Alameda Alliance for Health
Alameda Alliance for Health
Alameda Alliance for Health
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<strong>Alameda</strong> <strong>Alliance</strong> <strong>for</strong> <strong>Health</strong><br />
FORMULARY UPDATE<br />
Effective April 15, 2013<br />
<strong>Alameda</strong> <strong>Alliance</strong> <strong>for</strong> <strong>Health</strong> Pharmacy & Therapeutics (P & T) Committee Decisions<br />
The P &T Committee reviewed the efficacy, safety, cost, and utilization profiles of the<br />
following therapeutic categories at the March 7, 2013 meeting:<br />
• Hypnotics /insomnia<br />
• Statins<br />
• Psoriasis topical agents<br />
• Oral agents <strong>for</strong> the treatment of Diabetes<br />
• Atypical Antipsychotics<br />
*The P &T Committee approved the following modifications to the <strong>for</strong>mulary <strong>for</strong> the <strong>Alliance</strong>’s<br />
Medi-Cal, and <strong>Alliance</strong> Group Care programs:<br />
Generic Name &<br />
Strength/Dosage Form<br />
TEMAZEPAM<br />
ATORVASTATIN<br />
GLYBURIDE<br />
GLIMIPRIMIDE<br />
NATEGLINIDE<br />
CLOZAPINE<br />
ZIPRASIDONE<br />
PALIPERIDONE<br />
Brand Name<br />
RESTORIL<br />
LIPITOR<br />
STARLIX<br />
CLOZARIL; FAZACLO<br />
GEODON<br />
INVEGA<br />
Committee Actions<br />
ADD 22.5 MG AND 7.5 MG TO FORMULARY<br />
WITH PA<br />
REMOVE CODE 1; ADD TO FORMULARY WITH<br />
STEP EDIT LOVASTATIN 40;PRAVASTATIN 40,<br />
80; SIMVASTATIN 40,80<br />
ADD AGE EDIT FOR 65 AND OLDER<br />
ADD TO FORMULARY WITH STEP EDIT<br />
METFORMIN OR SULFONYLUREA<br />
ADD TO FORMULARY FOR IHSS WITH<br />
QUANTITY LIMIT OF 6/DAY<br />
ADD TO FORMULARY FOR IHSS WITH<br />
QUANTITY LIMIT OF 2/DAY<br />
ADD TO FORMULARY FOR IHSS WITH<br />
QUANTITY LIMIT OF 2/DAY<br />
QUETIAPINE<br />
SEROQUEL<br />
SEROQUEL XR<br />
ADD TO FORMULARY FOR IHSS WITH<br />
QUANTITY LIMIT OF 2/DAY<br />
OLANZAPINE<br />
ZYPREXA<br />
ADD TO FORMULARY FOR IHSS WITH<br />
QUANTITY LIMIT OF 1/DAY<br />
<strong>Alameda</strong> <strong>Alliance</strong> <strong>for</strong> <strong>Health</strong> (AAH01) Formulary Update<br />
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Generic Name &<br />
Strength/Dosage Form<br />
FLUTICASONE<br />
Brand Name<br />
FLOVENT DISKUS<br />
Committee Actions<br />
FORMULARY WITH STEP EDIT QVAR AND<br />
ADVAIR DISKUS<br />
PRIOR AUTHORIZATION GUIDELINES UPDATES<br />
TOPICAL NSAIDS<br />
DICLOFENAC (SOLARAZE)<br />
STEP THERAPY (VARIOUS)<br />
ARIPIPRAZOLE (ABILIFY)<br />
INCRETIN MIMETICS (BYETTA; VICTOZA)<br />
INSULIN DELIVERY SYSTEMS (APIDRA SOLOSTAR; LANTUS SOLOSTAR; HUMALOG<br />
KWIKPEN; NOVOLOG; NOVOLOG RAPID<br />
TOPICAL TACROLIMUSM (PROTOPIC)<br />
TOPICAL PIMECROLIMUS (ELIDEL)<br />
TESTOSTERONE TOPICAL TESTOSTERONE; TESTOSTERONE CYPIONATE;<br />
TESTOSTERONE ENANTHATE<br />
ESTROGEN PATCHES ALORA; CLIMARA, VIVELLE/VIVELLE DOT<br />
EPOETIN ALFA (EPOGEN;PROCRIT)<br />
DARBOEPOETIN ALFA (ARANESP)<br />
EZETIMIBE (ZETIA)<br />
ATORVATATIN LIPITOR<br />
ATOMOXETINE (STRATTERA)<br />
*Note: Drugs removed from the <strong>for</strong>mulary will NOT be grandfathered <strong>for</strong> utilizing<br />
members unless noted otherwise under “Committee Actions.”<br />
<strong>Alameda</strong> <strong>Alliance</strong> <strong>for</strong> <strong>Health</strong> (AAH01) Formulary Update<br />
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