BLUE SHIELD OF
CALIFORNIA
MEMBER FORMULARY
UPDATES TO 2000 BOOKLET
Effective July 1, 2000
Drugs added to the
Formulary:
AcipHexâ and Protonixâ: For gastric ulcer and reflux conditions (replacing
Prilosecâ and
Prevacidâ).
The P&T Committee determined that Aciphexâ and Protonixâ
have fewer drug-drug interactions, less side effects (such as diarrhea) and are
clinically equal to the older PPIs (Prilosecâ and Prevacidâ). AcipHexâ and Protonixâ cost less than Prilosecâ and Prevacidâ, and
are clinically effective alternatives.
Actosâ:
For add-on or second-line therapy for type II diabetes (pre-requisite therapy
of first-line diabetic medication required).
Aromasinâ:
For advanced breast cancer.
Avaproâ
& Avalideâ and Diovanâ
& Diovanâ HCT:
For high blood pressure (covered without a prior authorization if you have
recently tried and failed or had side effects to drugs such as Lotensinâ,
Prinivilâ or
Monoprilâ).
Aveloxâ:
Antibiotic used to treat respiratory infections including pneumonia,
bronchitis, sinusitis where resistant organisms are suspected (quantity limited
to a 5 to 10 day therapy).
Comtanâ: For
Parkinson’s Disease and must be used in conjunction with levodopa/carbidopa.
Evoxacâ: For
dry mouth in Sjögren’s Syndrome
Floventâ
& Floventâ Rotadisk: Oral-inhaled corticosteroid for
asthma.
Humalogâ Vial: Insulin for diabetes
Keppraâ:
Seizure medication
Singulairâ: Add-on or second-line therapy for asthma
(pre-requisite therapy inhaled corticosteroid therapy required).
Targretinâ:
For T-cell lymphoma.
Trileptalâ
For treatment of partial seizures.