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 2016. This formulary is subject to change without notice. ONLY the following medicine classes will be considered for Beat1 and Beat2: Atypical antipsychotics Butyrophenones Lithium Mood stabilizers Selective serotonin re-uptake inhibitors YES = formulary = non-formulary = excluded BIPOLAR MOOD DISORDER ACTIVE INGREDIENT A AMITRIPTYLINE GULF AMITRIPTYLINE 25MG T SANDOZ AMITRIPTYLINE 25 TREPILINE 25MG TAB TRYPTAL 25MG TAB C CARBAMAZEPINE DEGRAL 200MG TAB SANDOZ CARBAMAZEPINE SANDOZ CARBAMAZE CR 200 SANDOZ CARBAMAZE CR 400 TEGRETOL 200MG TAB TEGRETOL CR 200MG TAB TEGRETOL CR 400MG TAB ZEPTOL 200MG TAB 1
CHLORPROMAZINE LARGACTIL 100MG TAB LARGACTIL 25MG TAB LARGACTIL 25MG/5ML SYR LARGACTIL 50MG TAB CITALOPRAM ARROW CITALOPRAM 20MG TAB AURO-CITALOPRAM 20MG TAB AUSTELL-CITALOPRAM 10MG AUSTELL-CITALOPRAM 20MG AUSTELL-CITALOPRAM 40MG BIO CITALOPRAM 20MG TAB CILATE 20MG TAB CILIFT 20MG TAB CILORAM 20MG TAB CIPRAMIL 20MG TAB CITALOHEXAL 20MG TAB CITALOPRAM ACTOR 20MG TAB CITALOPRAM-WINTHROP 20MG CITALOPRAM-WINTHROP 40MG DEPRAMIL 20MG TAB DEPRAMIL 40MG TAB DRL CITALOPRAM 20MG TAB DRL CITALOPRAM 40MG TAB GLENMARK CITALOPRAM 20M MERCK-CITALOPRAM 20MG RAN-CITALOPRAM 20MG TAB SANDOZ CITALOPRAM 20MG SIMAYLA CITALOPRAM 20MG TALOMIL 20MG TAB CLOMIPRAMINE ANAFRANIL 10MG TAB 2
ANAFRANIL 25MG TAB ANAFRANIL SR 75MG TAB CLOMIDEP 25MG EQUIRM 10MG EQUIRM 25MG CLOZAPINE ASPEN CLOZAPINE 100MG TAB ASPEN CLOZAPINE 25MG TAB CLOMENT 100MG TAB CLOMENT 25MG TAB CLOZAPINE-HEXAL 100MG TAB CLOZAPINE-HEXAL 25MG LEPONEX 100MG TAB LEPONEX 25MG TAB D DOTHIEPIN SANDOZ DOTHIEPIN 25MG CAP SANDOZ DOTHIEPIN 75MG TAB THADEN 25MG CAP THADEN 75MG TAB E ESCITALOPRAM ACCORD ESCITALOPRAM 10MG ACCORD ESCITALOPRAM 20MG ASPEN ESCITALOPRAM 10MG CIPRALEX 10MG TAB CIPRALEX 20MG TAB CITRAZ 10MG TAB CITRAZ 20MG TAB CITRAZ 5MG TAB 3
DOLIN 10MG TAB DOLIN 20MG TAB ESCITALOPRAM 10MG BE-TAB ESCITALOPRAM 20MG BE-TAB ESCITALOPRAM WINTHROP 10 ESCITALOPRAM WINTHROP 20 ESCITALOPRAM WINTHROP 5 LEXAMIL 10MG TAB LEXAMIL 20MG TAB LEXAMIL 5MG TAB MACLEODS ESCITALOPRAM 10 MACLEODS ESCITALOPRAM 20 MARPREM 10MG TAB MARPREM 20MG TAB MARPREM 5MG TAB MYLAN ESCITALOPRAM 10MG NEXITO 10MG TAB ZITOLEX 10MG TAB ZITOLEX 20MG TAB ZYDUS ESCITALOPRAM 10MG T ZYTOMIL 10MG TAB ZYTOMIL 20MG TAB F FLUOXETINE A-LENN FLUOXETINE 20MG YES DEPROZAN CAP YES FLUOXETINE ACTOR 20MG CAP YES LILLY-FLUOXETINE 20MG YES LORIEN 20MG CAP YES LORIEN 20MG TAB YES NUZAK 20MG CAP YES PROHEXAL 20MG CAP YES PROHEXAL 20T PROHEXAL 40T 4
PROLAX 20MG CAP YES PROZAC 20MG CAP YES PROZAC 20MG TAB YES RANFLOCS 20 YES REZAK 20MG CAP YES SANDOZ FLUOXETINE 20MG YES TRIZAC 20MG CAP YES ZYDUS-FLUOXETINE 20MG YES FLUPENTHIXOL FLUANXOL DEP 20MG/1ML INJ FLUPHENAZINE MODECATE 25MG INJ 10ML MODECATE 25MG INJ 1ML MODECATE+SYRIN 25MG INJ FLUVOXAMINE FAVERIN 100MG TAB YES FLUVOXAMINE HEXAL 100MG YES LUVOX 100MG TAB YES G GABAPENTIN EPLEPTIN 100MG CAP EPLEPTIN 300MG CAP EPLEPTIN 400MG CAP NEUREXAL 100MG CAP NEUREXAL 300MG CAP NEUREXAL 400MG CAP NEURONTIN 100MG CAP NEURONTIN 300MG CAP NEURONTIN 400MG CAP NEURONTIN 600MG TAB NEURONTIN 800MG TAB RAN-GABAPENTIN 100MG CAP RAN-GABAPENTIN 300MG CAP RAN-GABAPENTIN 400MG CAP 5
H HALOPERIDOL SANDOZ HALOPERIDOL 1.5MG YES SANDOZ HALOPERIDOL 5MG YES SERENACE 0.5MG CAP YES SERENACE 10MG TAB YES SERENACE 5MG TAB YES I IMIPRAMINE ETHIPRAMINE 10MG TAB ETHIPRAMINE 25MG TAB TOFRANIL 10MG TAB TOFRANIL 25MG TAB L LAMOTRIGINE ARROW LAMOTRIGINE 100MG YES ARROW LAMOTRIGINE 200MG YES ARROW LAMOTRIGINE 25MG YES ARROW LAMOTRIGINE 50MG YES ASPEN LAMOTRIGINE 100MG YES ASPEN LAMOTRIGINE 25MG YES ASPEN LAMOTRIGINE 50MG YES ASPEN LAMOTRIGINE 200MG YES AUSTELL-LAMOTRIGINE 100MG YES AUSTELL-LAMOTRIGINE 200MG YES AUSTELL-LAMOTRIGINE 25MG YES AUSTELL-LAMOTRIGINE 50MG YES DYNA-LAMOTRIGINE 200MG YES DYNA-LAMOTRIGINE 100MG YES DYNA-LAMOTRIGINE 25MG YES DYNA-LAMOTRIGINE 50MG YES EPITEC 100MG TAB YES EPITEC 200MG TAB YES EPITEC 25MG TAB YES 6
EPITEC 50MG TAB YES LAMICTIN 25MG TAB YES LAMICTIN 100MG TAB YES LAMICTIN 200MG TAB YES LAMICTIN 50MG TAB YES LAMICTIN P 100MG DISP TAB LAMICTIN P 200MG DISP TAB LAMICTIN P 25MG DISP TAB LAMICTIN P 2MG DISP TAB LAMICTIN P 50MG DISP TAB LAMICTIN P 5MG DISP TAB LAMIDUS 100MG TAB YES LAMIDUS 200MG TAB YES LAMIDUS 50MG TAB YES LAMITOR 200MG TAB YES LAMITOR-100 YES LAMITOR-25 YES LAMITOR-50 YES MERCK-LAMOTRIGINE 100MG YES MERCK-LAMOTRIGINE 200MG YES MERCK-LAMOTRIGINE 25MG YES MERCK-LAMOTRIGINE 50MG YES SANDOZ LAMOTRIGINE 100MG YES SANDOZ LAMOTRIGINE 200MG YES SANDOZ LAMOTRIGINE 25MG YES SANDOZ LAMOTRIGINE 50MG YES LITHIUM CAMCOLIT 250MG TAB YES CAMCOLIT 400MG TAB YES QUILONUM RET 450MG TAB YES LOFEPRAMINE EMDALEN 70MG TAB M MAPROTILINE LUDIOMIL 25MG TAB YES 7
LUDIOMIL 75MG TAB YES MIANSERIN LANTAN 10MG TAB YES LANTAN 30MG TAB YES O OLANZAPINE ADCO OLANZAPINE 10MG TAB YES ADCO OLANZAPINE 2.5MG TAB YES ADCO OLANZAPINE 5MG TAB YES LANAZYP 10MG TAB YES LANAZYP 2.5MG TAB YES LANAZYP 5MG TAB YES MYLAN OLANZAPINE 10MG YES MYLAN OLANZAPINE 2.5MG YES MYLAN OLANZAPINE 5MG YES OLAWIN 10MG TAB YES OLAWIN 2.5MG TAB YES OLAWIN 5MG TAB YES OLAWIN 10MG ORADISPERSIB YES OLAWIN 5MG ORADISPERSIB YES OLAWIN 10MG ORADISPERSIB YES OLAWIN 5MG ORADISPERSIB YES OLEANZ 10MG TAB YES OLEANZ 2.5MG TAB YES OLEANZ 5MG TAB YES OLEANZ RAPITAB 10MG TAB YES OLEANZ RAPITAB 5MG TAB YES OLEXAR 10MG TAB YES OLEXAR 2.5MG TAB YES OLEXAR 5MG TAB YES PREXOLAN 2.5MG TAB YES PREXOLAN 5MG TAB YES PREXOLAN 10MG TAB YES 8
PREXOLAN 5MG OD TAB YES PREXOLAN 10MG OD TAB YES REDILANZ 2.5MG TAB YES REDILANZ 5MG TAB YES REDILANZ 10MG TAB YES ZYPREXA 10MG TAB YES ZYPREXA 2.5MG TAB YES ZYPREXA 5MG TAB YES ZYPREXA VELOTAB 10MG MLT YES ZYPREXA VELOTAB 5MG MLT YES OXCARBAZEPINE MYLAN OXCARBAZEPINE 300 MYLAN OXCARBAZEPINE 600 TRILEPTAL FCT 300MG TRILEPTAL FCT 600MG P PAROXETINE ADCO-PAROXETINE 20MG TAB YES APEX-PAROXETINE 20MG TAB YES AROPAX 20MG TAB YES AROPAX 30MG TAB YES AUSTELL-PAROXETINE 20MG YES AUSTELL-PAROXETINE 30MG YES AURO PAROXETINE 20MG TAB YES DEPAROC 20MG TAB YES HEXAL-PAROXETINE 20MG YES PARAX 20MG TAB YES PAROXETINE UNICORN 20MG YES PAXIL 20MG TAB YES SANDOZ PAROXETINE 20MG YES SERRAPRESS 20MG YES SERRAPRESS 30MG YES TEXINE 20MG TAB YES XET 20MG TAB YES ZYDUS-PAROXETINE 20MG YES 9
PIMOZIDE ORAP 1MG TAB ORAP 4MG TAB Q QUETIAPINE DOPAQUEL 25MG TAB DOPAQUEL 100MG TAB DOPAQUEL 200MG TAB DOPAQUEL 300MG TAB KIZOFRIN 200MG TAB KIZOFRIN 25MG TAB MYLAN QUETIAPINE 25MG MYLAN QUETIAPINE 100MG MYLAN QUETIAPINE 200MG MYLAN QUETIAPINE 300MG QUETOSER 25MG TAB QUETOSER 100MG TAB QUETOSER 200MG TAB QUETOSER 300MG TAB SEREZ 25MG TAB SEREZ 100MG TAB SEREZ 200MG TAB SEREZ 300MG TAB SEROQUEL 100MG SEROQUEL 200MG SEROQUEL 25MG SEROQUEL 300MG SEROQUEL XR 50MG SRT SEROQUEL XR 150MG SRT SEROQUEL XR 200MG SRT SEROQUEL XR 300MG SRT SEROQUEL XR 400MG SRT SIZORM 100MG TAB SIZORM 200MG TAB 10
SIZORM 25MG TAB SIZORM 300MG TAB TRUVALIN 25MG TAB TRUVALIN 100MG TAB TRUVALIN 200MG TAB TRUVALIN 300MG TAB R RISPERIDONE ASPEN RISPERIDONE 0.5MG ASPEN RISPERIDONE 1MG ASPEN RISPERIDONE 2MG ASPEN RISPERIDONE 3MG ASPEN RISPERIDONE 4MG AUROPERDAL 0.5MG TAB AUROPERDAL 1MG TAB AUROPERDAL 2MG TAB AUROPERDAL 3MG TAB AUROPERDAL 4MG TAB DRL RISPERIDONE 0.5MG TAB DRL RISPERIDONE 1MG TAB DRL RISPERIDONE 2MG TAB DRL RISPERIDONE 3MG TAB MYLAN RISPERIDONE 0.5MG MYLAN RISPERIDONE 1MG MYLAN RISPERIDONE 2MG PERIDA 0.5MG TAB PERIDA 1MG TAB PERIZAL 0.5MG TAB PERIZAL 1MG TAB PERIZAL 2MG TAB PERIZAL 3MG TAB RISNIA 0.5MG TAB RISNIA 1MG TAB RISNIA 2MG TAB 11
RISNIA 3MG TAB RISPACOR 0.5MG TAB RISPACOR 1MG TAB RISPACOR 2MG TAB RISPACOR 3MG TAB RISPACOR 4MG TAB RISPERDAL 0.5MG TAB RISPERDAL 1MG TAB RISPERDAL 2MG TAB RISPERDAL 3MG TAB RISPERDAL 4MG TAB RISPERDAL QUICKLET 0.5MG RISPERDAL QUICKLET 1MG RISPERDAL QUICKLET 2MG RISPERDAL QUICKLET 3MG RISPERIDONE HEXAL 0.5MG RISPERIDONE HEXAL 1MG TAB RISPERIDONE HEXAL 2MG TAB RISPERIDONE HEXAL 3MG TAB RISPERLET 0.5MG TAB RISPERLET 1MG TAB RISPERLET 2MG TAB RISPEVON 1MG TAB RISPEVON 2MG TAB RISPEVON 3MG TAB RISPEVON 4MG TAB RISPONZ 1MG TAB RISPONZ 2MG TAB RISPONZ 3MG TAB RISPONZ 4MG TAB SCHIZOROL 0.5MG TAB SCHIZOROL 1MG TAB SCHIZOROL 2MG TAB 12
ZOXADON 0.5MG ZOXADON 1MG ZOXADON 2MG T TOPIRAMATE ADCO-TOPIRAMATE 100MG TAB ADCO-TOPIRAMATE 200MG TAB ADCO-TOPIRAMATE 25MG TAB ADCO-TOPIRAMATE 50MG TAB EPIMATE 100MG TAB EPIMATE 200MG TAB EPIMATE 25MG TAB EPIMATE 50MG TAB EPITOZ 100MG TAB EPITOZ 25MG TAB EPITOZ 50MG TAB PAMIRAM 100MG TAB PAMIRAM 200MG TAB PAMIRAM 25MG TAB PAMIRAM 50MG TAB PIRAMAX 100MG TAB PIRAMAX 200MG TAB PIRAMAX 25MG TAB SANDOZ TOPIRAMATE 100MG SANDOZ TOPIRAMATE 200MG SANDOZ TOPIRAMATE 25MG SANDOZ TOPIRAMATE 50MG TOPALEX 25MG TAB TOPAMAX 25MG TAB TOPAMAX 50MG TAB TOPAMAX 100MG TAB TOPAMAX 200MG TAB TOPAMAX SC SPRIN 15MG TOPAMAX SC SPRIN 25MG 13
TOPAMAX SC SPRIN 50MG TOPIROL 100MG TAB TOPIROL 25MG TAB TOPIROL 50MG TAB TOPLEP 100MG TAB TOPLEP 200MG TAB TOPLEP 25MG TAB TOPLEP 50MG TAB TOPALEX 100MG TAB TOPALEX 50MG TAB TRIFLUOPERAZINE STELAZINE 1MG TAB STELAZINE 5MG TAB TRIMIPRAMINE TYDAMINE 25MG TAB TYDAMINE 50MG CAP V VALPROATE EPILIM 100MG CRUSH TAB YES EPILIM CR 200MG TAB YES EPILIM CR 300MG TAB YES EPILIM CR 500MG TAB YES EPILIZINE CR 200MG TAB YES EPILIZINE CR 300MG TAB YES EPILIZINE CR 500MG TAB YES NAVALPRO CR 200MG TAB YES NAVALPRO CR 300MG TAB YES NAVALPRO CR 500MG TAB YES VANAPRO 300MG TAB YES VANAPRO 500MG TAB YES VALPROIC ACID CONVULEX 150MG CAP YES CONVULEX 300MG CAP YES CONVULEX 500MG CAP YES CONVULEX 50MG/ML SYR YES 14
Z ZUCLOPENTHIXOL EPROLEP CR 300MG TAB YES EPROLEP CR 500MG TAB YES CLOPIXOL ACUPH 50MG INJ CLOPIXOL DEPOT 200MG INJ YES YES YES YES 15