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Drug List Changes

2010 Aetna Medicare Rx Plan (PDP)

Here are changes from a recent review of Aetna Medicare's Preferred Drug List (formulary). They are based on findings from the Food and Drug Administration (FDA) and drug makers, and other factors including cost. Changes occur, for example, because new drugs come on the market, we may learn that a prescription drug should now have a lower dose, it's moved to a different cost-sharing level (tier), or a generic version becomes available. We change our list to help provide you with appropriate, affordable drug benefits.

Carefully review the monthly changes below and their effective dates. If you are affected by preferred drug list changes, you will receive a letter explaining the changes. You can also speak with your doctor or pharmacist about the preferred drug list changes.  

View full Aetna Medicare Rx Plan (PDP) 2010 Comprehensive Formulary PDF Icon (93 pages, 342 KB)

UPPERCASE = Brand-name medications QL = Quantity limits
lower case italics = generic medications ST = Step therapy
Tier 1, 2, 3, 4, 5 = Copay tier level PR = Precertification

 

Date of Change: January 1, 2010

ULORIC Addition   Tier 3, ST

Date of Change: March 1, 2010

AMINOSYN IIM INJ 3.5%/D5W Addition   Tier 4
ARZERRA Addition   Tier 5, PR
augmented betamethasone dipropionate lotion 0.05% Addition   Tier 2
azelastine ophth soln 0.05% Addition   Tier 2
clindamycin phosphate-benzoyl peroxide gel 1-5% Addition   Tier 1
FANAPT Addition   Tier 4, PR, ST, QL=2/1 day
FANAPT PAK Addition   Tier 4, PR, ST, QL=16/365 days
HALFLYTELY KIT BWL-PREP Addition   Tier 4
INVEGA 1.5MG TABLETS Addition   Tier 4, ST, QL=1/1 day
LIPOSYN II INJ 10,20,30% Addition   Tier 4
piperacillin sodium-tazobactam sodium for inj 3-0.375 gm Addition   Tier 2
polyethylene glycol 3350 Addition   Tier 1
timolol ophth gel Addition   Tier 1
tramadol er Addition   Tier 1, QL=1/1 day
valacyclovir Addition   Tier 1
VIBATIV Addition   Tier 5, QL=3/1 day
VOTRIENT Addition   Tier 5, PR, QL=1/1 day

Date of Change: May 1, 2010

ACEON 2MG Formulary removal perindopril 2 mg Generic available Tier 2, QL=2/1 day
ACEON 4MG Formulary removal perindopril 4 mg Generic available Tier 2, QL=2/1 day
ACEON 8MG Formulary removal perindopril 8 mg Generic available Tier 2
ACULAR Formulary removal ketorolac 5 mg/ml Generic available Tier 2
ACULAR LS Formulary removal ketorolac 4 mg/ml Generic available Tier 2
CATAPRES-TTS-1 Formulary removal clonidine 0.00417 mg/hr Generic available Tier 2
CATAPRES-TTS-2 Formulary removal clonidine 0.00833 mg/hr Generic available Tier 2
CATAPRES-TTS-3 Formulary removal clonidine 0.0125 mg/hr Generic available Tier 2
IOPIDINE Formulary removal apraclonidine 5 mg/ml Generic available Tier 2
PROGRAF 1MG Formulary removal tacrolimus 1 mg Generic available Tier 2, PR
PROGRAF 5MG Formulary removal tacrolimus 5 mg Generic available Tier 2
PROGRAF 0.5MG Formulary removal tacrolimus 0.5 mg Generic available Tier 2, PR
RISPERDAL-M 1MG Formulary removal risperidone 1 mg Generic available Tier 2, QL=2/1 day
STARLIX 60MG Formulary removal nateglinide 60 mg Generic available Tier 2
STARLIX 120MG Formulary removal nateglinide 120 mg Generic available Tier 2
SUBUTEX 2MG Formulary removal buprenorphine 2 mg Generic available Tier 2, PR
SUBUTEX 8MG Formulary removal buprenorphine 8 mg Generic available Tier 2, PR
TRILEPTAL SOLUTION Formulary removal oxcarbazepine 60 mg/ml solution Generic available Tier 2

See the Aetna Medicare Glossary for unfamiliar terms.

See the Aetna Medicare Rx Find Prescriptions page for more information about Aetna Medicare's preferred drug list (formulary).

(Last updated 3/1/2010)

 

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Page Last Updated: March 1, 2010