If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost-sharing tier, we must notify affected members of the change at least 60 days before the change becomes effective, or at the time the member requests a refill of the drug, at which time the member will receive a 60-day supply of the drug. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug.
On April 15th, 2013, Abbott initiated a voluntary recall for the FreeStyle InsuLinx Blood Glucose Meter with an NDC number of 99073-0711-43. This voluntary, user-level recall was initiated because the FreeStyle InsuLinx Blood Glucose Meter may display and store in memory an incorrect result at extremely high blood glucose levels (≥ 1,024 mg/dL).
Effective June 1, 2013, the following changes will apply to the HealthSpring Formulary list of covered drugs.
|
Name of Affected
Drug
|
Reason for
Change
|
Alternative
Drug
|
| Seroquel 300mg |
Generic Available |
Quetiapine |
| Provigil 200mg |
Generic Available |
Modafinil |
| Tricor 48mg |
Generic Available |
Fenofibrate |
| Actoplus Met 15/850mg |
Generic Available |
Metformin HCL/
Pioglitazone HCL |
Effective March 25, 2013
On March 25, 2013, LifeScan initiated a voluntary recall for the OneTouch Verio IQ blood glucose meters. This recall was initiated because OneTouch Verio IQ blood glucose meters will turn off instead of displaying the message “EXTREME HIGH GLUCOSE above 600 mg/dL” when blood glucose level is 1,024 mg/dL or greater. When the meter is turned back on, the meter enters the set-up mode and requires the user to confirm the date and time settings before being able to test again. However, if the glucose level is still 1,024 mg/dL or greater when testing, the meter will shut down again.
Effective June 1, 2013
Effective June 1, 2013, the following changes will apply to the Bravo Health Formulary list of covered drugs.
|
Name of Affected
Drug
|
Reason for
Change
|
Alternative
Drug
|
| Seroquel 300 tab |
Generic Available |
quetiapine 300mg tab |
| Seroquel 400 tab |
Generic Available |
quetiapine 400mg tab |
| Seroquel 100 tab |
Generic Available |
quetiapine 100mg tab |
| Seroquel 25 tab |
Generic Available |
quetiapine 25mg tab |
| Seroquel 50 tab |
Generic Available |
quetiapine 50mg tab |
| Seroquel 200 tab |
Generic Available |
quetiapine 200mg tab |
| Geodon 20mg tab |
Generic Available |
ziprasidone 20mg tab |
| Geodon 40mg tab |
Generic Available |
ziprasidone 40mg tab |
| Geodon 60 mg tab |
Generic Available |
ziprasidone 60mg tab |
| Geodon 80mg tab |
Generic Available |
ziprasidone 80mg tab |
| Zyprexa 10mg Vial |
Generic Available |
olanzapine 10mg vial |
| Symbyax 50/6 |
Generic Available |
olanzapine/fluoxetine 50/6 tab |
| Symbyax 25/12 |
Generic Available |
olanzapine/fluoxetine 25/12 tab |
| Symbyax 25/6 |
Generic Available |
olanzapine/fluoxetine 25/6 tab |
| Symbyax 50/12 |
Generic Available |
olanzapine/fluoxetine 50/12 tab |
| Symbyax 25/3 |
Generic Available |
olanzapine/fluoxetine 25/3 tab |
| Viramune tab 200mg |
Generic Available |
nevirapine 200mg |
| Vancocin 125mg |
Generic Available |
vancomycin 125mg tab |
| Vancocin 250mg tab |
Generic Available |
vancomycin 250mg tab |
| Actos 15mg |
Generic Available |
pioglitazone 15mg tab |
| Actos 30mg |
Generic Available |
pioglitazone 30mg tab |
| Actos 45mg |
Generic Available |
pioglitazone 45mg tab |
| Actoplus met 500/15 |
Generic Available |
metformin/pioglitazone 500/15 |
| Actoplus met 850/15 |
Generic Available |
metformin/pioglitazone 850/15 |
| Singulair 10mg tab |
Generic Available |
montelukast 10mg tab |
| Singulair 5mg chew |
Generic Available |
montelukast 5mg chew |
| Singulair 4mg chew |
Generic Available |
montelukast 4mg chew |
| Revatio 20mg tab |
Generic Available |
sildenafil 20mg tab |
| Gabitril 2mg |
Generic Available |
tiagabine 2mg tab |
| Gabitril 4mg |
Generic Available |
tiagabine 4mg tab |
| Dovonex cream 0.0005% |
Generic Available |
calcipotriene cream 0.0005% |
| Ziagen tab 300mg |
Generic Available |
abacavir 300mg tab |
| Vfend 200mg vial |
Generic Available |
voriconazole 200mg vial |
| Prometrium 100mg tab |
Generic Available |
progesterone 100mg tab |
| Prometrium 200mg tab |
Generic Available |
progesterone 200mg tab |
| Plavix 75mg |
Generic Available |
clopidogrel 75mg tab |
| Plavix 300mg |
Generic Available |
clopidogrel 300 mg ta |
| Surmontil 25mg |
Generic Available |
trimipramine 25mg cap |
| Surmontil 50mg |
Generic Available |
trimipramine 50mg cap |
| Surmontil 100mg |
Generic Available |
trimipramine 100 mg cap |
Effective January 1, 2013
Effective January 1, 2013, the following changes will apply to HealthSpring Formulary (list of covered drugs).
| Name of Affected Drug |
Reason for Change
|
Alternative Drug
|
| ALKERAN |
Removed from formulary; Generic available |
melphalan |
| AMPYRA |
Quantity limit added (60 tablets per 30 days) |
|
| ANCOBON |
Removed from formulary; Generic available |
flucytosine |
| AROMASIN |
Removed from formulary; Generic available |
exemestane |
| AZITHROMYCIN 1GM |
Quantity limit changed (3 packs per 30 days) |
|
| BACITRACIN |
Removed from formulary; Generic available |
Baciim |
| BUDEPRION SR 150MG |
Quantity limit changed (60 tablets per 30 days) |
|
| BYSTOLIC |
Removed from formulary; Generic alternatives available |
metoprolol, carvedilol, atenolol/chlorthalidone |
| CARBATROL |
Removed from formulary; Generic available |
carbamazepine |
| CHANTIX 0.5MG |
Quantity limit changed (340 tablets per 365 days) |
|
| COUMADIN |
Removed from formulary; Generic available |
warfarin, Jantoven |
| DEPADE |
Prior Authorization added |
|
| DOVONEX |
Quantity limit added (120 grams per 30 days) |
|
| ELLENCE |
Removed from formulary; Generic available |
epirubicin |
| FELBATOL |
Removed from formulary; Generic available |
felbamate |
| FEMARA |
Removed from formulary; Generic available |
letrozole |
| FLOVENT HFA |
Quantity limit changed (22 grams per 30 days) |
|
| FLUDARA |
Removed from formulary; Generic available |
fludarabine |
| FORTICAL |
Removed from formulary; Generic available |
calcitonin (salmon) |
| FRAGMIN |
Removed from formulary; Generic alternatives available |
enoxaparin, fondaparinux |
| FURADANTIN |
Removed from formulary; Generic available |
nitrofurantoin |
| FUZEON 90MG/ML |
Quantity limit changed (1 kit per 30 days) |
|
| GEMZAR |
Removed from formulary; Generic available |
gemcitabine |
| GENOTROPIN |
Removed from formulary |
Saizen |
| GEODON 20MG SOLR |
Quantity limit changed (60 per 30 days) |
|
| MODAFINIL 100MG |
Quantity limit added (30 tablets per 30 days) |
|
| MODAFINIL 200MG |
Quantity limit added (30 tablets per 30 days) |
|
| NARDIL |
Removed from formulary; Generic available |
phenelzine |
| POTIGA 50MG |
Quantity limit changed (90 tablets per 30 days) |
|
| POTIGA 200MG |
Quantity limit changed (30 tablets per 30 days) |
|
| POTIGA 300MG |
Quantity limit changed (30 tablets per 30 days) |
|
| POTIGA 400MG |
Quantity limit changed (30 tablets per 30 days) |
|
| PRED FORTE |
Removed from formulary; Generic available |
prednisolone acetate |
| REBIF TITRATION PACK |
Quantity limit changed (4.2 per 28 days) |
|
| REVLIMID |
Prior Authroization added for new starts |
|
| TAZORAC GEL |
Quantity limit changed (100 grams per 30 days) |
|
| TEGRETOL XR |
Removed from formulary; Generic available |
carbamazepine |
| VENTOLIN HFA |
Removed from formulary; alternative available |
ProAir |
| ZINACEF |
Removed from formulary; Generic available |
cefuroxime |
Effective January 1, 2013, these additional changes will apply to the Prescription Drug Plan only.
|
Name of Affected Drug
|
Reason for Change
|
Alternative Drug
|
| ANTABUSE |
Generic Available |
disulfiram |
| ARIXTRA |
Generic Available |
fondaparinux sodium |
| COMBIVIR |
Generic Available |
lamivudine/zidovudine |
| DERMOTIC |
Generic Available |
fluocinolone/acetonide |
| ENTOCORT EC |
Generic Available |
budesonide capsule |
| EPIVIR |
Generic Available |
lamivudine |
| GASTROCROM ORAL SOLUTION |
Generic Available |
cromolyn sodium |
| LEVAQUIN |
Generic Available |
levofloxacin |
| LIPITOR |
Generic Available |
atorvastatin |
| NEURONTIN ORAL SOLUTION |
Generic Available |
gabapentin |
Effective November 15, 2012
Recently, Ranbaxy, a manufacturer of Atorvastatin Calcium, announced a voluntary, nationwide, retail-level of Atorvastatin Calcium 10mg, 20mg, and 40mg for 41 lots of numbers. Atorvastatin is the generic for the branded product LIPITOR, marked by Pfizer. This recall was initiated because the affected Atorvastatin tablet may contain a foreign substance described as small glass particles less than 1mm in size. Ranbaxy announces the recall proactively out of an abundance of caution.
Lot numbers affected are:
Atorvastatin calcium 10mg, 90 count bottle: 2436144; 2436582; 2441567; 2441567
Atorvastatin calcium 20mg, 90 count bottle: 2436731; 2437381; 2437940; 2437942; 2437945; 2437947; 2437952; 2437953; 2437960; 2440676; 2440677; 2440680; 2440681
Atorvastatin calcium 40mg; 500 count bottle: 243958; 2437957; 2440675
Atorvastatin calcium 40mg, 90 count bottle: 2434265; 2434824; 2434827; 2434829; 2434831; 2436725; 2436729; 2437380; 2437943; 2437949; 2434266; 2434826; 2434828; 2434830; 2436580; 2436727; 2437377; 2437941; 2437944; 2437950; 2437955
Effective November 1, 2012
Effective November 1, 2012, the following changes will apply to HealthSpring Formulary (list of covered drugs).
| Name of Affected Drug |
Reason for Change |
Alternative Drug |
| Zyprexa 2.5mg Tablet |
Generic Available |
Olanzapine 2.5mg Tablet |
| Zyprexa 10mg Tablet |
Generic Available |
Olanzapine 10mg Tablet |
| Zyprexa 20mg Tablet |
Generic Available |
Olanzapine 20mg Tablet |
| Zyprexa Zydis 10mg Tablet |
Generic Available |
Olanzapine ODT 10mg Tablet |
| Zyprexa 10mg IM Solution |
Generic Available |
Olanzapine 10mg IM Solution |
| Zyprexa 7.5mg Tablet |
Generic Available |
Olanzapine 7.5mg Tablet |
| Zyprexa 5mg Tablet |
Generic Available |
Olanzapine 5mg Tablet |
| Zyprexa 15mg Tablet |
Generic Available |
Olanzapine 15mg Tablet |
| Zyprexa Zydis 15mg Tablet |
Generic Available |
Olanzapine ODT 15mg Tablet |
| Zyprexa Zydis 5mg Tablet |
Generic Available |
Olanzapine ODT 5mg Tablet |
| Zyprexa Zydis 20mg Tablet |
Generic Available |
Olanzapine ODT 20mg Tablet |
| Avapro 300mg Tablet |
Generic Available |
IRBESARTAN 300mg Tablet |
| Avapro 75mg Tablet |
Generic Available |
IRBESARTAN 75mg Tablet |
| Avapro 150mg Tablet |
Generic Available |
IRBESARTAN 150mg Tablet |
| Avalide 12.5mg/150mg Tablet |
Generic Available |
HYDROCHLOROTHIAZIDE; IRBESARTAN 12.5mg/150mg Tablet |
| Avalide 12.5mg/300mg Tablet |
Generic Available |
HYDROCHLOROTHIAZIDE; IRBESARTAN 12.5mg/300mg Tablet |
| Seroquel 50mg Tablet |
Generic Available |
QUETIAPINE FUMARATE 50mg Tablet |
| Seroquel 100mg Tablet |
Generic Available |
QUETIAPINE FUMARATE 100mg Tablet |
| Seroquel 200mg Tablet |
Generic Available |
QUETIAPINE FUMARATE 200mg Tablet |
| Seroquel 400mg Tablet |
Generic Available |
QUETIAPINE FUMARATE 400mg Tablet |
| Seroquel 300mg Tablet |
Generic Available |
QUETIAPINE FUMARATE 300mg Tablet |
| Seroquel 25mg Tablet |
Generic Available |
QUETIAPINE FUMARATE 25mg Tablet |
| Provigil 100mg Tablet |
Generic Available |
MODAFINIL 100mg Tablet |
| Provigil 200mg Tablet |
Generic Available |
MODAFINIL 200mg Tablet |
| Vancocin 125mg Capsule |
Generic Available |
Vancomycin 125mg Capsule |
| Vancocin 250mg Capsule |
Generic Available |
Vancomycin 250mg Capsule |
| Geodon 60mg Capsule |
Generic Available |
ZIPRASIDONE 60mg Capsule |
| Geodon 20mg Capsule |
Generic Available |
ZIPRASIDONE 20mg Capsule |
| Geodon 80mg Capsule |
Generic Available |
ZIPRASIDONE 80mg Capsule |
| Geodon 40mg Capsule |
Generic Available |
ZIPRASIDONE 40mg Capsule |
| Surmontil 25mg Capsule |
Generic Available |
TRIMIPRAMINE 25mg Capsule |
| Surmontil 50mg Capsule |
Generic Available |
TRIMIPRAMINE 50mg Capsule |
| Surmontil 100mg Capsule |
Generic Available |
TRIMIPRAMINE 100mg Capsule |
Effective August 1, 2012
Effective August 1, 2012, the Bravo Health formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.
|
Name of
Affected Drug
|
Reasons for Change |
Alternative Drugs |
| ANTABUSE |
Generic Available |
DISULFIRAM |
| ARIXTRA |
Generic Available |
FONDAPARINUX SODIUM |
| COMBIVIR |
Generic Available |
LAMIVUDINE/ ZIDOVUDINE |
| DERMOTIC |
Generic Available |
FLUOCINOLONE/ ACETONIDE |
| ENTOCORT EC |
Generic Available |
BUDESONIDE CAP |
| EPIVIR |
Generic Available |
LAMIVUDINE |
| GASTROCROM |
Generic Available |
CROMOLYN SODIUM |
| LEVAQUIN |
Generic Available |
LEVOFLOXACIN |
| LIPITOR |
Generic Available |
ATORVASTATIN |
| NEURONTIN |
Generic Available |
GABAPENTIN |
Effective April 19, 2012
On April 19, 2012, Novartis announced that they will cease marketing Valturna® (aliskiren and valsartan, USP) tablets in the US. This announcement was made after consultations with the FDA due to preliminary results of the halted ALTITUDE study.
Valturna® has been used for controlling high blood pressure and to ensure an orderly transition of patients to alternate therapies. Novartis will make Valturna available until July 20, 2012 to allow physicians to transition patients to another medication. Patients taking Valturna should not stop their high blood pressure treatment without consulting their prescribing healthcare provider.
If you are a patient on Valturna®, we encourage you to discuss this information with your prescribing healthcare provider at your next (non-urgent) visit, prior to July 20, 2012, or to make an appointment before this time, to determine the appropriate alternate medication for you.
Effective February 24, 2012
On February 24, 2012, Glenmark Generics announced a voluntary, lot-specific recall of Norgestimate/Ethinyl Estradiol tablets, 0.18mg/0.035 mg, 0.215mg/0.035 mg, 0.25mg/0.035mg:
Norgestimate/Ethinyl Estradiol Tablets, NDC 68462-565-29
Lot Numbers 04110101, 04110106, 04110107, Expiration date: 7/31/2013
Lot Numbers 04110114, 04110124, 04110129, Expiration date: 8/31/2013
Lot Number 04110134, Expiration date: 9/31/2013
This recall was initiated because of a packaging error, where select blisters were rotated 180 degrees within the card, reversing the weekly tablet orientation and making the lot number and expiry date visible only on the outer pouch. Any blister for which the lot number and expiry date is not visible is subject to recall.
Effective January 31, 2012
On January 31, 2012, Pfizer Inc. initiated a voluntary recall of 14 lots of Lo/Ovral®-28 (norgestrel/ethinyl estradiol) Tablets, NDC 24090-801-84, and 14 Lots of Norgestrel and Ethinyl Estradiol Tablets (generic) because some blister packs may contain an inexact count of inert or active ingredient tablets and the tablets may be out of sequence.
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