| Interferon Alfacon-1 |
Infergen |
| ANTI-INFECTIVE |
HEPATITIS B&C |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Bexarotene |
Targretin |
| CANCER/IMMUNOSUPPRESSION |
CANCER CHEMOTHERAPY |
| PA |
| 12/1/2011 |
Formulary Removal |
| |
| Oprelvekin |
Neumega |
| CANCER/IMMUNOSUPPRESSION |
HEMATOLOGY |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Sargramostim |
Leukine |
| CANCER/IMMUNOSUPPRESSION |
HEMATOLOGY |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Interferon Alfa-2A,Recomb. |
Roferon-A |
| CANCER/IMMUNOSUPPRESSION |
IMMUNOMODULATORS |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Interferon Alfa-2B,Recomb. |
Intron A |
| CANCER/IMMUNOSUPPRESSION |
IMMUNOMODULATORS |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Interferon Alfa-N3 |
Alferon N |
| CANCER/IMMUNOSUPPRESSION |
IMMUNOMODULATORS |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Interferon Gamma-1B,Recomb. |
Actimmune |
| CANCER/IMMUNOSUPPRESSION |
IMMUNOMODULATORS |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Aldesleukin |
Proleukin |
| CANCER/IMMUNOSUPPRESSION |
IMMUNOMODULATORS |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Pegfilgrastim |
Neulasta |
| CANCER/IMMUNOSUPPRESSION |
HEMATOLOGY |
| SPN PA QL |
| 12/1/2011 |
Formulary Removal |
| |
| Atorvastatin |
Lipitor |
| CARDIOVASCULAR |
LIPID MANAGEMENT |
| GC ST QL |
| 11/30/2011 |
Formulary Addition; generic covered 11/30/11 |
| |
| Rivaroxaban |
Xarelto |
| CARDIOVASCULAR |
CIRCULATION/COAGULATION |
| |
| 2/1/2012 |
Formulary Addition |
| |
| Venlafaxine HCl XR |
Effexor XR |
| CENTRAL NERVOUS SYSTEM |
ANTIDEPRESSANTS |
| GC QL |
| 12/1/2011 |
Step Edit Removal |
| |
| Isotretinoin |
Accutane |
| DERMATOLOGY |
ACNE |
| GC |
| 12/1/2011 |
Prior Auth Removal |
| |
| Bexarotene |
Targretin |
| DERMATOLOGY |
TOPICAL ANTINEOPLASTIC |
| PA |
| 12/1/2011 |
Formulary Removal |
| |
| Collagenase |
Santyl |
| DERMATOLOGY |
TOPICAL ENZYMES |
| |
| 1/1/2012 |
Formulary Removal |
| |
| Somatropin |
Serostim |
| ENDOCRINE |
GROWTH HORMONE RELATED |
| SPN PA |
| 12/1/2011 |
Formulary Removal |
| |
| Teriparatide |
Forteo |
| ENDOCRINE |
OSTEOPOROSIS |
| SPN QL |
| 12/1/2011 |
Prior Auth Removal |
| |
| Sitagliptin/Simvastatin |
Juvisync |
| ENDOCRINE |
DIABETES, ORAL |
| |
| 2/1/2012 |
Formulary Addition |
| |
| Hyoscyamine Sulfate |
Levbid |
| GASTROINTESTINAL |
ANTISPASMODICS |
| GC |
| 12/1/2011 |
Formulary Removal |
| |
| Lansoprazole |
Prevacid |
| GASTROINTESTINAL |
ULCER THERAPY |
| GC QL |
| 1/1/2012 |
Step Edit Removal |
| |
| Pantoprazole |
Protonix |
| GASTROINTESTINAL |
ULCER THERAPY |
| GC QL |
| 1/1/2012 |
Formulary Addition |
| |
| Celecoxib |
Celebrex |
| PAIN/INFLAMMATION |
ANTI-INFLAMMATORY |
| ST QL |
| 12/1/2011 |
Formulary Removal |
| |
| Morphine Sulfate |
Avinza |
| PAIN/INFLAMMATION |
NARCOTIC ANALGESICS |
| QL |
| 12/1/2011 |
Formulary Removal |
| |
| Mometasone Furoate |
Nasonex |
| RESPIRATORY |
INHALED NASAL AGENTS |
| QL |
| 12/1/2011 |
Formulary Removal |
| |