Volume 1

► NEW DRUGS	Standard Plan	Select Plan	Closed Plan
Omnaris (ciclesonide nasal susp)
Indicated for the treatment of nasal symptoms of seasonal allergic rhinitis (SAR) in patients ≥ 6 years of age and for perennial allergic rhinitis (PAR) in patients ≥ 12 years of age. In a limited category (allergy - intranasal)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.
Pristiq (desvenlafaxine SR tab)
Indicated for the treatment of major depressive disorder (MDD) in adults. In a limited category (antidepressants - SNRI type) Quantity Limits/DACON applies	Brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Not covered.
Treanda (bendamustine hcl for IV sol.)
Indicated for the treatment of patients with chronic lymphocytic leukemia (CLL). Not in a limited category (antineoplastics). Specialty Pharmacy Program Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the brand copay. If the customer does not have the SPP it may be considered under the medical benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the preferred brand copay. If the customer does not have the SPP it may be considered under the medical benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the preferred brand copay. If the customer does not have the SPP it may be considered under the medical benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.
Arcalyst (rilonacept for subcutaneous injection)
Indicated for the treatment of cryopyrin-associated periodic syndromes (CAPS), including familial cold auto-inflammatory syndrome (FCAS) and Muckle-Wells (MWS) in adults and children 12 years and older. Prior Authorization applies Specialty Pharmacy Program	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy program (SPP), this product may be obtained through the specialty pharmacy network at the third tier, non-preferred brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	Not covered.
Patanase (olopatadine nasal solution)
Indicated for the relief of the symptoms of seasonal allergic rhinitis (SAR) in patients 12 years of age and older. In a limited category (allergy - intranasal) Quantity Limits/DACON applies	Brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Not covered.
Cimzia (certolizumab for subcutaneous injection)
A tumor necrosis factor-alpha (TNF) antagonist indicated for reduction of the signs and symptoms of Crohn's disease and maintaining response in adult patients with moderate to severe active disease who have had an inadequate response to conventional therapy. In a limited category (gastrointestinal agents - miscellaneous)	Brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Not covered.
Relistor (methylnaltrexone bromide, for subcutaneous injection)
Indicated for the treatment of opioid-induced constipation in patients with advanced illness who are receiving palliative care, when response to laxative therapy has not been sufficient. Prior Authorization applies	Brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Third tier, non-preferred brand copay. Coverage limits determined by the benefit design chosen by the plan sponsor.	Not covered.

► LINE EXTENSIONS	Standard Plan	Select Plan	Closed Plan
Luvox CR (fluvoxamine maleate ER cap)
Indicated for the treatment of social anxiety disorder (SAD) and obsessive compulsive disorder (OCD) in adults. In a limited category (antidepressants - SSRI Type) Quantity Limits/DACON applies	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.
Treximet
Treximet, a combination of Imitrex (sumatriptan) and naproxen sodium (an NSAID), is indicated for the acute treatment of migraine attacks in adults. In a limited category (migraine) Quantity Limits apply	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.
Xyzal Solution (levocetirizine)
Indicated for the relief of the symptoms of seasonal and perennial allergic rhinitis and for the treatment of uncomplicated chronic idiopathic urticaria in adults and children ages 6 years and older. In a limited category (antihistamines) Quantity Limits/DACON applies	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.
Voltaren Gel (diclofenac sodium topical gel)
An NSAID indicated for the relief of the pain of osteoarthritis of joints amenable to topical treatment, such as the knees and those of the hands. In a limited category (analgesics and narcotics)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.
Actonel 150mg (risedronate sodium tab)
Indicated for the treatment and prevention of osteoporosis in post-menopausal women. In a limited category (osteoporosis) Quantity Limits/DACON applies	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.
Zingo (lidoderm powder device)
Indicated for use on intact skin to provide topical local analgesia prior to medical procedures. Not in a limited category	Brand copay.	Second tier, preferred brand copay.	Second tier, preferred brand copay.

► DRUG CLASS REVIEW	Standard Plan	Select Plan	Closed Plan
Humatrope, Norditropin, Nutropin/AQ
Full Class review of Growth Hormones used in the treatment of growth hormone deficiency. In a limited category (growth hormones) Nonstandard Category Prior Authorization applies Specialty Pharmacy Program Effective October 1, 2008.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the second tier, preferred brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the second tier, preferred brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.
Genotropin, Omnitrope, Saizen, Serostim, Tev-Tropin, Zorbtive
Full Class review of Growth Hormones used in the treatment of growth hormone deficiency. In a limited category (growth hormones) Nonstandard Category Prior Authorization applies Specialty Pharmacy Program Effective October 1, 2008.	If the customer has the Specialty Pharmacy Program (SPP), this product may be obtained through the specialty pharmacy network at the brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	If the customer has the Specialty Pharmacy program (SPP), this product may be obtained through the specialty pharmacy network at the third tier, non-preferred brand copay. If the customer does not have the SPP it may be considered under the pharmacy benefit. Coverage and pharmacy provider(s) determined by the benefit design selected by the plan sponsor.	Not covered.

► PPL UPDATES	Standard Plan	Select Plan	Closed Plan
Tricor
Tricor is added to preferred product status, effective October 1, 2008. In a limited category (cholesterol lowering medications)	Brand copay.	Second tier, preferred brand copay.	Second tier, preferred brand copay.
Activella 0.5mg - 0.1mg
Activella 0.5 - 0.1 is being removed from preferred status. In a limited category (hormone replacement therapy)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.
Simcor
Simcor is a combination of simvastatin and extended release niacin indicated for the treatment of primary hypercholesterolemia, mixed dyslipidemia or hypertriglyceridemia when therapy with either agent alone is considered inadequate. Prior therapy review will apply as an electronic step edit. The electronic edit reviews claim history for prior use of Advicor or simvastatin. In a limited category (cholesterol lowering) Quantity Limits/DACON applies	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.
Sular 10mg, 20mg, 30mg, 40mg tablets (nisoldipine SR tablets)
Indicated for the treatment of hypertension either alone, or in combination with other antihypertensive agents. Sular 10mg, 20mg, 30mg, and 40mg tablets are moved to third tier non-preferred status because the reformulated products Sular 8.5mg, 17mg, 25.5 mg, and 34 mg tablets are available at second tier preferred status. In a limited category (blood pressure - calcium channel blockers) Quantity Limit/DACON applies	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
Activella 1mg - 0.5mg
Activella 1mg - 0.5mg is being removed from preferred status because the generic equivalent, estradiol-norethindrone acetate 1mg - 0.5mg is available at the generic copay. In a limited category (hormone replacement therapy)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.
Requip
Requip is being removed from preferred status because the generic equivalent, ropinirole, is available at the generic co-pay. In a limited category (anti-Parkinsons disease agents)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.
Precose
Precose is being removed from preferred status because the generic equivalent, acarbose, is available at the generic copay. In a limited category (antidiabetics)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.
Yasmin
Yasmin is being removed from preferred status because the generic equivalent, Ocella, is available at the generic copay. In a limited category (contraceptives-oral)	Brand copay.	Third tier, non-preferred brand copay.	Not covered.

	September 2008



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 August committee meetings. Additions to the Preferred Products List (PPL) are effective immediately. All other changes are effective November 1 unless otherwise noted. Current information related to Innoviant and its offerings is available at http://www.innoviant.com/. A copy of this newsletter can also be found on the website.