Benefits Plans - Prescription Drug Plan: Drug Plan Updates and New Drug Releases - Drug Reviews

Page last updated: Wednesday, 26-May-2010 20:51:27 EDT

March, April, May 2005

The following drug considerations were reviewed and determined for formulary inclusion and tier placement by the U-M Pharmaceutical Benefits Advisory Committee in March, April, and May 2005.

Drug Name Indication PDL Class
Yes/N
Action
Regranex Diabetic Ulcers No Tier 3
Rythmol SR Antiarrhythmic No Tier 2
Tikosyn Antiarrhythmic No Tier 2
Helidac H. Pylori No Tier 3
Marinol Nausea & Vomiting No Tier 2
Neulasta Hematopoietic No Tier 2
Roferon-A Immunomodulators No Tier 2
Pexeva Antidepressant No Tier 3
Tracleer PAH No Tier 2
Darvon Narcotic Analgesic No Tier 3, Generic available
Demerol Narcotic Analgesic No Tier 3, Generic available
Minipress Blood Pressure No Tier 3, Generic available
Noroxin Anit-Infective No Tier 3, Generic available
Percodan Narcotic Analgesic No Tier 3, Generic available
Zephrex LA Decongestant No Tier 3, Generic available
Donnatal IBS No Tier 3, Generic available
Librium Anitanxiety No Tier 3, Generic available
Peridex Gingivitis No Tier 3, Generic available
Enablex Urinary Incontinence Yes Tier 3
Vesicare Urinary Incontinence Yes Tier 3
Fosrenol Electrolyte Depleter No Tier 2
Lunesta Sedative Hypnotic No Tier 3
Luveris Fertility No Tier 2
Ventavis PAH No Tier 2, PA
Combunox Narcotic Analgesic No Tier 3
Flovent HFA Inhaler Yes Tier 2
Estrace Vag Estrogen No Tier 2
Prefest Estrogen Yes Tier 2
Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.