 Diclofenac sod. 100mg Diclofenac sod. 100mg Diclofenac sod 25mg Diclofenac sod 50mg tab Indomethacin 25mg Ibuprofen 200mg Ibuprofen 400mg Ibuprofen 600mg Naproxen 250mg Naproxen 500mg PANAMOR SR 100MG TAB DIFEN SR 100MG MERCK-DICLOFENAC 25MG MERCK-DICLOFENAC 50MG ARTHREXIN 25MG RANFEN 200MG RANFEN 400MG SANDOZ IBUPROFEN 600MG TAB NAPFLAM 250MG NAPFLAM 500MG Selective COX2 Meloxicam 15mg FLEXOCAM 15MG Selective COX2 Meloxicam 7.5mg FLEXOCAM 7.5MG ARROW MELOXICAM 15MG ARROW MELOXICAM 7.5MG Specific COX2 - COXIB Etoricoxib 60mg ARCOXIA 60MG TAB Motivation indicating the risk factors considered for their use over conventional antiinflammatory therapy OSTEOPOROSIS Biphosphonates Alendronate 10mg OSTEOBON 10MG TAB OSTENA M80 Biphosphonates Alendronate 70mg OSTENA FEMAX 70MG TAB Biphosphonates Alendronate 70mg; Cholecalciferol 70ug FOSAVANCE 70MG TAB Biphosphonates Ibandronic acid 150mg tab BONIVA 150MG TAB Vitamin D2 Ergocalciferol iu CALCIFEROL Calcium Calcium carbonate 1250mg; Vitamin D3 400iu factors factors factors factors B-CAL-D TAB Only in proven osteoporosis 9
10 Selective oestrogen receptor modulators Raloxifene HCl 60mg EVISTA 60MG Dual action bone agents Strontium ranelate PROTOS 2g/sachet Paget's Disease Biphosphonates Alendronate 10mg OSTEOBON 10MG TAB M88 Biphosphonates Alendronate 70mg OSTENA FEMAX 70MG TAB Biphosphonates Alendronate 70mg; Cholecalciferol 70ug FOSAVANCE 70MG TAB Biphosphonates Ibandronic acid 150mg tab BONIVA 150MG TAB Vitamin D2 Ergocalciferol iu CALCIFEROL Calcium Calcium carbonate 1250mg; Vitamin D3 400iu B-CAL-D TAB Selective oestrogen receptor modulators Raloxifene HCl 60mg EVISTA 60MG Dual action bone agents Strontium ranelate PROTOS 2g/sachet PSORIASIS Emoliients and Lotion Aqueous Cream 400g EPI-MAX JUNIOR L40 Emoliients and Lotion Aqueous Cream 500g Epizone A Emoliients and Lotion Emulsifying ointment 500g UNG EMULSIFICANS factors factors factors factors factors factors factors factors Limited to 400 gram per month Limited to 500 gram per month Limited to 500 gram per month Emoliients and Lotion Emulsifying ointment 500g EPIZONE E Limited to 500g per month Cortico-steroids Hydrocortisone 25g DILUCORT CREAM DILUCORT OINTMENT Cortico-steroids Hydrocortisone 1g/100g MYLOCORT 1GM/100GM CREAM MYLOCORT 1GM/100GM OINT BETNOVATE 1MG/GM Cortico-steroids Betamethasone 1mg/g TOPIVATE 1MG/GM CREAM OINTMENT LENOVATE 0.1% Cortico-steroids Betamethasone 0.1% LENOVATE 0.1% OINT CREAM Cortico-steroids Cortico-steroids Cortico-steroids Calcipotriol 50mcg, betamethasone dipropiante 0,5mg/g Betamethasone [as dipropionate] 0;5mg; salicylic acid 20mg/g Betamethasone [as dipropionate] 0;5mg; salicylic acid 30mg/g XAMIOL GEL DIPROSALIC LOTION DIPROSALIC OINT Cortico-steroids Betamethasone as valerate BETNOVATE SCALP LOTION prescription. Limited to 30gram per month prescription prescription prescription 10
11 Cortico-steroids Clobetasol 0.5mg/g DOVATE 0.5MG/G CREAM Cortico-steroids Clobetasol 0.5mg/g DOVATE 0.5MG/G OINTMENT Dermatologicals Calcipotriol DOVONEX SCALP Dermatologicals Coal tar POLYTAR prescription prescription prescription prescription Dermatologicals Coal tar EPIZONE LPC CREAM Dermatologicals Coal tar TRITAR SHAMPOO prescription Dermatologicals Coal tar COAL TAR SOLUTION Dermatologicals Tazarotene 0.05% ZORAC 0.05% GEL Sjögren's Disease Analgesics Paracetamol 500mg Napamol 500mg 5 Aminosalycilic acid M35.0 derivative Sulphasalazine 500mg Salazopyrin 500mg 5 Aminosalycilic acid derivative Sulphasalazine 500mg Salazopyrin EN 500 Corticosteroids Prednisone 5mg Be-tabs prednisone Cytostatic Methotrexate Methotrexate 2.5mg Immunosuppressive Azathioprine 50mg Azamun 50mg Immunosuppressive Chloroquine 200mg Plasmoquine 200mg NSAID'S Indomethacin 100mg Arthrexin 100mg supp. NSAID'S Indomethacin 25mg Betacin 25mg NSAID'S Ibuprofen 200mg Ranfen 200mg Arthrexin 25mg NSAID'S Ibuprofen 400mg Ranfen 400mg NSAID'S Ibuprofen 600mg Sandoz ibuprofen 600 mg Selective COX II Meloxicam 15mg Flexocam 15mg Selective COX II Meloxicam 7.5mg Flexocam 7.5mg NSAID'S Naproxen 250mg Napflam 250mg NSAID'S Naproxen 500mg Napflam 500mg Arrow Meloxicam 15mg Arrow Meloxicam 7.5mg prescription 11
12 NSAID'S Diclofenac 25mg Panamor 25mg NSAID'S Diclofenac 50mg Panamor 50mg NSAID'S Diclofenac SR 100mg Panamor sr Vitamins Folic acid 5mg Be-tabs folic 5mg Other Ophthalmics Other Ophthalmics White petrolatum 573mg; minoil 425mg; lanolin alcohols 2mg/g Dextran-70 1mg; hydroxypropyl methylcellulose 3mg/ml Duratears 3.5G eye oint Tears Naturale eye drops 12
GINETTE TABS ORATANE 10MG MEDITRIM 480MG AUSTELL CETIRIZINE 10MG
SCRIPTPHARM RISK MANAGEMENT CHRONIC MEDICINE FORMULARY NEDGROUP SAVINGS PLAN CHRONIC CONDITIONS ACNE (Cystic Nodular ONLY) Acne L70.1 Acne 21 beige tabs: Cyproterone acetate 2mg; ethinylestradiol 0.035mg
GINETTE TABS. Acne Isotretinoin 20mg ORATANE 20MG MEDITRIM 480MG. Tetracyclines Doxycycline HCl 100mg CYCLIDOX 100MG
SCRIPTPHARM RISK MANAGEMENT CHRONIC MEDICINE FORMULARY Nedgroup Traditional, Comprehensive and Platinum non-pmb Formulary CHRONIC CONDITIONS ACNE (Cystic Nodular ONLY) Acne 21 beige tabs: Cyproterone acetate
SCRIPTPHARM RISK MANAGEMENT CHRONIC MEDICINE FORMULARY Nedgroup Traditional, Comprehensive and Platinum non-pmb Formulary
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YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 A NO BENEFIT SANDOZ AMITRIPTYLINE 25
Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular
YES = formulary NO = non-formulary NO BENEFIT = excluded. Beat4 Beat1 Beat 3 Pace2 Beat2 Pace1 Pace3 Pace4 A NO BENEFIT SANDOZ AMITRIPTYLINE 25
Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular
YES = formulary NO = non-formulary NO BENEFIT = excluded
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Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
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ANTIDEPRESSANTS Serotonin Selective Reuptake Inhibitors citalopram 10, 20, 40 mg, 10 mg/5cc $ 0.40 No escitalopram 10, 20 mg $ 2.60 Yes fluoxetine 10, 20 mg, 20 mg/5 ml $ 0.40 Yes fluvoxamine 25, 50, 100
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DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 702 M %
December 16 No Category M changes so the reductions imposed in May which were only supposed to last until September continue As in November, most changes are Category A lines with a few Category C. Significant
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