COMPREHENSIVE PMB FORMULARY 1-Dec-16

COMPREHENSIVE PMB FORMULARY 1-Dec-16 Depending on the specific scheme option, products included on this chronic medicines formulary will not attract a co-payment if authorised by Chronic Medicine Management for a disease on the CDL and obtained from the Designated Service Provider (where applicable). Reimbursement will however be subject to the Chronic Medicine Management clinical guidelines and protocols and the Medicine Price List (MPL). Please Note: Products in red are preferred formulary drugs (drugs of choice) and include information on reimbursement criteria. Products not in red i.e. products in black (non-preferred formulary drugs) are also reimbursed on the comprehensive options without a co-payment, subject to reimbursement criteria, available funds and benefit design. However, all new treatments should, wherever possible, be commenced with preferred agents. Not only are these medicines generally the most cost-effective in their class, but they are also reimbursed unlimited on all options. Where members have non-pmb benefits and/or where there are compelling indications, alternative agents for the treatment of CDL (Chronic Disease List) illnesses may be considered for pre-authorisation. KEY to Chronic Medicine Management Reimbursement Criteria for use of preferred formulary drugs: Quantity/dosage and duration of authorisation may vary - depending on the requested drug. Accepted Treatment - will be authorised without requesting additional clinical information (unless specific concerns e.g. unusual dose requests). Clinical Review - will be authorised if the drug history or co-morbidity clearly indicates that use of the drug is indicated in the specific patient. Clinical Motivation - specific clinical information required before reimbursement is considered Specialist Script - will require a relevant specialist's prescription before reimbursement is considered Specialist Motivation - will require a relevant specialist motivation before reimbursement is considered Special Investigations (SI) - results of recent relevant tests required before reimbursement is considered * : these agents are only available on more comprehensive options Nappi code Drug Name Active Ingredient Strength Drug Form Chronic Medicine Management Reimbursement Criteria for preferred formulary drugs Asthma Inhaled B2 agonists 819603 ASTHAVENT 200 DS Salbutamol 100MCG INH Accepted treatment 849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment 700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment 878219 ASTHAVENT DP Salbutamol 200MCG CPS 706544 BEROTEC HFA 200 DOSE Fenoterol 100MCG INH 791415 BRICANYL TURBOHALER Terbutaline 0.5MG INH 720748 BRICANYL 100 DOSE Terbutaline.5MG/1DOSE TBH 824623 COMBIVENT MDI Salbutamol and other drugs for obstructive airway diseases 20MCG/100MCG INH 718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH 707882 DUOVENT HFA 200DOSE aminophylline 50MCG/20MCG INH 775363 VENTEZE COMPLETE Salbutamol 100MCG INH Accepted treatment 711213 VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment 720723 VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment 703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment Long acting B2 agonists 820911 FORADIL DRY Formoterol 12MCG CPS Clinical Review 704175 FORATEC DP CAPS Formoterol 12MCG CAP Clinical Review 710307 FORATEC HFA 120DOSE Formoterol 12MCG INH Clinical Review 840246 OXIS TURBUHALER Formoterol 9MCG INH Clinical Review 818496 SEREVENT ACCUHALER Salmeterol 50MCG INH 708289 SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH 787302 SEREVENT INHAL(120) Salmeterol 25MCG INH 791695 SEREVENT INHAL(60) Salmeterol 25MCG INH Inhaled corticosteroids 705269 ALVESCO 160MCG 120 DOSE Ciclesonide 160MCG INH 705267 ALVESCO 160MCG 60 DOSE Ciclesonide 160MCG INH 705265 ALVESCO 80MCG 60 DOSE Ciclesonide 80MCG INH 717571 ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH 717581 ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH 717572 ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH

717582 ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH 827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Accepted treatment 827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Accepted treatment 819638 BECLATE INHALER Beclomethasone 100MCG INH Accepted treatment 820083 BECLATE INHALER Beclomethasone 200MCG INH Accepted treatment 819611 BECLATE INHALER Beclomethasone 50MCG INH Accepted treatment 897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Accepted treatment 897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Accepted treatment 704176 BUDEFLAM DP CAPS Budesonide 200MCG CAP Accepted treatment 720735 CICLOVENT 120 DOSE Ciclesonide 160MCG INH 720711 CICLOVENT 120 DOSES Ciclesonide 80MCG INH 721620 CICLOVENT 60 DOSE Ciclesonide 160MCG INH 721621 CICLOVENT 60 DOSE Ciclesonide 80MCG INH 818453 FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP 818461 FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP 818488 FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP 818445 FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP 703275 FLIXOTIDE 50 CFC FREE 120 ACT Fluticasone 50MCG INH 897752 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH 897759 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH 715009 FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment 715008 FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment 715007 FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment 715753 FOXAIR 25/125 120DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH Accepted treatment 715754 FOXAIR 25/250 120DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH Accepted treatment 715752 FOXAIR 25/50 120 DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH Accepted treatment 839329 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 100MCG INH Accepted treatment 839337 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 200MCG INH Accepted treatment 839310 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 50MCG INH Accepted treatment 704020 INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF Accepted treatment 704021 INFLAMMIDE 200 NOVOLIZER COMPL Budesonide 200MCG INH Accepted treatment 707879 INFLAMMIDE NOVOLIZER COMPLETE 100DOSE Budesonide 400MCG INH Accepted treatment 707881 INFLAMMIDE NOVOLIZER REFILL 100DOSE Budesonide 400MCG REF Accepted treatment 791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH Accepted treatment 791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Accepted treatment 823791 PULMICORT TURB (100 DOSE) Budesonide 400MCG ATH 715190 SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment 715191 SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment 715189 SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment 894990 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment 895006 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment 894989 SERETIDE 25/50 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment 874493 SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH Accepted treatment 874507 SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH Accepted treatment 874515 SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH Accepted treatment 700173 SYMBICORD TURBO 120 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH 705984 SYMBICORD 320/9MCG PER INHALATION Formutoterol and other anti- asthmatics 9MCG/320MCG INH 700172 SYMBICORD TURBO 60 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH 705986 SYMBICORD 80/4.5MCG PER INHALATION Formutoterol and other anti- asthmatics 4.5MCG/80MCG INH 720219 VANNAIR 160/4.5MCG PER INHALATION 120 DO formoterol and budesonide 4.5MCG/160MCG INH 720218 VANNAIR 80/4.5MCG PER INHALATION 120 DOS formoterol and budesonide 4.5MCG/80MCG INH Oral Xanthines 782769 CHRONOPHYLLIN Theophylline 250MG CAP 725005 EUPHYLLIN RETARD Theophylline 250MG SRT 743119 MICROPHYLLIN Theophylline 125MG SRC 743127 MICROPHYLLIN Theophylline 250MG SRC 748498 NUELIN Theophylline 125MG TAB 748528 NUELIN LIQUID Theophylline 25MG/5ML SYR

748501 NUELIN SA 250 Theophylline 250MG TAB 755281 PHYLLOCONTIN Aminophylline 225MG SRT 815357 PULMOPHYLLIN SR 300 Theophylline 300MG SRT Clinical Review 788368 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT Clinical Review 788376 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT Clinical Review 770388 THEOPHEN Theophylline SYR Clinical Review 783005 THEOPLUS Theophylline 200MG SRT 783013 THEOPLUS Theophylline 300MG SRT 785105 UNIPHYL Theophylline 400MG SRT 816159 UNIPHYL Theophylline 600MG SRT Oral Corticosteroids 716381 ADCO PREDNISOLONE Prednisolone 15MG/5ML LIQ Specialist script 714552 ASPELONE Prednisolone 15MG/5ML LIQ Specialist script 814407 CAPSOID Prednisolone 5MG TAB Specialist script 800155 LENISOLONE Prednisolone 5MG TAB Specialist script 742759 METICORTEN Prednisone 50MG TAB 742732 METICORTEN Prednisone 5MG TAB 752304 PANAFCORT Prednisone 5MG TAB Specialist script 788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Specialist script 700170 PREFLAM Prednisolone 15MG/5ML SYR Specialist script 703720 PRELONE Prednisolone 5MG TAB 805149 PRELONE Prednisolone 15MG/5ML SYR Specialist script 703603 PULMISON ORAL SOLUTION Prednisone 5MG/1ML SYR Specialist script 836826 PULMISON TABS Prednisone 20MG TAB 818267 TROLIC Prednisone 5MG TAB Specialist script Addison's disease Oral Corticosteroids 716693 COVOCORT Hydrocortisone 10MG TAB Accepted treatment 726540 FLORINEF ACETATE Fludrocortisone 0.1MG TAB Accepted treatment Bipolar Mood Disorder Mood Stabilizers 705441 ASPEN LAMOTRIGINE 100MG Lamotrigine 100MG TAB Accepted treatment 705436 ASPEN LAMOTRIGINE 25MG Lamotrigine 25MG TAB Accepted treatment 705440 ASPEN LAMOTRIGINE 50MG Lamotrigine 50MG TAB Accepted treatment 707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment 707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment 707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment 707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment 712078 CAMCOLIT Lithium 250MG TAB Accepted treatment 712086 CAMCOLIT Lithium 400MG TAB Accepted treatment 715980 CONVULEX Valproic acid 150MG CAP Accepted treatment 781541 CONVULEX Valproic acid 250MG/5ML SYR Accepted treatment 715999 CONVULEX Valproic acid 300MG CAP Accepted treatment 781568 CONVULEX Valproic acid 500MG CAP Accepted treatment 712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment 710389 DYNA-LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment 710390 DYNA-LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment 710387 DYNA-LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment 710388 DYNA-LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment 818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment 818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment 818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment 821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment 780545 EPILIM SUGAR FREE Valproic acid 200MG/5ML SYR Accepted treatment 718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment 718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment

718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment 721460 EPROLEP CR 200 Valproic acid 200MG SRT Accepted treatment 720762 EPROLEP CR 300 Valproic acid 300MG SRT Accepted treatment 721055 EPROLEP CR 500 Valproic acid 500MG SRT Accepted treatment 704381 EPITEC 100MG Lamotrigine 100MG TAB Accepted treatment 704382 EPITEC 200MG Lamotrigine 200MG TAB Accepted treatment 704379 EPITEC 25MG Lamotrigine 25MG TAB Accepted treatment 704380 EPITEC 50MG Lamotrigine 50MG TAB Accepted treatment 707361 LAMEPTIL Lamotrigine 100MG TAB Accepted treatment 707362 LAMEPTIL Lamotrigine 200MG TAB Accepted treatment 707359 LAMEPTIL Lamotrigine 25MG TAB Accepted treatment 707360 LAMEPTIL Lamotrigine 50MG TAB Accepted treatment 805521 LAMICTIN Lamotrigine 100MG TAB Accepted treatment 819034 LAMICTIN Lamotrigine 200MG TAB Accepted treatment 805505 LAMICTIN Lamotrigine 25MG TAB Accepted treatment 805513 LAMICTIN Lamotrigine 50MG TAB Accepted treatment 813907 LAMICTIN P100 Lamotrigine 100MG DSP Accepted treatment 704533 LAMICTIN P2 Lamotrigine 2MG DSP Accepted treatment 891716 LAMICTIN P200 Lamotrigine 200MG DSP Accepted treatment 813893 LAMICTIN P25 Lamotrigine 25MG DSP Accepted treatment 813885 LAMICTIN P5 Lamotrigine 5MG DSP Accepted treatment 891708 LAMICTIN P50 Lamotrigine 50MG DSP Accepted treatment 710887 LAMIDUS Lamotrigine 100MG TAB Accepted treatment 710888 LAMIDUS Lamotrigine 200MG TAB Accepted treatment 710885 LAMIDUS Lamotrigine 50MG TAB Accepted treatment 704488 LAMITOR Lamotrigine 100MG TAB Accepted treatment 704486 LAMITOR Lamotrigine 25MG TAB Accepted treatment 704487 LAMITOR Lamotrigine 50MG TAB Accepted treatment 712217 LAMITOR Lamotrigine 200MG TAB Accepted treatment 718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment 718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment 718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment 720026 VANAPRO Valproic acid 300MG SRT Accepted treatment 720027 VANAPRO Valproic acid 500MG SRT Accepted treatment 758833 QUILONUM RETARD Lithium 450MG TAB Accepted treatment 712523 ROLAB-CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment 705597 SANDOZ CARBAMAZEPINE CR200 Carbamazepine 200MG SRT Accepted treatment 705602 SANDOZ CARBAMAZIPINE CR400 Carbamazepine 400MG SRT Accepted treatment 705248 SANDOZ LAMOTRIGINE Lamotrigine 100MG TAB Accepted treatment 705249 SANDOZ LAMOTRIGINE Lamotrigine 200MG TAB Accepted treatment 705251 SANDOZ LAMOTRIGINE Lamotrigine 25MG TAB Accepted treatment 705250 SANDOZ LAMOTRIGINE Lamotrigine 50MG TAB Accepted treatment 769398 TEGRETOL Carbamazepine 200MG TAB 779652 TEGRETOL CR Carbamazepine 200MG SRT Accepted treatment 779660 TEGRETOL CR Carbamazepine 400MG SRT Accepted treatment 769401 TEGRETOL S Carbamazepine 100MG/5ML SUS Accepted treatment 715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment Antipsychotic agents 720687 ADCO OLANZAPINE Olanzapine 2.5MG TAB 720691 ADCO OLANZAPINE Olanzapine 5MG TAB 720692 ADCO OLANZAPINE Olanzapine 10MG TAB 721653 ZYLENA Olanzapine 10MG TAB 721652 ZYLENA Olanzapine 5MG TAB 712192 ABILIFY 5MG Aripiprazole 5MG TAB 705634 ABILIFY 10MG Aripiprazole 10MG TAB 705635 ABILIFY 15MG Aripiprazole 15MG TAB 705636 ABILIFY 30MG Aripiprazole 30MG TAB 717082 ASPEN CLOZAPINE Clozapine 100MG TAB Accepted treatment (clinical motivation for low-cost options)

717081 ASPEN CLOZAPINE Clozapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 711471 ASPEN RISPERIDONE Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 711472 ASPEN RISPERIDONE Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 711473 ASPEN RISPERIDONE Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 711474 ASPEN RISPERIDONE Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 711475 ASPEN RISPERIDONE Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 716500 AUROPERDAL Risperidone.5MG TAB Accepted treatment (clinical motivation for low-cost options) 716501 AUROPERDAL Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 716502 AUROPERDAL Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 716503 AUROPERDAL Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 716504 AUROPERDAL Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 714686 AUROPIDONE Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 714687 AUROPIDONE Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 714688 AUROPIDONE Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 714689 AUROPIDONE Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 714690 AUROPIDONE Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 705386 BIO-SULPIRIDE Sulpiride 200MG TAB Accepted treatment 700178 CLOMENT Clozapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 700176 CLOMENT Clozapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 789798 CLOPIXOL Zuclopenthixol 10MG TAB 796751 CLOPIXOL Zuclopenthixol 2MG TAB 714852 CLOPIXOL DEPOT Zuclopenthixol 200MG/1ML INJS Accepted treatment 705844 CLOZAPINE-HEXAL Clozapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 716051 DOPAQUEL Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 716052 DOPAQUEL Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 716050 DOPAQUEL Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 716053 DOPAQUEL Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 712212 DRL RISPERIDONE Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 712211 DRL RISPERIDONE Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 712210 DRL RISPERIDONE Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 712209 DRL RISPERIDONE Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 726656 FLUANXOL Flupentixol.5MG TAB 726664 FLUANXOL Flupentixol 1MG TAB 726672 FLUANXOL DEPOT 1ML Flupentixol 20MG/1ML INJS Accepted treatment 703465 GEODON Ziprasidone 20MG CAP 703468 GEODON Ziprasidone 40MG CAP 703475 GEODON Ziprasidone 60MG CAP 703476 GEODON Ziprasidone 80MG CAP 719549 GULF HALOPERIDOL Haloperidol 5MG TAB Accepted treatment 715666 INVEGA Paliperidone 3MG SRT 715667 INVEGA Paliperidone 6MG SRT 715668 INVEGA Paliperidone 9MG SRT 720529 LANAZYP Olanzapine 10MG TAB 720527 LANAZYP Olanzapine 2.5MG TAB 720528 LANAZYP Olanzapine 5MG TAB 735884 LARGACTIL Chlorpromazine 100MG TAB Accepted treatment 735868 LARGACTIL Chlorpromazine 25MG TAB Accepted treatment 735876 LARGACTIL Chlorpromazine 50MG TAB Accepted treatment 736716 LEPONEX Clozapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 736708 LEPONEX Clozapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 718997 MYLAN OLANZAPINE Olanzapine 10MG TAB 718995 MYLAN OLANZAPINE Olanzapine 2.5MG TAB 718996 MYLAN OLANZAPINE Olanzapine 5MG TAB 716670 MYLAN QUETIAPINE Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 716671 MYLAN QUETIAPINE Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 716668 MYLAN QUETIAPINE Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 716672 MYLAN QUETIAPINE Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 712191 MYLAN RISPERIDONE Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options)

712190 MYLAN RISPERIDONE Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 712189 MYLAN RISPERIDONE Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 744301 MODECATE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment 744328 MODECATE+SYRINGE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment 715996 OLEANZ Olanzapine 10MG TAB 715994 OLEANZ Olanzapine 2.5MG TAB 715995 OLEANZ Olanzapine 5MG TAB 715968 OLEANZ RAPITAB Olanzapine 10MG MLT 715967 OLEANZ RAPITAB Olanzapine 5MG MLT 715659 OLEXAR Olanzapine 10MG TAB 715657 OLEXAR Olanzapine 2.5MG TAB 715658 OLEXAR Olanzapine 5MG TAB 721389 OLAWIN Olanzapine 10MG TAB 721385 OLAWIN Olanzapine 2.5MG TAB 721388 OLAWIN Olanzapine 5MG TAB 721390 OLAWIN ORADISPERSIBLE Olanzapine 10MG MLT 721386 OLAWIN ORADISPERSIBLE Olanzapine 5MG MLT 720981 KIZOFRIN Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 720979 KIZOFRIN Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 720980 KIZOFRIN Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 720982 KIZOFRIN Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 721745 QUETIAPINE BIOTECH Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 721746 QUETIAPINE BIOTECH Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 721744 QUETIAPINE BIOTECH Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 721747 QUETIAPINE BIOTECH Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 720894 SPEC QUETIAPINE Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 721710 SPEC QUETIAPINE Quetiapine 150MG TAB Accepted treatment (clinical motivation for low-cost options) 720896 SPEC QUETIAPINE Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 720893 SPEC QUETIAPINE Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 720897 SPEC QUETIAPINE Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 751073 ORAP Pimozide 1MG TAB 751081 ORAP Pimozide 4MG TAB 712617 PERIZAL Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 712618 PERIZAL Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 712619 PERIZAL Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 712621 PERIZAL Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 720334 PERIDA Risperidone.5MG TAB Accepted treatment (clinical motivation for low-cost options) 720335 PERIDA Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 719807 PREXOLAN ODT Olanzapine 10MG MLT 719806 PREXOLAN ODT Olanzapine 5MG MLT 720714 PREXOLAN Olanzapine 10MG TAB 720712 PREXOLAN Olanzapine 2.5MG TAB 720713 PREXOLAN Olanzapine 5MG TAB 718353 PSYQUET Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 718354 PSYQUET Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 718352 PSYQUET Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 718355 PSYQUET Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 716636 QUETOSER Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 716637 QUETOSER Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 716635 QUETOSER Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 716638 QUETOSER Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 715685 REDILANZ Olanzapine 10MG TAB 715683 REDILANZ Olanzapine 2.5MG TAB 715684 REDILANZ Olanzapine 5MG TAB 717996 RISNIA Risperidone.5MG TAB Accepted treatment (clinical motivation for low-cost options) 717997 RISNIA Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 717998 RISNIA Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 717999 RISNIA Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options)

714101 RISPACOR Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 713967 RISPACOR Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 713966 RISPACOR Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 713965 RISPACOR Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 713964 RISPACOR Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 891523 RISPERDAL Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 828432 RISPERDAL Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 801860 RISPERDAL Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 801879 RISPERDAL Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 705474 RISPERDAL CONSTA Risperidone 25MG VIAL Specialist motivation 705475 RISPERDAL CONSTA Risperidone 37.5MG VIAL Specialist motivation 705476 RISPERDAL CONSTA Risperidone 50MG VIAL Specialist motivation 710790 RISPERIDONE HEXAL Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 710791 RISPERIDONE HEXAL Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 710793 RISPERIDONE HEXAL Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 711419 RISPERLET Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 711420 RISPERLET Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 711421 RISPERLET Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 718226 RISPEVON Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 718227 RISPEVON Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 718228 RISPEVON Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 718229 RISPEVON Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 711537 RISPONZ Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 711534 RISPONZ Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 711536 RISPONZ Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 711538 RISPONZ Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 730335 ROLAB-HALOPERIDOL Haloperidol 1.5MG TAB Accepted treatment 730327 ROLAB-HALOPERIDOL Haloperidol 5MG TAB Accepted treatment 715736 SCHIZOROL Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 715737 SCHIZOROL Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 715738 SCHIZOROL Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 763411 SERENACE Haloperidol 0.5MG CAP Accepted treatment 763446 SERENACE Haloperidol 1.5MG TAB Accepted treatment 763535 SERENACE Haloperidol 10MG TAB Accepted treatment 763454 SERENACE Haloperidol 5MG TAB Accepted treatment 716652 SEREZ Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 716653 SEREZ Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 716651 SEREZ Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 716654 SEREZ Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 850535 SEROQUEL Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 850543 SEROQUEL Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 850527 SEROQUEL Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 703344 SEROQUEL Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 713747 SEROQUEL XR Quetiapine 50MG SRT 717404 SEROQUEL XR Quetiapine 150MG SRT 713748 SEROQUEL XR Quetiapine 200MG SRT 713749 SEROQUEL XR Quetiapine 300MG SRT 713750 SEROQUEL XR Quetiapine 400MG SRT 718704 SIZONORM Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 718705 SIZONORM Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options) 718674 SIZONORM Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 718706 SIZONORM Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 892310 SOLIAN Amisulpride 200MG TAB 892309 SOLIAN Amisulpride 50MG TAB 766410 STELAZINE Trifluoperazine 1MG TAB Accepted treatment 766437 STELAZINE Trifluoperazine 5MG TAB Accepted treatment 716647 TRUVALIN Quetiapine 100MG TAB Accepted treatment (clinical motivation for low-cost options) 716648 TRUVALIN Quetiapine 200MG TAB Accepted treatment (clinical motivation for low-cost options)

716646 TRUVALIN Quetiapine 25MG TAB Accepted treatment (clinical motivation for low-cost options) 716649 TRUVALIN Quetiapine 300MG TAB Accepted treatment (clinical motivation for low-cost options) 718469 XEPLION PREFILLED SYRINGE 0.5ML Paliperidone 50MG/.5ML INJ Specialist motivation 718470 XEPLION PREFILLED SYRINGE 0.75ML Paliperidone 75MG/.75ML INJ Specialist motivation 718472 XEPLION PREFILLED SYRINGE 1.5ML Paliperidone 150MG/1.5ML INJ Specialist motivation 718471 XEPLION PREFILLED SYRINGE 1ML Paliperidone 100MG/1ML INJ Specialist motivation 711511 ZOXADON Risperidone 0.5MG TAB Accepted treatment (clinical motivation for low-cost options) 711512 ZOXADON Risperidone 1MG TAB Accepted treatment (clinical motivation for low-cost options) 711513 ZOXADON Risperidone 2MG TAB Accepted treatment (clinical motivation for low-cost options) 721750 ZOXADON Risperidone 3MG TAB Accepted treatment (clinical motivation for low-cost options) 721752 ZOXADON Risperidone 4MG TAB Accepted treatment (clinical motivation for low-cost options) 827517 ZYPREXA Olanzapine 10MG TAB 864188 ZYPREXA Olanzapine 2.5MG TAB 827509 ZYPREXA Olanzapine 5MG TAB Antidepressants 704904 ADCO-PAROXETINE Paroxetine 20MG TAB 703391 A-LENNON FLUOXETINE Fluoxetine 20MG CAP Accepted treatment 791571 AROPAX Paroxetine 20MG TAB 703219 AROPAX 30 Paroxetine 30MG TAB 704647 AROPAX CR Paroxetine 12.5MG SRT 704646 AROPAX CR Paroxetine 25MG SRT 713583 ARROW CITALOPRAM Citalopram 20MG TAB Accepted treatment 713584 ARROW CITALOPRAM Citalopram 40MG TAB Accepted treatment 713356 AURO-CITALOPRAM Citalopram 20MG TAB Accepted treatment 718058 AURO PAROXETINE Paroxetine 20MG TAB 707396 AUSTELL-CITALOPRAM Citalopram 10MG TAB Accepted treatment 707398 AUSTELL-CITALOPRAM Citalopram 20MG TAB Accepted treatment 707397 AUSTELL-CITALOPRAM Citalopram 40MG TAB Accepted treatment 707399 AUSTELL-PAROXETINE Paroxetine 20MG TAB 707400 AUSTELL-PAROXETINE Paroxetine 30MG TAB 717094 BIO CITALOPRAM Citalopram 20MG TAB Accepted treatment 707888 CILATE Citalopram 20MG TAB Accepted treatment 700157 CILIFT Citalopram 20MG TAB Accepted treatment 711988 CILORAM Citalopram 20MG TAB Accepted treatment 810622 CIPRAMIL Citalopram 20MG TAB Accepted treatment 704331 CITALOHEXAL Citalopram 20MG TAB Accepted treatment 716521 CITALOPRAM ACTOR Citalopram 20MG TAB Accepted treatment 709407 CITALOPRAM-WINTHROP Citalopram 20MG TAB Accepted treatment 709644 CITALOPRAM-WINTHROP Citalopram 40MG TAB Accepted treatment 704792 DEPAROC Paroxetine 20MG TAB 704328 DEPRAMIL 20MG Citalopram 20MG TAB Accepted treatment 705252 DEPRAMIL Citalopram 40MG TAB Accepted treatment 894303 DEPROZAN Fluoxetine 20MG CAP Accepted treatment 713445 DRL CITALOPRAM Citalopram 20MG TAB Accepted treatment 713757 DRL CITALOPRAM Citalopram 40MG TAB Accepted treatment 724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment 724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment 716520 FLUOXETINE ACTOR Fluoxetine 20MG CAP Accepted treatment 717372 GLENMARK CITALOPRAM Citalopram 20MG TAB Accepted treatment 718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment 707386 HEXAL-PAROXETINE Paroxetine 20MG TAB 735795 LANTANON Mianserin 10MG TAB 735817 LANTANON Mianserin 30MG TAB 820016 LILLY-FLUOXETINE Fluoxetine 20MG CAP Accepted treatment 821063 LORIEN Fluoxetine 20MG CAP Accepted treatment 700877 LORIEN 20MG Fluoxetine 20MG TAB Accepted treatment 840653 NUZAK Fluoxetine 20MG CAP Accepted treatment 705186 PARAX 20 Paroxetine 20MG TAB

716745 PAROXETINE UNICORN Paroxetine 20MG TAB 705417 MERCK-CITALOPRAM 20 Citalopram 20MG TAB Accepted treatment 704794 PAXIL 20 Paroxetine 20MG TAB 879282 PROHEXAL Fluoxetine 20MG CAP Accepted treatment 894243 PROHEXAL 20T Fluoxetine 20MG DSP Accepted treatment 894249 PROHEXAL 40T Fluoxetine 40MG DSP Accepted treatment 719658 PROLAX Fluoxetine 20MG CAP Accepted treatment 757888 PROTHIADEN Dothiepin 25MG CAP Accepted treatment 822981 PROZAC Fluoxetine 20MG TAB Accepted treatment 757969 PROZAC 20 Fluoxetine 20MG CAP Accepted treatment 700686 RANFLOCS Fluoxetine 20MG CAP Accepted treatment 707426 REZAK Fluoxetine 20MG CAP Accepted treatment 784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment 838713 ROLAB-FLUOXETINE Fluoxetine 20MG CAP Accepted treatment 704590 SANDOZ CITALOPRAM Citalopram 20MG TAB Accepted treatment 704721 SANDOZ PAROXETINE Paroxetine 20MG TAB 705122 SERRAPRESS 20 Paroxetine 20MG TAB 707304 SIMAYLA CITALOPRAM Citalopram 20MG TAB Accepted treatment 702769 TALOMIL Citalopram 20MG TAB Accepted treatment 717561 TEXINE Paroxetine 20MG TAB 800198 THADEN Dothiepin 25MG CAP Accepted treatment 800201 THADEN Dothiepin 75MG TAB Accepted treatment 771120 TOFRANIL Imipramine 10MG TAB Accepted treatment 771139 TOFRANIL Imipramine 25MG TAB Accepted treatment 772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment 771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment 705174 TRIZAC Fluoxetine 20MG CAP Accepted treatment 772860 TRYPTANOL Amitriptyline 25MG TAB Accepted treatment 705633 XET 20MG Paroxetine 20MG TAB 705064 ZYDUS FLUOXETINE Fluoxetine 20MG CAP Accepted treatment 711911 ZYDUS-PAROXETINE Paroxetine 20MG TAB Bronchiectasis Antibiotic therapy will be evaluated on an individual basis Chronic Obstructive Pulmonary Disease Inhaled B2 agonists 819603 ASTHAVENT 200 DS Salbutamol 100MCG INH Accepted treatment 849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment 700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment 878219 ASTHAVENT DP Salbutamol 200MCG CPS 706544 BEROTEC HFA 200 DOSE Fenoterol 100MCG INH 791415 BRICANYL TURBOHALER Terbutaline 0.5MG INH 720748 BRICANYL 100 DOSE Terbutaline.5MG/1DOSE TBH 824623 COMBIVENT MDI Salbutamol and other drugs for obstructive airway diseases 20MCG/100MCG INH 718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH 707882 DUOVENT HFA 200DOSE Fenoterol and ipratropium bromide 50MCG/20MCG INH 775363 VENTEZE COMPLETE Salbutamol 100MCG INH Accepted treatment 711213 VENTEZE CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment 720723 VENTIMAX CFC FREE 200 DOSE Salbutamol 100MCG INH Accepted treatment 703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment Long acting B2 agonists 820911 FORADIL DRY Formoterol 12MCG CPS 704175 FORATEC DP CAPS Formoterol 12MCG CAP 710307 FORATEC HFA 120DOSE Formoterol 12MCG INH 717402 ONBREZ BREEZHALER (30 CAPS & INHALER) Indacaterol KIT 840246 OXIS TURBUHALER Formoterol 9MCG INH 818496 SEREVENT ACCUHALER Salmeterol 50MCG INH

708289 SEREVENT CFC-FREE 120DOSE Salmeterol 25MCG INH 787302 SEREVENT INHAL(120) Salmeterol 25MCG INH 791695 SEREVENT INHAL(60) Salmeterol 25MCG INH Inhaled corticosteroids 705269 ALVESCO 160MCG 120 DOSE Ciclesonide 160MCG INH 705267 ALVESCO 160MCG 60 DOSE Ciclesonide 160MCG INH 705265 ALVESCO 80MCG 60 DOSE Ciclesonide 80MCG INH 717571 ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH 717581 ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH 717572 ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH 717582 ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH 827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Special Investigations (SI) 827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Special Investigations (SI) 819638 BECLATE INHALER Beclomethasone 100MCG INH Special Investigations (SI) 820083 BECLATE INHALER Beclomethasone 200MCG INH Special Investigations (SI) 819611 BECLATE INHALER Beclomethasone 50MCG INH Special Investigations (SI) 897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Special Investigations (SI) 897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Special Investigations (SI) 704176 BUDEFLAM DP CAPS Budesonide 200MCG CAP Special Investigations (SI) 720735 CICLOVENT 120 DOSE Ciclesonide 160MCG INH 720711 CICLOVENT 120 DOSES Ciclesonide 80MCG INH 721620 CICLOVENT 60 DOSE Ciclesonide 160MCG INH 721621 CICLOVENT 60 DOSE Ciclesonide 80MCG INH 818453 FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP 818461 FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP 818488 FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP 818445 FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP 703275 FLIXOTIDE 50 CFC FREE 120 ACT Fluticasone 50MCG INH 897752 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH 897759 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH 715009 FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH Special Investigations (SI) 715008 FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH Special Investigations (SI) 715007 FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH Special Investigations (SI) 715753 FOXAIR 25/125 120DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH Special Investigations (SI) 715754 FOXAIR 25/250 120DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH Special Investigations (SI) 715752 FOXAIR 25/50 120 DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH Special Investigations (SI) 839329 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 100MCG INH Special Investigations (SI) 839337 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 200MCG INH Special Investigations (SI) 839310 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 50MCG INH Special Investigations (SI) 704020 INFLAMMIDE 200 NOVOLIZE REFIL Budesonide 200MCG REF Special Investigations (SI) 704021 INFLAMMIDE 200 NOVOLIZER COMPL Budesonide 200MCG INH Special Investigations (SI) 707879 INFLAMMIDE NOVOLIZER COMPLETE 100DOSE Budesonide 400MCG INH Special Investigations (SI) 707881 INFLAMMIDE NOVOLIZER REFILL 100DOSE Budesonide 400MCG REF Special Investigations (SI) 791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH Special Investigations (SI) 791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Special Investigations (SI) 823791 PULMICORT TURB (100 DOSE) Budesonide 400MCG ATH 715190 SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Special Investigations (SI) 715191 SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Special Investigations (SI) 715189 SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Special Investigations (SI) 894990 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Special Investigations (SI) 895006 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Special Investigations (SI) 894989 SERETIDE 25/50 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Special Investigations (SI) 874493 SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH Special Investigations (SI) 874507 SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH Special Investigations (SI) 874515 SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH Special Investigations (SI) 700173 SYMBICORD TURBO 120 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH 705984 SYMBICORD 320/9MCG PER INHALATION Formutoterol and other anti- asthmatics 9MCG/320MCG INH 700172 SYMBICORD TURBO 60 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH

705986 SYMBICORD 80/4.5MCG PER INHALATION Formutoterol and other anti- asthmatics 4.5MCG/80MCG INH 720219 VANNAIR 160/4.5MCG PER INHALATION 120 DO formoterol and budesonide 4.5MCG/160MCG INH 720218 VANNAIR 80/4.5MCG PER INHALATION 120 DOS formoterol and budesonide 4.5MCG/80MCG INH Anticholinergic inhalers (short acting) 706543 ATROVENT HFA 200 DOSE Ipratropium bromide 20MCG INH Accepted treatment 715574 IPVENT HFA 200 DOSE Ipratropium bromide 40MCG/1DOSE INH Accepted treatment Oral Xanthines 782769 CHRONOPHYLLIN Theophylline 250MG CAP 725005 EUPHYLLIN RETARD Theophylline 250MG SRT 743119 MICROPHYLLIN Theophylline 125MG SRC 743127 MICROPHYLLIN Theophylline 250MG SRC 748498 NUELIN Theophylline 125MG TAB 748501 NUELIN SA 250 Theophylline 250MG TAB 755281 PHYLLOCONTIN Aminophylline 225MG SRT 815357 PULMOPHYLLIN SR 300 Theophylline 300MG SRT Accepted treatment 788368 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT Accepted treatment 788376 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT Accepted treatment 783005 THEOPLUS Theophylline 200MG SRT 783013 THEOPLUS Theophylline 300MG SRT 785105 UNIPHYL Theophylline 400MG SRT 816159 UNIPHYL Theophylline 600MG SRT Oral Corticosteroids 814407 CAPSOID Prednisolone 5MG TAB Special Investigations (SI) 800155 LENISOLONE Prednisolone 5MG TAB Special Investigations (SI) 742759 METICORTEN Prednisone 50MG TAB 742732 METICORTEN Prednisone 5MG TAB 752304 PANAFCORT Prednisone 5MG TAB 788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Special Investigations (SI) 703720 PRELONE Prednisolone 5MG TAB 836826 PULMISON TABS Prednisone 20MG TAB 818267 TROLIC Prednisone 5MG TAB Special Investigations (SI) Cardiac failure/ Cardiomyopathy Anticoagulants 778362 WARFARIN Warfarin 5MG TAB Accepted treatment 709906 CIPLA WARFARIN 1MG Warfarin 1MG TAB Accepted treatment 712390 CIPLA-WARFARIN Warfarin 3MG TAB Accepted treatment 709905 CIPLA WARFARIN 5MG Warfarin 5MG TAB Accepted treatment Diuretics 780618 ADCO-RETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment 701807 ALDACTONE Spironolactone 100MG TAB 701793 ALDACTONE Spironolactone 25MG APP Accepted treatment 702803 AMILORETIC Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment 702811 AMILORETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment 807796 ARELIX Piretanide 3MG TAB 807818 ARELIX Piretanide 6MG TAB 707423 AUSTELL-FUROSEMIDE Furosemide 40MG TAB Accepted treatment 707421 AUSTELL-FUROSEMIDE Furosemide 20MG TAB Accepted treatment 808695 BETARETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment 821845 BEURISES Furosemide 40MG TAB Accepted treatment 711152 BURINEX Bumetanide 1MG TAB 711160 BURINEX K Bumetanide and potassium TAB 700820 CATEXAN 2.5MG Indapamide 2.5MG TAB Accepted treatment 710313 CIPLA-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment 819417 DAPAMAX Indapamide 2.5MG TAB Accepted treatment 833045 DAPTRIL Indapamide 2.5MG TAB Accepted treatment 719984 DEZRETIC 5MG/50MG Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment 716048 DINO-RETIC Furosemide 40MG TAB Accepted treatment

705967 DIURESIX Furosemide 40MG TAB Accepted treatment 721824 DYAZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment 716962 DYNA INDAPAMIDE SR Indapamide 1.5MG SRT 890470 HEXAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment 822825 HYDRO-LESS Indapamide 2.5MG TAB Accepted treatment 735930 LASIX Furosemide 20MG TAB 735949 LASIX Furosemide 40MG TAB 735957 LASIX Furosemide 500MG TAB 839515 LASIX ORAL Furosemide 10MG/1ML SLN Clinical review 857769 MYLAN FUROSEMIDE Furosemide 40MG TAB Accepted treatment 703329 MYLAN-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment 744379 MODURETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment 746002 NATRILIX Indapamide 2.5MG TAB Accepted treatment 830836 NATRILIX SR Indapamide 1.5MG SRT 758272 PURESIS Furosemide 40MG TAB 780146 RENEZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment 880949 RIDAQ Hydrochlorothiazide 25MG TAB Accepted treatment 710437 RIDAQ Hydrochlorothiazide 12.5MG TAB Accepted treatment 702951 ROLAB-AMILORIDE HCL/HYDROCHLOROTHIAZIDE Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment 731668 ROLAB-FUROSEMIDE Furosemide 40MG TAB Accepted treatment 831026 ROLAB-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment 769665 ROLAB-SPIRONOLACTONE Spironolactone 25MG TAB Accepted treatment 706531 SPEC-CO-AMILORIDE Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment 898937 SPIRACTIN Spironolactone 100MG TAB 765910 SPIRACTIN Spironolactone 25MG TAB Accepted treatment 707191 TORAHEXAL Torasemide 10MG TAB 707189 TORAHEXAL Torasemide 2.5MG TAB 707190 TORAHEXAL Torasemide 5MG TAB 820369 UNAT Torasemide 2.5MG TAB 820377 UNAT Torasemide 5MG TAB 820385 UNAT Torasemide 10MG TAB 774057 URIREX-K Hydrochlorothiazide and potassium TAB Accepted treatment Potassium supplementation 735353 KLOREF Potassium chloride 500MG EEF 755753 PLENISH K Potassium chloride 600MG TAB Accepted treatment 719270 POTASSIUM CHLORIDE UNICORN Potassium chloride 600MG TAB Accepted treatment 702947 SANDOZ K-600 Potassium chloride 600MG TAB Accepted treatment 764396 SLOW-K Potassium chloride 600MG TAB Accepted treatment 718911 ULTIPOT Potassium chloride 600MG TAB Accepted treatment 768227 SWISS-KAL SR Potassium chloride SRT ACE inhibitors 708119 ACCUMAX Quinapril 10MG TAB Accepted treatment 708120 ACCUMAX Quinapril 20MG TAB Accepted treatment 783293 ACCUPRIL Quinapril 5MG TAB 783307 ACCUPRIL Quinapril 10MG TAB Accepted treatment 783315 ACCUPRIL Quinapril 20MG TAB Accepted treatment 853186 ACCUPRIL Quinapril 40MG TAB 715649 ACESYL Perindopril 4MG TAB 852333 BIO-CAPTOPRIL Captopril 25MG TAB Accepted treatment 714869 ACTI-PREX (GLENMARK PERINDOPRIL) Perindopril 4MG TAB 721626 AUSTELL ENALAPRIL Enalapril 10MG TAB Accepted treatment 721627 AUSTELL ENALAPRIL Enalapril 20MG TAB Accepted treatment 721625 AUSTELL ENALAPRIL Enalapril 5MG TAB Accepted treatment 886843 ADCO-ENALAPRIL 10MG Enalapril 10MG TAB Accepted treatment 886851 ADCO-ENALAPRIL 20MG Enalapril 20MG TAB Accepted treatment 881481 ALAPREN 10 Enalapril 10MG TAB Accepted treatment 881503 ALAPREN 20 Enalapril 20MG TAB Accepted treatment 881473 ALAPREN 5 Enalapril 5MG TAB Accepted treatment

715957 APEX-RAMIPRIL Ramipril 10MG CAP 715954 APEX-RAMIPRIL Ramipril 2.5MG CAP 715955 APEX-RAMIPRIL Ramipril 5MG CAP 711161 ARROW RAMIPRIL Ramipril 5MG TAB 711162 ARROW RAMIPRIL Ramipril 10MG TAB 715938 APEX-LISINOPRIL Lisinopril 20MG TAB Accepted treatment 714678 AURO-LISINOPRIL Lisinopril 10MG TAB Accepted treatment 714679 AURO-LISINOPRIL Lisinopril 20MG TAB Accepted treatment 714677 AURO-LISINOPRIL Lisinopril 5MG TAB Accepted treatment 716505 AURO PERINDOPRIL Perindopril 4MG TAB 716506 AURO PERINDOPRIL Perindopril 8MG TAB 704354 AUSTELL LISINOPRIL 2.5MG Lisinopril 2.5MG TAB Accepted treatment 712598 AUSTELL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment 708189 AUSTELL LISINOPRIL 20MG Lisinopril 20MG TAB Accepted treatment 705752 AUSTELL-RAMIPRIL 1.25MG Ramipril 1.25MG CAP 705755 AUSTELL-RAMIPRIL 10MG Ramipril 10MG CAP 705753 AUSTELL-RAMIPRIL 2.5MG Ramipril 2.5MG CAP 705754 AUSTELL-RAMIPRIL 5MG Ramipril 5MG CAP 717293 BINDACE Perindopril 4MG TAB 717294 BINDACE Perindopril 8MG TAB 795267 CAPACE Captopril 25MG TAB Accepted treatment 837628 CAPTOHEXAL Captopril 12.5MG TAB Accepted treatment 837636 CAPTOHEXAL Captopril 25MG TAB Accepted treatment 837644 CAPTOHEXAL Captopril 50MG TAB Accepted treatment 836451 CAPTOMAX Captopril 25MG TAB Accepted treatment 836478 CAPTOMAX Captopril 50MG TAB Accepted treatment 794058 CIBACE Benazepril 10MG TAB 710302 CIPLA-PERINDOPRIL Perindopril 4MG TAB 710510 CIPLA-PERINDOPRIL Perindopril 8MG TAB 715786 CIPLASYL Perindopril 4MG TAB 715795 CIPLASYL Perindopril 8MG TAB 894324 CIPLATEC 10 Enalapril 10MG TAB Accepted treatment 701729 CIPLATEC 20MG Enalapril 20MG TAB Accepted treatment 894316 CIPLATEC 5 Enalapril 5MG TAB Accepted treatment 785121 COVERSYL Perindopril 4MG TAB 705915 COVERSYL Perindopril 10MG TAB 891279 ENAP 10MG Enalapril 10MG TAB Accepted treatment 891280 ENAP 20MG Enalapril 20MG TAB Accepted treatment 891272 ENAP 5MG Enalapril 5MG TAB Accepted treatment 712763 ENVAS Enalapril 10MG TAB Accepted treatment 712762 ENVAS Enalapril 5MG TAB Accepted treatment 701392 HEXAL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment 701394 HEXAL-LISINOPRIL Lisinopril 20MG TAB Accepted treatment 701387 HEXAL-LISINOPRIL Lisinopril 5MG TAB Accepted treatment 867853 HR-ENALAPRIL 10 Enalapril 10MG TAB Accepted treatment 867861 HR-ENALAPRIL 20 Enalapril 20MG TAB Accepted treatment 867845 HR-ENALAPRIL 5 Enalapril 5MG TAB Accepted treatment 862622 HYPACE Enalapril 5MG TAB Accepted treatment 792756 INHIBACE Cilazapril 5MG TAB 716794 LYSIN Lisinopril 10MG TAB Accepted treatment 716792 LYSIN Lisinopril 5MG TAB Accepted treatment 805068 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 2MG CAP 805033 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 0.5MG CAP 852619 MYLAN CAPTOPRIL Captopril 25MG TAB Accepted treatment 899429 MYLAN-CAPTOPRIL Captopril 50MG TAB Accepted treatment 705450 MYLAN-FOSINOPRIL 10 Fosinopril 10MG TAB 705453 MYLAN-FOSINOPRIL 20 Fosinopril 20MG TAB 791954 MONOPRIL Fosinopril 10MG TAB

791962 MONOPRIL Fosinopril 20MG TAB 714527 PEARINDA Perindopril 4MG TAB 714528 PEARINDA Perindopril 8MG TAB 717783 PERINDOPRIL UNICORN Perindopril 4MG TAB 717784 PERINDOPRIL UNICORN Perindopril 8MG TAB 721339 PERISTAR Perindopril 4MG TAB 721340 PERISTAR Perindopril 8MG TAB 708109 PHARMAPRESS Enalapril 5MG TAB Accepted treatment 868914 PHARMAPRESS Enalapril 10MG TAB Accepted treatment 868922 PHARMAPRESS Enalapril 20MG TAB Accepted treatment 703541 PREXUM Perindopril 4MG TAB 720387 PREXUM Perindopril 5MG TAB 714646 PREXUM Perindopril 10MG TAB 711171 QUINACE Quinapril 10MG TAB Accepted treatment 711172 QUINACE Quinapril 20MG TAB Accepted treatment 708981 QUINAGEN Quinapril 5MG TAB 708982 QUINAGEN Quinapril 10MG TAB Accepted treatment 708983 QUINAGEN Quinapril 20MG TAB Accepted treatment 708985 QUINAGEN Quinapril 40MG TAB 705457 QUINASPEN 10MG Quinapril 10MG TAB Accepted treatment 705447 QUINASPEN 20MG Quinapril 20MG TAB Accepted treatment 704374 RAMIPRIL HEXAL Ramipril 2.5MG TAB 704375 RAMIPRIL HEXAL Ramipril 5MG TAB 704022 RAMIWIN Ramipril 1.25MG CAP 704023 RAMIWIN Ramipril 2.5MG CAP 704025 RAMIWIN Ramipril 5MG CAP 705426 RAMPIL 1.25MG Ramipril 1.25MG CAP 705429 RAMPIL 10MG Ramipril 10MG CAP 705427 RAMPIL 2.5MG Ramipril 2.5MG CAP 705428 RAMPIL 5MG Ramipril 5MG CAP 710611 RAN-PERINDOPRIL Perindopril 4MG TAB 704975 RAN RAMIPRIL Ramipril 10MG CAP 759783 RENITEC Enalapril 10MG TAB Accepted treatment 810355 RENITEC Enalapril 2.5MG TAB Accepted treatment 759767 RENITEC Enalapril 20MG TAB Accepted treatment 759759 RENITEC Enalapril 5MG TAB Accepted treatment 707383 RETACE Ramipril 2.5MG TAB 707385 RETACE Ramipril 5MG TAB 706238 RILACE Ramipril 2.5MG CAP 706237 RILACE Ramipril 5MG CAP 706239 RILACE Ramipril 10MG CAP 850896 ROLAB-CAPTOPRIL Captopril 25MG TAB Accepted treatment 850918 ROLAB-CAPTOPRIL Captopril 50MG TAB Accepted treatment 707311 SIMAYLA LISINOPRIL Lisinopril 10MG TAB Accepted treatment 707312 SIMAYLA LISINOPRIL Lisinopril 20MG TAB Accepted treatment 707869 SIMAYLA RAMIPRIL Ramipril 10MG CAP 700692 SINOPREN 10 Lisinopril 10MG TAB Accepted treatment 700694 SINOPREN 20 Lisinopril 20MG TAB Accepted treatment 700691 SINOPREN 5 Lisinopril 5MG TAB Accepted treatment 712615 SPEC-PERINDOPRIL Perindopril 4MG TAB 712616 SPEC-PERINDOPRIL Perindopril 8MG TAB 841579 TRITACE Ramipril 1.25MG TAB 841587 TRITACE Ramipril 2.5MG TAB 841595 TRITACE Ramipril 5MG TAB 782602 TRITACE Ramipril 10MG CAP 710297 VECTORYL Perindopril 4MG TAB 710925 VECTORYL Perindopril 8MG TAB 839779 ZAPTO Captopril 25MG TAB Accepted treatment