YES = formulary NO = non-formulary NO BENEFIT = excluded

Transcription

1 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 group of generic equivalent medicines which is reviewed and updated regularly. MRP sets a maximum reimbursable price for a list of generically similar medicines with a cost lower than that of the original medicine. There may be instances where a generic alternative costs more than the set MRP. If you opt to use the original medicine and a generic alternative is available, or you use a medicine that costs more than the MRP, you will have to pay the difference between the price of the chosen medicine and that of MRP. This formulary is effective from 1 January This formulary is subject to change without notice. ONLY the following medicine classes will be considered for Beat1 and Beat2: COX inhibitors Corticosteroid Drug modifying agent (DMARD) Folic acid Intestinal inflammatory agents YES = formulary NO = non-formulary NO BENEFIT = excluded RHEUMATOID ARTHRITIS A AZATHIOPINE AZAMUN 50MG NO YES YES AZAPRESS 50MG TAB NO YES YES AZATHIOPRINE PCH 50MG TAB NO YES YES IMURAN 50MG TAB NO YES YES ZAPRINE 50MG TAB NO YES YES B BETAMETHASONE BETANOID 0.6MG/5ML SYR NO YES YES STEROMIEN 0.6MG/5ML SYR NO YES YES C CHLOROQUINE NIVAQUINE 200MG TAB NO YES YES PLASMOQUINE 200MG CAP NO YES YES MIRQUIN SYR NO NO YES CYCLOPHOSPHAMIDE ENDOXAN 50MG TAB NO YES YES D DICLOFENAC SODIUM ADCO-DICLOFENAC 50MG TAB YES YES YES 1

2 ADCO-DICLOFENAC 25MG TAB YES YES YES A-LENNON DICLOFENAC 50MG YES YES YES DICLOHEXAL 25MG YES YES YES DICLOHEXAL 50MG YES YES YES DIFEN SR 100MG NO NO YES FORTFEN SR 100MG CAP NO NO YES MYLAN DICLOFENAC 25MG YES YES YES MYLAN DICLOFENAC 50MG YES YES YES PANAMOR 25MG TAB YES YES YES PANAMOR AT 50MG TAB YES YES YES PANAMOR SR 100MG TAB NO NO YES PANAMOR SR 75MG TAB NO NO YES SANDOZ DICLOFENAC 100SR NO NO YES SANDOZ DICLOFENAC 25 YES YES YES SANDOZ DICLOFENAC 50MG YES YES YES VELTEX 100MG CAP NO NO YES VELTEX 75MG CAP NO NO YES VOLTAREN 25MG TAB YES YES YES VOLTAREN 75MG TAB NO NO YES VOLTAREN GT 50MG TAB YES YES YES VOLTAREN SR 100MG TAB NO NO YES F FOLIC ACID AHA FOLIC ACID 5MG TAB YES YES YES BE-TABS FOLIC ACID 5MG YES YES YES FOLIC ACID 5MG TAB YES YES YES I IBUPRUFEN ADCO-IBUPROFEN 400MG TAB NO YES YES BETAGESIC 200MG TAB NO YES YES BETAPROFEN 200MG TAB NO YES YES BETAPROFEN 400 FC NO YES YES BREN 400MG TAB NO YES YES BRUFEN PAED SUSP NO YES YES IBOFLAM 200MG TAB NO YES YES 2

3 IBU 200MG TAB NO YES YES IBUGESIC 100MG/5ML SUSP NO YES YES IBUMED 200MG TAB NO YES YES IBUNATE 200MG NO YES YES INZA 200MG TAB NO YES YES INZA 400MG TAB NO YES YES LENAFEN 200MG NO YES YES NORFLAM T 200MG NO YES YES NUROFEN CAPLETS 200MG NO YES YES NUROFEN CHILDREN SUGAR FR NO YES YES NUROFEN EXTRA STRENGTH NO YES YES NUROFEN FOR CHILD STRAWBE NO YES YES NUROFEN TAB NO YES YES PAINIL 200MG TAB NO YES YES RANFEN 200MG TAB NO YES YES RANFEN 400MG TAB NO YES YES SANDOZ IBUPROFEN 200MG NO YES YES SANDOZ IBUPROFEN 400MG NO YES YES SANDOZ IBUPROFEN 600MG NO YES YES INDOMETHACIN ADCO-INDOMETHACIN 25 CAP NO YES YES ADVIL LIQUI GEL NO YES YES AMDOCIN 25MG NO YES YES ARTHREXIN 25MG CAP NO YES YES BETACIN 25MG CAP NO YES YES FLAMECID 25MG CAP NO YES YES GULF INDOMETHACIN 25MG NO YES YES MEDIFLEX 25MG CAP NO YES YES METHOCAPS 25MG NO YES YES SANDOZ INDOMETHACIN 25MG NO YES YES L LEFLUNOMIDE ARAVA 10MG NO YES YES ARAVA 20MG NO YES YES 3

4 M MELOXICAM ADCO-MELOXICAM 15MG TAB NO NO YES ADCO-MELOXICAM 7.5MG TAB NO YES YES ARROW MELOXICAM 15MG TAB NO NO YES ARROW MELOXICAM 7.5MG TAB NO YES YES ARTHROCOX 15MG TAB NO NO YES ARTHROCOX 7.5MG TAB NO YES YES COXFLAM 15MG NO NO YES COXFLAM 7.5MG NO YES YES FLAMARYX 15MG TAB NO NO YES FLAMARYX 7.5MG TAB NO YES YES FLEXOCAM 15MG TAB NO NO YES FLEXOCAM 7.5MG TAB NO YES YES LOXIFLAM 15MG NO NO YES LOXIFLAM 7.5MG NO YES YES M-CAM 15MG TAB NO NO YES M-CAM 7.5MG TAB NO YES YES MEDOXICAM 15MG TAB NO NO YES MEDOXICAM 7.5MG TAB NO YES YES MELFLAM 15MG TAB NO NO YES MELFLAM 7.5MG TAB NO YES YES MOBIC 15MG TAB NO NO YES MOBIC 7.5MG TAB NO YES YES SANDOZ MELOXICAM 7.5MG NO YES YES SANDOZ MELOXICAM 15MG NO NO YES ZYDUS-MELOXICAM 15MG TAB NO NO YES ZYDUS-MELOXICAM 7.5MG TAB NO YES YES METHOTREXATE METHOTREXATE 2.5MG TAB YES YES YES P&U METHOTREXATE 500MG NO YES YES P&U METHOTREXA 50MG/2ML NO YES YES P PREDNISONE BE-TABS PREDNISONE 5MG YES YES YES METICORTEN 5MG TAB YES YES YES 4

5 PANAFCORT 5MG TAB YES YES YES TROLIC 5MG TAB YES YES YES Q QUININE SULPHATE QUININE SULPH 300MG TAB NO BENEFIT YES YES S SULPHASALAZINE SALAZOPYRIN 500MG TAB YES YES YES SALAZOPYRIN-EN 500MG YES YES YES 5