Drug Name |
Description of Change |
Cost-effective Alternatives |
Amicar solution |
Moving to a higher level |
aminocaproic acid solution |
Diastat kit |
Moving to a higher level |
diazepam kit |
Dyrenium capsule |
Moving to a higher level |
triamterene capsule |
Ery-Tab 500 mg delayed-release tablet |
Moving to a higher level |
erythromycin base 500 mg delayed-release tablet |
Firazyr syringe |
No longer covered |
icatibant syringe |
Lyrica capsule |
Moving to a higher level |
pregabalin capsule |
Lyrica solution |
No longer covered |
pregabalin solution |
Noxafil delayed-release tablet |
No longer covered |
posaconazole delayed-release tablet |
Orfadin 2 mg, 5 mg, 10 mg capsules |
Moving to a higher level |
nitisinone 2 mg, 5 mg, 10 mg capsules |
Rozerem tablet |
No longer covered |
ramelteon tablet |