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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 : Biguanides Intermediate acting Insulins Long acting Insulins Sulphonylureas Glucose Meter strips- funded as per protocols and guidelines Glucose Meter Lancets- funded as per protocols and guidelines Glucose Meter Needles- funded as per protocols and guidelines YES = formulary = non-formulary = excluded DIABETES MELLITUS 2 C CHLORPROPAMIDE HYPOMIDE 250MG TAB G GLIBENCLAMIDE BIO-GLIBENCLAMIDE TAB DAONIL 5MG TAB DIACARE TAB GLYCOMIN 5MG TAB SANDOZ GLIBENCLAMIDE 5MG GLICLAZIDE ALEMBIC GLICLAZIDE 80MG YES ARROW GLICLAZIDE 80MG TAB YES AUSTELL-GLICLAZIDE 40MG YES AUSTELL-GLICLAZIDE 80MG YES DIAGLUCIDE MR 30MG SRT DIAGLUCIDE MR 60MG SRT 1

2 DIAGLUCIDE 80MG TAB YES DIAGLUMED 80MG TAB YES DIAMICRON MR 30MG TAB DIAMICRON MR 60MG TAB DIARAN MR 30MG TAB DYNA GLICLAZIDE SR 30MG GLYCRON 80MG TAB YES GLYGARD 80MG TAB YES MYLAN GLICLAZIDE 80MG YES SANDOZ GLICLAZIDE 80MG YES GLIMEPIRIDE ACCORD GLIMEPIRIDE 1MG TAB YES ACCORD GLIMEPIRIDE 2MG TAB YES ACCORD GLIMEPIRIDE 4MG TAB YES AMARYL 1MG TAB YES AMARYL 2MG TAB YES AMARYL 3MG TAB YES AMARYL 4MG TAB YES ASPEN GLIMEPIRIDE 1MG TAB YES ASPEN GLIMEPIRIDE 2MG TAB YES ASPEN GLIMEPIRIDE 4MG TAB YES AUSTELL GLIMEPIRIDE 1MG YES AUSTELL GLIMEPIRIDE 2MG YES AUSTELL GLIMEPIRIDE 4MG YES DIAGLIM 1MG TAB YES DIAGLIM 2MG TAB YES DIAGLIM 4MG TAB YES EUGLIM 1GM TAB YES EUGLIM 2MG TAB YES EUGLIM 4MG TAB YES GLAMARYL 1MG TAB YES GLAMARYL 2MG TAB YES GLAMARYL 4MG TAB YES GLIMEHEXAL 1MG TAB YES 2

3 GLIMEHEXAL 2MG TAB YES GLIMEHEXAL 4MG TAB YES MYLAN GLIMEPIRIDE 1MG YES MYLAN GLIMEPIRIDE 2MG YES MYLAN GLIMEPIRIDE 4MG YES SANDOZ GLIMEPIRIDE 1MG YES SANDOZ GLIMEPIRIDE 2MG YES SANDOZ GLIMEPIRIDE 4MG YES SULPHONUR 1MG TAB YES SULPHONUR 2MG TAB YES SULPHONUR 4MG TAB YES ZYDUS-GLIMEPIRIDE 1MG TAB YES ZYDUS-GLIMEPIRIDE 2MG TAB YES ZYDUS-GLIMEPIRIDE 4MG TAB YES M METFORMIN ACCORD METFORMIN 500MG TAB YES ACCORD METFORMIN 850MG TAB YES APEX-METFORMIN 500MG TAB YES APEX-METFORMIN FORTE 850MG YES ARROW METFORMIN 500MG TAB YES ARROW METFORMIN 850MG TAB YES AUSTELL-METFORMIN 500MG YES AUSTELL-METFORMIN 850MG YES BIGSENS 1000MG TAB YES BIGSENS 500MG TAB YES BIGSENS 850MG TAB YES DIABETMIN 850MG TAB YES DIAFORMIN 500MG TAB YES DIAFORMIN FORTE 850MG TAB YES DIAMIN 500MG TAB YES DIAMIN 850MG TAB YES DIAPHAGE 1000MG TAB YES DIAPHAGE 500MG TAB YES 3

4 DIAPHAGE 850MG TAB YES FORMINAL 500MG TAB YES FORMINAL 850MG TAB YES GLUCORM 500MG TAB YES GLUCORM 850MG TAB YES GLUCOPHAGE 1000MG TAB YES GLUCOPHAGE 500MG TAB YES GLUCOPHAGE F 850MG TAB YES GLUCOPHAGE XR 500MG TAB YES INDO METFORMIN FC 500MG TAB YES INDO METFORMIN FC 850MG TAB YES MENGEN 1000MG TAB YES MENGEN 500MG TAB YES MENGEN 850MG TAB YES MERCK-METFORMIN 500MG TAB YES METCHEK 500MG TAB YES METCHEK 850MG TAB YES METFORAL 500MG TAB YES METFORAL 850MG TAB YES METFORMIN ALKEM 500MG T YES METFORMIN ALKEM 850MG T YES METORED 1000MG TAB YES METORED 500MG TAB YES METORED 850MG TAB YES METPHAGE 500MG TAB YES METPHAGE 850MG TAB YES MYLAN METFORMIN 500MG YES MYLAN METFORMIN 850MG YES ROMIDAB 1000MG TAB YES ROMIDAB 500MG TAB YES ROMIDAB 850MG TAB YES SANDOZ METFORM 500 FC YES SANDOZ METFORM 500MG YES 4

5 SANDOZ METFORM 850 FC YES SANDOZ METFORM 850MG YES INSULIN ACTRAPHANE 10ML ACTRAPHANE PSET 3M APIDRA 10ML VIAL APIDRA 3ML CART APIDRA I OPTISET PENSET 3 APIDRA SOLO DISP PEN 3ML BIOSULIN CARTRIDGE BIOSULIN L CARTRIDGE 3ML BIOSULIN N CARTRIDGE 3ML BIOSULIN R CARTRIDGE 3ML HUMALOG 10ML HUMALOG 3ML SOL FOR IN HUMALOG MIX 25 10ML HUMALOG MIX 25 CAR 3ML HUMALOG MIX 25 PEN 3ML HUMALOG MIX 50 PEN 3ML HUMALOG PEN 3ML HUMULIN 30/70 10ML HUMULIN 30/70 3ML CART HUMULIN 30/70 PEN 3ML YES HUMULIN N 10ML HUMULIN N 3ML CART HUMULIN N PEN 3ML YES HUMULIN R 10ML HUMULIN R 3ML CART HUMULIN R PEN 3ML DISP LEVEMIR 3ML FLEXPEN LEVEMIR 3ML PREFILLED LANTUS CART 300IU/3ML 5

6 LANTUS SOLOSTAR 100IU/ML VOMIX 30 FLEXPEN 3ML VOMIX 30 PENFILL 3ML VORAPID FLEXPEN 3ML YES VORAPID PENFILL 3ML YES VORAPID 10ML INJ OPTISULIN PENS PROTAPHANE 10ML PROTAPHANE FLEXPEN 3ML *GLUCOSE METER STRIPS YES *GLUCOSE METER NEEDLES YES *GLUCOSE METER LANCETS YES 6

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