The following is a list of the most commonly prescribed drugs. It represents an abbreviatedversion of the drug list (formulary) that is at the core of your prescription-drug benefit plan. The list is not all-inclusive and does not guarantee coverage. In addition to using this list,you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. 2013 Express Scripts PLEASE NOTE: The symbol * next to a drug signifies that it is subject to nonformulary status when a generic is available throughout the year. Not all the drugs listed are covered by all National Preferred Formulary prescription-drug benefit programs; check your benefit materials for the specific drugs covered and the copayments for your prescription-drug benefit program. For specific For Orange County Government questions about your coverage, please call the phone number printed on your ID card. A B D G H E O C M I P J F K L N THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2013 THROUGH DECEMBER 31, 2013. THIS LIST IS SUBJECT TO CHANGE. You can get more information and updates to this document at our website at www.express-scripts.com. 2013 Express Scripts Holding Company All Rights Reserved PRMTAQNANP-13 (08/13/12) Examples of Nonformulary Medications With Selected Formulary Alternatives
The following is a list of some nonformulary brand-name medications with examples of selected alternatives that are on the formulary.
Column 1 lists examples of nonformulary medications.
Column 2 lists some alternatives that can be prescribed. Nonformulary Formulary Alternative Nonformulary Formulary Alternative
fenofibrate/micronized, Tricor*, Trilipix
fenofibrate/micronized, Tricor*, Trilipix
Q
ciprofloxacin/er, levofloxacin, ofloxacin,
R U
ORTHO EVRA, ORTHO generic oral contraceptives, Beyaz,
V
ciprofloxacin/er, levofloxacin, ofloxacin,
S
oxybutynin er, Detrol LA, Enablex, Toviaz,
ciprofloxacin/er, levofloxacin, ofloxacin,
W
fenofibrate/micronized, Tricor*, Trilipix
fenofibrate/micronized, Tricor*, Trilipix
FLOVENT DISKUS, HFA Asmanex, Pulmicort Flexhaler, Qvar
X
fenofibrate/micronized, Tricor*, Trilipix
Z T
The symbol [INJ] next to a drug name indicates that the drug is available in injectable form only. For the member: Generic medications contain the same active ingredients as their corresponding brand-name medications, although
they may look different in color or shape. They have been FDA-approved under strict standards. For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate. Thank you. Brand-name drugs are listed in CAPITAL letters.
Generic drugs are listed in lower case letters. THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2013 THROUGH DECEMBER 31, 2013. THIS LIST IS SUBJECT TO CHANGE. You can get more information and updates to this document at our website at www.express-scripts.com. 2013 Express Scripts Holding Company All Rights Reserved PRMTAQNANP-13 (08/13/12)
Personal General Health Care for The Traveler Before The Trip Pre-existing Medical Conditions It is important that travelers have the best advice and care in planning for a productive and pleasant trip. If you plan to travel and have a pre-existing medical condition, consult a local medical doctor four to six weeks before departure; if possible, bring a brief medical history. It is be
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