January 2009


	Standard Plan	Select Plan	Closed Plan

► BENEFIT DESIGN OPTIONS	A benefit plan with a one or two-tier structure that includes generic and brands. There is no difference between preferred and nonpreferred brands.	A benefit plan with a three-tier structure that includes generics, preferred brands and nonpreferred brands.	A benefit plan with a two-tier structure that includes generics and preferred brands. Nonpreferred brands are not covered.

► NEW DRUGS	Standard Plan	Select Plan	Closed Plan
No new drugs reviewed at the January meetings

► LINE EXTENSIONS	Standard Plan	Select Plan	Closed Plan
No line extensions reviewed at the January meetings

► DRUG CLASS REVIEW Overactive Bladder Agents	Standard Plan	Select Plan	Closed Plan
oxybutynin, oxybutynin ER
Full Class review of agents in the category of Incontinence (Urinary), used in the treatment of overactive bladder. DACON edits may apply to some products	Generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.
Enablex, Oxytrol, Vesicare
Full Class review of agents in the category of Incontinence (Urinary), used in the treatment of overactive bladder. DACON edits may apply to some products Vesicare remains at Tier 2 preferred status. Enablex and Oxytrol are being added to preferred status.	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Detrol, Detrol LA, Ditropan, Ditropan XL, Sanctura, Sanctura XR
Full Class review of agents in the category of Incontinence (Urinary), used in the treatment of overactive bladder. DACON edits may apply to some products Ditropan and Ditropan XL remain at Tier 3 non- preferred status. Detrol / LA, Sanctura / XR are being removed from preferred status.	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.

► DRUG CLASS REVIEW Proton Pump Inhibitors (PPIs)	Standard Plan	Select Plan	Closed Plan
*omeprazole, pantoprazole**
Full review of Proton Pump Inhibitors in the category of Gastrointestinal Agents (Anti-Ulcer). DACON edits may apply to some products *See additional information for omeprazole under Clinical Programs, Generic$ Rx	Generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.
Prilosec OTC*
Full review of Proton Pump Inhibitors in the category of Gastrointestinal Agents (Anti-Ulcer). *Prilosec OTC is available only to members of plans that have chosen to include the RxOTC program.	Generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.
Nexium, Prevacid
Full review of Proton Pump Inhibitors in the category of Gastrointestinal Agents (Anti-Ulcer). DACON edits apply Prevacid remains at Tier 2 preferred status. Nexium is being added to preferred status.	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Aciphex, Prilosec, Protonix, Zegerid
Full review of Proton Pump Inhibitors in the category of Gastrointestinal Agents (Anti-Ulcer). DACON edits may apply to some products Aciphex, Prilosec, and Zegerid remain at Tier 3 non- preferred status. Protonix is being removed from preferred status.	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.

► SPECIAL ANNOUNCEMENT Important changes are taking place for the Proton Pump Inhibitor class, effective April 1, 2009. Innoviant Clinical Services Department will be offering webcasts to provide an in depth explanation of these changes to Plan Sponsors. Please watch your email over the next few weeks for an invitation to attend one of these informational sessions.

► PPL UPDATES	Standard Plan	Select Plan	Closed Plan
Enablex (darifenacin hydrobromide)
Used in the treatment of overactive bladder or urinary incontinence. Enablex is added to second tier preferred brand status. DACON edits apply In a limited category (Incontinence-Urinary)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Oxytrol (oxybutynin TD patch)
Used for the treatment of overactive bladder or urinary incontinence. Oxytrol is added to second tier preferred brand status. DACON edits apply In a limited category (Incontinence-Urinary)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Nexium (esomeprazole magnesium)
A proton pump inhibitor used in the treatment of ulcers. Nexium is added to second tier preferred brand status. DACON edits apply In a limited category (Gastrointestinal Agents- Anti-Ulcer)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Protonix (pantoprazole sodium)
A proton pump inhibitor (PPI) used in the treatment of ulcers. Protonix is removed from preferred status. DACON edits apply In a limited category (Gastrointestinal Agents- Anti-Ulcer)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.
Detrol, Detrol LA (tolterodine tartrate)
Used in the treatment of overactive bladder or urinary incontinence. Detrol / LA is removed from preferred status. DACON edits apply In a limited category (Incontinence-Urinary)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.
Sanctura, Sanctura XR (solifenacin chloride)
Used in the treatment of overactive bladder or urinary incontinence. Sanctura / XR is removed from preferred status. DACON edits apply In a limited category (Incontinence-Urinary)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.

► BRANDS WITH GENERICS AVAILABLE	Standard Plan	Select Plan	Closed Plan
Imitrex (sumatriptan succinate) nasal spray
Imitrex Nasal Spray is a "triptan" medication used in the treatment of migraine headaches. This medication is being removed from preferred status because the generic equivalent, sumatriptan nasal spray, is available at the generic copay. Quantity limits apply. In a limited category (Migraine)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.

► Clinical Programs: Quantity Limits	Standard Plan	Select Plan	Closed Plan
Cialis 5mg tab (tadalafil)
Used in the treatment of erectile dysfunction. Quantity Limit has been updated to allow 30 tablets per 30 days to reflect optional approved dosing regimen of one tablet daily for this strength. Please note, the Cialis 2.5 mg tablet also has the 30 tablet per 30 day limit in effect. Non-standard category (erectile dysfunction) In a limited category (sexual dysfunction)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Sancuso (granisetron transdermal patch)
Used for the prevention of nausea and vomiting in cancer patients undergoing chemotherapy. A quantity limit of one patch per copay will apply as part of the Quantity Limits program. In a limited category (antiemetics)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.
estradiol patch
Listed item will be added to the Quantity limits program, effective April 1, 2009.	Generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.	First tier, generic copay. Coverage determined by the benefit design chosen by the plan sponsor.
Alora, Climara-Pro, Estraderm, Menostar
Listed items will be added to the Quantity limits program, effective April 1, 2009.	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Second tier, preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.
Climara, Combipatch, Estrasorb, Estrogel, Vivelle, Vivelle-Dot
Listed items will be added to the Quantity limits program, effective April 1, 2009.	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.

► Clinical Programs: DACON	Standard Plan	Select Plan	Closed Plan
Prandimet
A combination of repaglinide and metformin which is indicated as an adjunct to diet and exercise to improve control of blood sugar in adults with Type 2 diabetes mellitus who are already being treated with the same agents alone or in combination. Prior therapy review applies as an electronic step edit. The electronic edit reviews claim history for prior use of two of the following agents: metformin, a sulfonylurea, a TZD. Prandimet is being added to the DACON program. In a limited category (anti-diabetic)	Brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage determined by the benefit design chosen by the plan sponsor.	Not covered.

► Clinical Programs: Generic$ Rx	Standard Plan	Select Plan	Closed Plan
omeprazole
Omeprazole delayed release capsules (generic for Prilosec) will be added to the Generic$ Rx Program. Generic$ Rx is an optional program that allows members to receive generic medications in select therapy classes for a zero copayment.	Zero copay for members of plans that have chosen to include the Generic$ Rx Program. Coverage will be determined by the benefit design selected by the plan sponsor	Zero copay for members of plans that have chosen to include the Generic$ Rx Program. Coverage will be determined by the benefit design selected by the plan sponsor	Zero copay for members of plans that have chosen to include the Generic$ Rx Program. Coverage will be determined by the benefit design selected by the plan sponsor

► SPECIAL ANNOUNCEMENT Important changes are taking place for the Proton Pump Inhibitor class, effective April 1, 2009. Innoviant Clinical Services Department will be offering webcasts to provide an in depth explanation of these changes to Plan Sponsors. Please watch your email over the next few weeks for an invitation to attend one of these informational sessions.

	February 2009



Innoviant's Business Committee meets monthly to evaluate product status (tier placements) and new prescription products approved by the Food and Drug Administration (FDA). Decisions made by the Innoviant Business Committee are based on information and recommendations provided by Prescription Solutions' National Pharmacy & Therapeutics Committee (NPTC). The P&T is comprised of independent physician providers, affiliated plan physicians and pharmacists. The following table summarizes the decisions made at the January committee meetings. All changes are effective April 1, 2009. Current information related to Innoviant and its offerings is available at www.innoviant.com. A copy of this newsletter can also be found on the website (http://www.innoviant.com/customers/publications/default.asp).