No. | Drug Name | Decision |
1) | Rufinamide 200mg Tablet (Inovelon) | Agreed to accept as Special Formulary (upon request). |
2) | Yellow Fever Vaccine Injection (Stamaril) | Agree to accept as Special Formulary (non-claimable). |
3) | Dapagliflozin 10mg Tablet (Forxiga) | Rejected to add Cardiologists as prescriber, to maintain current restriction. |
4) | Baricitinib 4mg Tablet (Olumiant) | Rejected as Special Formulary. Availability of Tofacitinib 5mg Tablet in the UMMC formulary. Suggest to apply to use using BUK on named patient basis. |
5) | Esomeprazole 20mg MUPS Tablet Esomeprazole 40mg MUPS Tablet Multiple Unit Pellet System (Nexium / Axiago) | Agree to accept as Standard Formulary to replace Omeprazole 2mg/mL Syrup. |
6) | Aripiprazole 400mg Prolonged Release Injection (Abilify Maintena) | Agree to accept as Special Formulary. |
7) | Liothyronine 100mcg Injection | Agree to delete from the UMMC formulary. Availability of Levothyroxine 200mcg Injection in the UMMC formulary. |
8) | Polymixin B Neomycin Hydrocortisone Ear Drops (Pocin) | Agree to delete from the UMMC formulary. Ototoxicity due to Neomycin component and removal from APPL contract list. |
9) | Varenicline 1mg Tablet (Champix) | Agree to delete from the UMMC formulary. Closure of Smoking Cessation Clinic, no prescriptions seen since 2016, slow movement and easily available in community pharmacies. |
10) | Varenicline 0.5mg Tablets x 11 Varenicline 1mg Tablets x 14 (Champix Starter Pack) | Agree to delete from the UMMC formulary. Closure of Smoking Cessation Clinic, no prescriptions seen since 2016, slow movement and easily available in community pharmacies. |
11) | Clodronate Sodium 800mg Tablet (Bonefos) | Agree to delete from the UMMC formulary. Company discontinuation. |
12) | Isotretinoin 10mg Capsule (Roaccutane) | Rejected to delete from the UMMC formulary, to maintain current restriction. |
13) | Isotretinoin 20mg Capsule (Roaccutane) | Rejected to delete from the UMMC formulary, to maintain current restriction. |
14) | Dulaglutide 0.75mg Injection Dulaglutide 1.5mg Injection (Trulicity) | Pending press release on cardiovascular safety outcome trial in June 2019. Costs more than existing agents available in the UMMC formulary. Suggest to review pricing. |
