Microsoft word - state of tn 0112 fmt usec v2.docx
January 2012
State of Tennessee Drug List
The State of Tennessee Drug List is a list of preferred drugs for your prescription benefit. This list includes Generics and Preferred Brand drugs. Generic drugs are in lowercase italics. Not all covered generics are listed. Those listed are examples of what may be prescribed. Preferred Brand drugs are in CAPS. These are the most cost-effective brand-name drugs for you. Non-preferred Brand drugs are not listed. Most of these brand-name drugs are covered but will cost you the most. Generics should be considered the first line of prescribing. If there is no generic available, there may be more than one brand-name drug to treat a condition. PLAN MEMBER HEALTH CARE PROVIDER
Ask your doctor to consider prescribing a generic drug or a
Your patient is covered under a prescription benefit plan
preferred brand-name drug from this list, if medically appropriate.
administered by CVS Caremark. As a way to help manage health
Take this list along when you see your doctor.
care costs, authorize generic substitution whenever possible. If you
Please note:
believe a brand-name product is necessary, consider prescribing a brand name on this list.
• If you have questions about your prescription coverage or
Please note:
• Visit www.caremark.com, or
• Generics should be considered the first line of prescribing.
• Contact a CVS Caremark Customer Care representative
• This drug list represents a summary of prescription coverage.
toll-free at 1-877-522-TNRX (8679).
It is not all-inclusive and does not guarantee coverage.
• For mail service, CVS Caremark may contact your doctor
• Unless specifically indicated, drug list products will include all
after getting your prescription. They may ask your doctor to
consider a preferred brand drug or a generic. Your doctor may
• Log in to www.caremark.com to check coverage and copay
choose, when medically appropriate, to prescribe a different
brand-name drug or generic in place of your original
• Any brand-name drug for which a generic product becomes
available may be designated as a non-preferred product.
ANALGESICS § NUCLEOSIDE REVERSE ANTIVIRALS TRANSCRIPTASE § CYTOMEGALOVIRUS VISCOSUPPLEMENTS INHIBITORS § PENICILLINS CHEMOKINE RECEPTOR ANTAGONISTS § HEPATITIS AGENTS ANTI-INFECTIVES ANTIBACTERIALS FUSION INHIBITORS § CEPHALOSPORINS NUCLEOTIDE REVERSE § TETRACYCLINES TRANSCRIPTASE INTEGRASE INHIBITORS INHIBITORS § HERPES AGENTS NON-NUCLEOSIDE PROTEASE INHIBITORS § ERYTHROMYCINS / § ANTIFUNGALS REVERSE TRANSCRIPTASE MACROLIDES INHIBITORS § INFLUENZA AGENTS ANTIRETROVIRALS ANTIRETROVIRAL § FLUOROQUINOLONES COMBINATIONS § MISCELLANEOUS
For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative toll-free at 1-877-522-TNRX (8679). § ANTIDEMENTIA § HYPNOTICS, NONBENZODIAZEPINES § ANGIOTENSIN II ANTINEOPLASTIC RECEPTOR ANTAGONISTS / CALCIUM CHANNEL DIURETIC COMBINATIONS BLOCKER / ANTILIPEMIC MIGRAINE COMBINATIONS ANTIDEPRESSANTS § ALKYLATING AGENTS § SELECTIVE SEROTONIN § MONOAMINE OXIDASE AGONISTS INHIBITORS (MAOIs) § DIGITALIS GLYCOSIDES § SELECTIVE SEROTONIN DIRECT RENIN INHIBITORS / REUPTAKE INHIBITORS DIURETIC COMBINATIONS ANGIOTENSIN II RECEPTOR SELECTIVE SEROTONIN ANTAGONIST / CALCIUM § ANTIMETABOLITES AGONIST / NONSTEROIDAL CHANNEL BLOCKER / ANTI-INFLAMMATORY DIURETIC COMBINATIONS DRUG (NSAID) DIRECT RENIN INHIBITOR / COMBINATIONS CALCIUM CHANNEL ANGIOTENSIN II RECEPTOR BLOCKER COMBINATIONS HORMONAL ANTAGONIST / DIRECT ANTINEOPLASTIC AGENTS MULTIPLE SCLEROSIS RENIN INHIBITOR § ANTIESTROGENS COMBINATIONS DIRECT RENIN INHIBITOR /
§ SEROTONIN CALCIUM CHANNEL NOREPINEPHRINE BLOCKER / DIURETIC COMBINATIONS REUPTAKE INHIBITORS § ANTIARRHYTHMICS § AROMATASE INHIBITORS (SNRIs) 2 NARCOLEPSY / CATAPLEXY § DIURETICS § LUTEINIZING HORMONE- RELEASING HORMONE ANTILIPEMICS ENDOCRINE AND (LHRH) AGONISTS METABOLIC § BILE ACID RESINS § MISCELLANEOUS ANDROGENS CHOLESTEROL KINASE INHIBITORS ABSORPTION INHIBITORS ANTIDIABETICS § ANTIPARKINSONIAN § BIGUANIDES PULMONARY ARTERIAL HYPERTENSION § FIBRATES ENDOTHELIN RECEPTOR ANTAGONISTS § BIGUANIDE / SULFONYLUREA COMBINATIONS § HMG-CoA REDUCTASE § ANTIPSYCHOTICS, INHIBITORS PHOSPHODIESTERASE ATYPICALS INHIBITORS DIPEPTIDYL PEPTIDASE-4 § MISCELLANEOUS (DPP-4) INHIBITORS § PROSTAGLANDIN NIACINS / COMBINATIONS VASODILATORS DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITOR / CARDIOVASCULAR BIGUANIDE COMBINATIONS § ACE INHIBITORS § BETA-BLOCKERS CENTRAL NERVOUS INCRETIN MIMETIC AGENTS § ANTICONVULSANTS § ATTENTION DEFICIT HYPERACTIVITY DISORDER § ACE INHIBITOR / INSULINS DIURETIC COMBINATIONS § CALCIUM CHANNEL BLOCKERS
For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative toll-free at 1-877-522-TNRX (8679). INSULIN SENSITIZERS § CALCINEURIN INHIBITORS DERMATOLOGY INSULIN SENSITIZER / ESTROGENS BIGUANIDE COMBINATIONS § ORAL RAPAMYCIN DERIVATIVES GENITOURINARY INSULIN SENSITIZER / RESPIRATORY SULFONYLUREA § BENIGN PROSTATIC COMBINATIONS HYPERPLASIA ANAPHYLAXIS TREATMENT § TRANSDERMAL § MEGLITINIDES § ANTICHOLINERGICS § ESTROGEN / § SULFONYLUREAS PROGESTINS, ORAL § URINARY § ANTICHOLINERGIC / BETA ANTISPASMODICS AGONIST COMBINATIONS § ACTINIC KERATOSIS SUPPLIES HUMAN GROWTH HORMONES § ANTIPSORIATICS, BETA AGONISTS, INHALANTS § SHORT ACTING § PROGESTINS, ORAL IMMUNOMODULATORS HEMATOLOGIC CALCIUM REGULATORS SELECTIVE ESTROGEN § ANTICOAGULANTS § BISPHOSPHONATES RECEPTOR MODULATORS § LOCAL ANALGESICS LONG ACTING § THYROID SUPPLEMENTS § MISCELLANEOUS SKIN AND MUCOUS MEMBRANE § CALCITONINS § LEUKOTRIENE RECEPTOR § PLATELET AGGREGATION ANTAGONISTS INHIBITORS GASTROINTESTINAL OPHTHALMIC PARATHYROID HORMONES § BETA-BLOCKERS, § H2 RECEPTOR NONSELECTIVE ANTAGONISTS § NASAL ANTIHISTAMINES CONTRACEPTIVES § MONOPHASIC IMMUNOLOGIC INFLAMMATORY BOWEL BETA-BLOCKERS, § NASAL STEROIDS SELECTIVE BIOLOGIC DISEASE- § ORAL AGENTS MODIFYING AGENTS § CARBONIC ANHYDRASE INHIBITORS, TOPICAL § TRIPHASIC IMMUNOMODULATORS INTERFERONS STEROID / BETA AGONIST § RECTAL AGENTS § PROSTAGLANDINS COMBINATIONS FOUR PHASE PANCREATIC ENZYMES IMMUNOSUPPRESSANTS § SYMPATHOMIMETICS § EXTENDED CYCLE § STEROID INHALANTS § ANTIMETABOLITES § PROTON PUMP INHIBITORS TRANSDERMAL
For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative toll-free at 1-877-522-TNRX (8679). QUICK REFERENCE DRUG LIST
For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative toll-free at 1-877-522-TNRX (8679). FOR YOUR INFORMATION:Generics should be considered the first line of prescribing. This drug list is a list of preferred drugs for your prescription benefit. It is not all-inclusive and does not guarantee coverage. Any brand drug for which a generic product becomes available may be designated as a non-preferred product. This list represents brand products in CAPS and generic products in lowercase italics. Not all covered generics are listed. Those listed are examples of what may be prescribed. Unless specifically indicated, drug list products will include all dosage forms. Listed products may be available generically in certain strengths or dosage forms. Dosage forms on this list will be consistent with the category and use where listed. Log in to www.caremark.com to check coverage and copay information for a specific medicine.
Generics are available in this class and should be considered the first line of prescribing.
Copayment, copay or coinsurance means the amount a member is required to pay for a prescription in accordance with a Plan, which may be a deductible, a percentage of the prescription price, a fixed amount or other charge, with the balance, if any, paid by a Plan.
Indicates the proposed mechanism of action, based on the American Psychiatric Association Summary of Treatment Recommendations.
An Accu-Chek or OneTouch blood glucose meter will be provided at no charge by the manufacturer to those individuals currently using a meter other than Accu-Chek or OneTouch. For more information on how to obtain a free blood glucose meter, call toll-free: 1-800-588-4456. Members must have CVS Caremark Mail Service Pharmacy benefits to qualify.
(PA2) Prior Authorization required for 36 years of age and older.
Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers. Listed products are for informational purposes only and are not intended to replace the clinical judgment of the prescriber.
2012. All rights reserved. 106-22161-1-0112
www.caremark.com
For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative toll-free at 1-877-522-TNRX (8679).
This article was downloaded by: [Isfahan University of Technology]On: 30 May 2010Access details: Access Details: [subscription number 907377393]Publisher Taylor & FrancisInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UKPhosphorus, Sulfur, and Silicon and the Related ElementsPublication details
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