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Mhrs_restrictive formulary jan12.xls
Restrictive Formulary RESTRICTIVE PMB FORMULARY Effective 1 Jan 2012
Products included on this chronic medicines formulary wil not attract a co-payment if authorised by Chronic Medicine Management for a disease on the CDL and obtained from the Designated Service Provider. Reimbursement will however be subject to the Chronic Medicine Management clinical guidelines and protocols and the Medicine Price List (MPL). KEY to Chronic Medicine Management Reimbursement Criteria: Quantity/dosage and duration of authorisation may vary - depending on the requested drug. Accepted Treatment - wil be authorised without requesting additional clinical information (unless specific concerns e.g. unusual dose requests). Clinical Review - wil be authorised if the drug history or co-morbidity clearly indicates that use of the drug is indicated in the specific patient. Clinical Motivation - specific clinical information required before reimbursement is considered Specialist Script - wil require a relevant specialist's prescription before reimbursement is considered Specialist Motivation - wil require a relevant specialist motivation before reimbursement is considered Special Investigations (SI) - results of recent relevant tests required before reimbursement is considered Drug Name Active Ingredient Strength Chronic Medicine Management Reimbursement Criteria for formulary drugs Asthma Inhaled B2 agonists AIROMIR INHALER Long acting B2 agonists FO Inhaled corticosteroids BECEZE INHALER COMPLETE Restrictive Formulary Oral Xanthines PULMOPHYLLIN SR 200 Oral Corticosteroids ADCO PREDNISOLONE Addison's disease Oral Corticosteroids COVOCORT Bipolar Mood Disorder Mood Stabilisers ARROW LAMOTRIGINE Restrictive Formulary Restrictive Formulary Antipsychotic agents ASPEN RISPERIDONE
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Restrictive Formulary
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Antidepressants ARROW CITALOPRAM Restrictive Formulary Bronchiectasis
Antibiotic therapy wil be evaluated on an individual basis
Chronic Obstructive Pulmonary Disease Inhaled B2 agonists AIROMIR INHALER Inhaled corticosteroids Restrictive Formulary Anticholinergic inhalers (short acting) ATROVENT 40 MAC COMPL 300 DOSE Oral Xanthines PULMOPHYLLIN SR 200 Oral Corticosteroids CAPSOID Restrictive Formulary Cardiac failure/ Cardiomyopathy Anticoagulants WARFARIN Diuretics ADCO-RETIC
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Potassium supplementation PLENISH K ACE inhibitors ACCUMAX Restrictive Formulary Restrictive Formulary ACE inhibitor and diuretic combinations AURO-LISINOPRIL CO Restrictive Formulary Angiotensin Receptor Blockers COZAAR Angiotensin Receptor Blockers and diuretic combinations COZAAR COMP Beta-blockers ADCO-ATENOLOL Restrictive Formulary Alpha-beta blockers ASPEN CARVEDILOL Beta-blocker and diuretic combinations ADCO-LOTEN Cardiac glycosides LANOXIN Restrictive Formulary Chronic Renal Disease For diuretics and antihypertensives, refer to "Hypertension" Calcium TITRALAC Vitamin D CALCIFEROL Oral Iron and Folic Acid supplementation AHA FERROUS SULPHATE Parenteral Iron Preparations COSMOFER AMPOULE 2ML Erythropoietin ARANESP PREFILLED SYRINGE 0.3ML Restrictive Formulary Coronary Artery Disease Aspirin ASPIRIN (WHITE) Nitrates ANGISED Restrictive Formulary Beta-blockers ADCO-ATENOLOL Calcium channel antagonists ADALAT XL Restrictive Formulary Restrictive Formulary Crohn's Disease Aminosalicylic acid preparations SALAZOPYRIN Immunosuppressants AZAMUN Methotrexate ABITREXATE-20ML Steroid preparations (oral) CAPSOID Steroid preparations (enemas) ENTOCORD ENEMAS Diabetes Mellitus Type 1 Insulin INSU ACTRAPH HMGE 10ML VIAL Restrictive Formulary
INSU APIDRA SOLOSTAR DISPOSABLE PENS 3ML
Applicances Diabetic strips, needles and lancets Diabetes Mellitus Type 2 Biguanides ACCORD METFORMIN Restrictive Formulary Sulphonylureas ALEMBIC GLICLAZIDE Thiazolidines ACTOS 15MG Insulin INSU ACTRAPH HMGE 10ML VIAL Restrictive Formulary
INSU APIDRA SOLOSTAR DISPOSABLE PENS 3ML
Applicances Diabetic strips, needles and lancets Diabetes Insipidus Desmopressin DDAVP Dysrhythmias Anticoagulants WARFARIN Antiplatelet agents ASPIRIN (WHITE) Restrictive Formulary Beta-blockers ADCO-ATENOLOL Restrictive Formulary Cardiac glycosides LANOXIN Calcium channel antagonists CALCICARD SR Anti-arrhythmics ARYCOR Epilepsy ADCO-PHENOBARB VITALET ELIXIR Restrictive Formulary Restrictive Formulary Restrictive Formulary Glaucoma Sympathomimetics ALPHAGAN Parasympathomimetics ISOPTO CARPINE 15ML Carbonic anhydrase inhibitor AZOPTIC EYE DROP Beta-blockers GLAUCOSAN 0.25% 5ML Combination products COMBIGAN 2MG/5MG 5ML Prostaglandin derivatives LUMIGAN 3ML Acetazolamide AZOMID Haemophilia Tranexamic Acid CYKLOKAPRON Desmopressin DDAVP Analgesics ACTAMOL Restrictive Formulary Restrictive Formulary Hyperlipidaemia Statins ADCO-SIMVASTATIN Restrictive Formulary Fibrates BEZACHOLE SR Nicotinic Acid NICOTINIC ACID Hypertension Sympathetic Nervous System Blockers RESERPINE Alpha-aderenergic blockers ADCO-DOXAZASIN Arterial Vasodilators APRESOLINE Diuretics ADCO-RETIC
Hydrochlorothiazide and potassium-sparing agents
Restrictive Formulary
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Hydrochlorothiazide and potassium-sparing agents
Beta-blockers ADCO-ATENOLOL Restrictive Formulary Beta-blocker and diuretic combinations AD Calcium channel antagonists ADALAT XL Restrictive Formulary ACE inhibitors ACCUMAX Restrictive Formulary Restrictive Formulary Angiotensin Receptor Blockers Restrictive Formulary Angiotensin Receptor Blockers and diuretic combinations COZAAR COMP Hypothyroidism ELTROXIN Multiple sclerosis Anticholinergics DITROPAN Immunosuppressants ABITREXATE-20ML Restrictive Formulary Muscle relaxants LIORESAL Tricyclic Antidepressants ETHIPRAMINE Carbamazepine DEGRANOL Analgesics ANTALGIC 500 Restrictive Formulary
Acetylsalicylic acid comb. excl. psycholeptics
Non-steroidal anti-inflammatories AD Restrictive Formulary Restrictive Formulary Parkinson's Disease Levodopa combinations CARBILEV Dopamine agonists and other AKINETON Restrictive Formulary Rheumatoid arthritis Disease modifying agents ABITREXATE-20ML Immunosuppressants AZAMUN Alkylating agents EN Non-steroidal anti-inflammatories ADCO-DICLOFENAC Restrictive Formulary Restrictive Formulary Oral Corticosteroids ADCO PREDNISOLONE Schizophrenia Antipsychotic agents ASPEN RISPERIDONE
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Restrictive Formulary
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Restrictive Formulary
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Accepted treatment (clinical motivation for low-cost options)
Antidepressants ETHIPRAMINE Mood Stabilisers ARROW LAMOTRIGINE Restrictive Formulary Systemic Lupus Erythematosus Non-steroidal anti-inflammatories ADCO-DICLOFENAC Restrictive Formulary Restrictive Formulary Oral Corticosteroids CAP Anticoagulants ASPIRIN (WHITE) Disease modifying agents Restrictive Formulary Immunosuppressants AZAMUN Alkylating agents ENDOXAN Ulcerative colitis Aminosalicylic acid preparations SALAZOPYRIN Immunosuppressants AZAMUN Steroid preparations (oral) CAPSOID Steroid preparations (enemas) ENTOCORD ENEMAS
Bara en tunn brädvägg skilde cellen från samhället därute. Genom en smal springa kunde jag skymta den trafikerade gatan, människor som skyndade förbi på Slussen. Jag hörde ljudet av deras klackar mot trottoaren och fragment av samtal och bruset av bilar och bussar. Från detta gömställe kände jag mig som en suverän observatör. Där fanns allt som behövdes för livets nödtorft, en b
ASRP Newsletter Tuesday April 26, 2005 The Atlantic Swine Research Partnership brings this daily market report to you. To subscribe or unsubscribe to this service please contact Dan (hurnik@asrp.ca) Quote of the Day: N/A Today’s News (Articles) 1) Distribution of the erm (B) gene, tetracycline resistance genes, and Tn1545-like transposons in macrolide- and lincosamide- resistant
Restrictive Formulary