Formulary Change Notifications - 2013 and Prior

Cigna-HealthSpring may add or remove drugs from our formulary during the year. If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug (and/or move a drug to a higher cost-sharing tier), we will notify you of the change at least 60 days before the date that the change becomes effective. However, if the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market or Medicare no longer covers a drug previously covered, we will immediately remove the drug from our formulary.

 

Prospective (60-day) Formulary Change Notification for National Prescription Drug Plan, Medicare Advantage Prescription Drug Plans, and TotalCare Plans.  Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.



Effective October 1, 2013

Effective October 1, 2013 the listed changes will apply to the HealthSpring Bravo Health Formulary list of covered drugs:

Name of Affected Drug
Changes Reason for Change
Carisoprodol 350mg tab Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
Indomethacin 25mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Indomethacin 50mg
Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
indomethacin 75 mg ER Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
Methocarbamol 500mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
Methocarbamol 750mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
Methyldopa 250mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
Methyldopa 500mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
dipyridamole 25mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
dipyridamole 75mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
dipyridamole 50mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
cyclobenzaprine 5mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
cyclobenzaprine 10mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
cyproheptadine 4mg Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
hydroxyzine 10mg tab Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
hydroxyzine 100mg cap Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
hydroxyzine 25mg cap Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

hydroxyzine 25mg tab
Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
hydroxyzine 50mg tab Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
hydroxyzine 50mg cap Removed from Formulary This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available
 

Effective September 1, 2013

Effective September 1, 2013 the listed changes below will apply to the following HealthSpring/Bravo plans:
Name of Affected Drug
Changes Reason for Change

Glyburide 1.25mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Glyburide 1.5mg tab micronized

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Glyburide 2.5 mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Glyburide 3mg tab micronized

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Glyburide 5mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Glyburide 6mg tab micronized

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Guanfacine 1mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Guanfacine 2mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Zaleplon 10mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Zaleplon 5mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Zolpidem 10mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

Zolpidem 5mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

glyburide/metformin 1.25/250 tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

glyburide/metformin 2.5/500 tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

glyburide/metformin 5/500 tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

benzotropine 1mg/ml injection

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

benzotropine 1mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

benzotropine 2mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

benzotropine 0.5mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

trihexyphenidyl 2mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

trihexyphenidyl 0.4mg mg/ml solution

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available

trihexyphenidyl 5mg tab

Requires Prior Authorization for members 65 years of age and older

This drug has high risk of safety issues in patients 65 years of age and greater and safer alternatives are available



Effective August 1, 2013
 
Effective August 1, 2013, the following changes will apply to new starts of the HealthSpring Formulary list of covered drugs. 
Name of Affected Drug
Changes
amitriptyline 100mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 10mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 150mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 25mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 50mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 75mg Requires Prior Authorization for members 65 years of age and older
benzotropine 0.5mg tab Requires Prior Authorization for members 65 years of age and older
benzotropine 1mg tab Requires Prior Authorization for members 65 years of age and older
benzotropine 1mg/ml injection Requires Prior Authorization for members 65 years of age and older
benzotropine 2mg tab Requires Prior Authorization for members 65 years of age and older
Benztropine 2mg Requires Prior Authorization for members 65 years of age and older
clomipramine 25mg tab Requires Prior Authorization for members 65 years of age and older
clomipramine 50mg tab Requires Prior Authorization for members 65 years of age and older
clomipramine 75mg tab Requires Prior Authorization for members 65 years of age and older
Digoxin 0.125mg Quantity Limit #30 per 30 days added
Digoxin 0.25mg Requires Prior Authorization for members 65 years of age and older
doxepin 100mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 10mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 10mg/ml solution Requires Prior Authorization for members 65 years of age and older
doxepin 150mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 25mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 50mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 75mg tab Requires Prior Authorization for members 65 years of age and older
Estradiol 0.5mg Requires Prior Authorization for members 65 years of age and older
Estradiol 1mg Requires Prior Authorization for members 65 years of age and older
Estradiol 2mg Requires Prior Authorization for members 65 years of age and older
Glyburide 1.25mg tab Requires Prior Authorization for members 65 years of age and older
Glyburide 1.5mg tab micronized Requires Prior Authorization for members 65 years of age and older
Glyburide 2.5 mg tab Requires Prior Authorization for members 65 years of age and older
Glyburide 3mg tab micronized Requires Prior Authorization for members 65 years of age and older
Glyburide 5mg tab Requires Prior Authorization for members 65 years of age and older
Glyburide 6mg tab micronized Requires Prior Authorization for members 65 years of age and older
glyburide/metformin 1.25/250 tab Requires Prior Authorization for members 65 years of age and older
glyburide/metformin 2.5/500 tab Requires Prior Authorization for members 65 years of age and older
glyburide/metformin 5/500 tab Requires Prior Authorization for members 65 years of age and older
Guanfacine 1mg tab Requires Prior Authorization for members 65 years of age and older
Guanfacine 2mg tab Requires Prior Authorization for members 65 years of age and older
imipramine  25mg Requires Prior Authorization for members 65 years of age and older
imipramine 50mg Requires Prior Authorization for members 65 years of age and older
megestrol acetate 20mg tab Requires Prior Authorization for members 65 years of age and older
megestrol acetate 40mg tab Requires Prior Authorization for members 65 years of age and older
megestrol acetate 40mg/ml suspension Requires Prior Authorization for members 65 years of age and older
Nitrofurantoin 100mg cap
Quantity Limit 90 days’ supply per 365 days was added
Nitrofurantoin 50mg cap
Quantity Limit 90 days’ supply per 365 days was added
Premarin 0.3mg tab  Requires Prior Authorization for members 65 years of age and older
Premarin 0.45mg tab Requires Prior Authorization for members 65 years of age and older
Premarin 0.625mg tab Requires Prior Authorization for members 65 years of age and older
Premarin 0.9 mg tab Requires Prior Authorization for members 65 years of age and older
Premarin 1.25mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 1.25mg/ml soln Requires Prior Authorization for members 65 years of age and older
Promethazine 12.5mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 25mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 50mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 50mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 100mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 10mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 25mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 50mg tab Requires Prior Authorization for members 65 years of age and older
trihexyphenidyl 0.4mg mg/ml
solution
Requires Prior Authorization for members 65 years of age and older
trihexyphenidyl 2mg tab Requires Prior Authorization for members 65 years of age and older
trihexyphenidyl 5mg tab Requires Prior Authorization for members 65 years of age and older
Trimipramine 100mg tab Requires Prior Authorization for members 65 years of age and older
Trimipramine 25mg tab Requires Prior Authorization for members 65 years of age and older
Trimipramine 50mg tab Requires Prior Authorization for members 65 years of age and older
Zaleplon 10mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zaleplon 10mg tab Requires Prior Authorization for members 65 years of age and older
Zaleplon 5mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zaleplon 5mg tab Requires Prior Authorization for members 65 years of age and older
Zolpidem 10mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zolpidem 10mg tab Requires Prior Authorization for members 65 years of age and older
Zolpidem 5mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zolpidem 5mg tab Requires Prior Authorization for members 65 years of age and older

Effective July 26, 2013

On July 26th 2013, Nova Diabetes Care initiated a voluntary recall for Nova Max Glucose Test Strips (NDC 08548-0434-37 and 08548-0435-23) and Nova Max Plus Glucose Meter Kits (NDC 08548-0434-35). This voluntary, user-level recall was initiated because some test strips in the listed lot numbers may report a false blood sugar result that is higher than the actual blood sugar level.


Effective July 1, 2013
Effective July 1, 2013 the listed changes below will apply to the following HS plans:

HealthSpring Preferred (HMO-POS) HealthSpring Premier (HMO-POS)
HealthSpring Preferred DFW (PPO) HealthSpring Premier Bay (HMO-POS)
HealthSpring Preferred (HMO) HealthSpring Premier SMS (HMO-POS)
HealthSpring Preferred Bay (HMO) HealthSpring Premier (HMO-POS)
HealthSpring Preferred SMS (HMO) HealthSpring Premier KNX (HMO-POS)
HealthSpring Preferred (HMO) HealthSpring Premier NGA (HMO-POS)
HealthSpring Preferred KNX (HMO) HealthSpring Premier NMS (HMO-POS)
HealthSpring Preferred NGA (HMO) HealthSpring Premier WVA (HMO-POS)
HealthSpring Preferred WVA (HMO) HealthSpring Achieve (HMO SNP)

Name of Affected
Drug
Reason for Change Alternative Drug
Seroquel 300 tab Generic Available quetiapine 300mg tab
Seroquel 400 tab Generic Available quetiapine 400mg tab
Seroquel 100 tab Generic Available quetiapine 100mg tab
Seroquel 25 tab Generic Available quetiapine 25mg tab
Seroquel 50 tab Generic Available quetiapine 50mg tab
Seroquel 200 tab Generic Available quetiapine 200mg tab
Geodon 20mg tab Generic Available ziprasidone 20mg tab
Geodon 40mg tab Generic Available ziprasidone 40mg tab
Geodon 60 mg tab Generic Available ziprasidone 60mg tab
Geodon 80mg tab Generic Available ziprasidone 80mg tab
Zyprexa 10mg Vial Generic Available olanzapine 10mg vial
Symbyax 50/6 Generic Available olanzapine/fluoxetine 50/6 tab
Symbyax 25/12 Generic Available olanzapine/fluoxetine 25/12 tab
Symbyax 25/6 Generic Available olanzapine/fluoxetine 25/6 tab
Symbyax 50/12 Generic Available olanzapine/fluoxetine 50/12 tab
Symbyax 25/3 Generic Available olanzapine/fluoxetine 25/3 tab
Viramune tab 200mg Generic Available nevirapine 200mg
Vancocin 125mg Generic Available vancomycin 125mg tab
Vancocin 250mg tab Generic Available vancomycin 250mg tab
Actos 15mg Generic Available pioglitazone 15mg tab
Actos 30mg Generic Available pioglitazone 30mg tab
Actos 45mg Generic Available pioglitazone 45mg tab
Actoplus met 500/15 Generic Available metformin/pioglitazone 500/15
Actoplus met 850/15 Generic Available metformin/pioglitazone 850/15
Singulair 10mg tab Generic Available montelukast 10mg tab
Singulair 5mg chew Generic Available montelukast 5mg chew
Singulair 4mg chew Generic Available montelukast 4mg chew
Revatio 20mg tab Generic Available sildenafil 20mg tab
Gabitril 2mg Generic Available tiagabine 2mg tab
Gabitril 4mg Generic Available tiagabine 4mg tab
Dovonex cream 0.0005% Generic Available calcipotriene cream 0.0005%
Ziagen tab 300mg Generic Available abacavir 300mg tab
Vfend 200mg vial Generic Available voriconazole 200mg vial
Prometrium 100mg tab Generic Available progesterone 100mg tab
Prometrium 200mg tab Generic Available progesterone 200mg tab
Plavix 75mg Generic Available clopidogrel 75mg tab
Plavix 300mg Generic Available clopidogrel 300 mg tab
Surmontil 25mg Generic Available trimipramine 25mg cap
Surmontil 50mg Generic Available trimipramine 50mg cap
Surmontil 100mg Generic Available trimipramine 100 mg cap
 
 
Effective July 1, 2013, the following changes will apply to the HealthSpring Formulary list of covered drugs.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Seroquel 300mg Generic Available Quetiapine
Provigil 200mg Generic Available Modafinil
Tricor 48mg Generic Available Fenofibrate
Actoplus Met 15/850mg Generic Available Metformin HCL/
Pioglitazone HCL


Effective June 1, 2013
 
Effective June 1, 2013, the following changes will apply to the HealthSpring Formulary list of covered drugs. Click here for Arkansas, Oklahoma, Texarkana formulary changes or for Retiree formulary changes.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Seroquel 300 tab Generic Available quetiapine 300mg tab
Seroquel 400 tab Generic Available quetiapine 400mg tab
Seroquel 100 tab Generic Available quetiapine 100mg tab
Seroquel 25 tab Generic Available quetiapine 25mg tab
Seroquel 50 tab Generic Available quetiapine 50mg tab
Seroquel 200 tab Generic Available quetiapine 200mg tab
Geodon 20mg tab Generic Available ziprasidone 20mg tab
Geodon 40mg tab Generic Available ziprasidone 40mg tab
Geodon 60 mg tab Generic Available ziprasidone 60mg tab
Geodon 80mg tab Generic Available ziprasidone 80mg tab
Zyprexa 10mg Vial Generic Available olanzapine 10mg vial
Symbyax 50/6 Generic Available olanzapine/fluoxetine 50/6 tab
Symbyax 25/12 Generic Available olanzapine/fluoxetine 25/12 tab
Symbyax 25/6 Generic Available olanzapine/fluoxetine 25/6 tab
Symbyax 50/12 Generic Available olanzapine/fluoxetine 50/12 tab
Symbyax 25/3 Generic Available olanzapine/fluoxetine 25/3 tab
Viramune tab 200mg Generic Available nevirapine 200mg
Vancocin 125mg Generic Available vancomycin 125mg tab
Vancocin 250mg tab Generic Available vancomycin 250mg tab
Actos 15mg Generic Available pioglitazone 15mg tab
Actos 30mg Generic Available pioglitazone 30mg tab
Actos 45mg Generic Available pioglitazone 45mg tab
Actoplus met 500/15 Generic Available metformin/pioglitazone 500/15
Actoplus met 850/15 Generic Available metformin/pioglitazone 850/15
Singulair 10mg tab Generic Available montelukast 10mg tab
Singulair 5mg chew Generic Available montelukast 5mg chew
Singulair 4mg chew Generic Available montelukast 4mg chew
Revatio 20mg tab Generic Available sildenafil 20mg tab
Gabitril 2mg Generic Available tiagabine 2mg tab
Gabitril 4mg Generic Available tiagabine 4mg tab
Dovonex cream 0.0005% Generic Available calcipotriene cream 0.0005%
Ziagen tab 300mg Generic Available abacavir 300mg tab
Vfend 200mg vial Generic Available voriconazole 200mg vial
Prometrium 100mg tab Generic Available progesterone 100mg tab
Prometrium 200mg tab Generic Available progesterone 200mg tab
Plavix 75mg Generic Available clopidogrel 75mg tab
Plavix 300mg Generic Available clopidogrel 300 mg ta
Surmontil 25mg Generic Available trimipramine 25mg cap
Surmontil 50mg Generic Available trimipramine 50mg cap
Surmontil 100mg Generic Available trimipramine 100 mg cap

Effective June 1, 2013, the following changes will apply to the Arkansas, Oklahoma and Texarkana Formulary list of covered drugs (affecting contracts: H1266, H2038, H2676, H4125, H4871, H6972, H7811).
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Lexapro Soln 5mg/ml Generic Available escitalopram soln 5mg/ml
Zyprexa 10mg Vial Generic Available olanzapine 10mg vial
Actos 15mg Generic Available pioglitazone 15mg
Actos 30mg Generic Available pioglitazone 30mg
Actoplus met 500/15 Generic Available pioglitazone/metformin 500/15
Actoplus met 850/15 Generic Available pioglitazone/metformin 850/15
Singular 10mg tab Generic Available montelukast 10mg tab
Singular 5mg chew Generic Available montelukast 5mg chew
Singular 4mg chew Generic Available montelukast 4mg chew
VFEND IV 200mg Generic Available voriconazole 200mg vial
Revatio 20MG Generic Available sildenafil 20mg
Tricor 145mg Generic Available fenofibrate 145mg
Tricor 48mg Generic Available fenofibrate 48mg
Gabitril 2mg Generic Available tiagabine 2mg
Gabitril 4mg Generic Available tiagabine 4mg
Ziagen 300mg Generic Available abacavir 300mg
Vancocin 125 mg Generic Available vancomycin 125mg
Vancocin 250 mg Generic Available vancomycin 250mg
 
 
Effective June 1, 2013, the following changes will apply to the HealthSpring Retiree Formulary list of covered drugs.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Symbyax 50/6 Generic Available olanzapine/fluoxetine 50/6 tab
Symbyax 25/12 Generic Available olanzapine/fluoxetine 25/12 tab
Symbyax 25/6 Generic Available olanzapine/fluoxetine 25/6 tab
Symbyax 50/12 Generic Available olanzapine/fluoxetine 50/12 tab
Symbyax 25/3 Generic Available olanzapine/fluoxetine 25/3 tab
Viramune tab 200mg Generic Available nevirapine 200mg
Vancocin 125mg Generic Available vancomycin 125mg tab
Vancocin 250mg tab Generic Available vancomycin 250mg tab
Actos 15mg Generic Available pioglitazone 15mg tab
Actos 30mg Generic Available pioglitazone 30mg tab
Actos 45mg Generic Available pioglitazone 45mg tab
Actoplus met 500/15 Generic Available metformin/pioglitazone 500/15
Actoplus met 850/15 Generic Available metformin/pioglitazone 850/15
Singulair 4mg chew Generic Available montelukast 4mg chew
Singulair 10mg tab Generic Available montelukast 10mg tab
Singulair 5mg tab Generic Available montelukast 5mg tab
Revatio 20mg tab Generic Available sildenafil 20mg tab
Gabitril 2mg Generic Available tiagabine 2mg tab
Gabitril 4mg Generic Available tiagabine 4mg tab
Dovonex cream 0.005% Generic Available calcipotriene cream 0.005%
Ziagen tab 300mg Generic Available abacavir 300mg tab
Vfend 200mg vial Generic Available voriconazole 200mg vial
Prometrium 100mg tab Generic Available progesterone 100mg tab
Prometrium 200mg tab Generic Available progesterone 200mg tab
 


Effective April 15, 2013
 
On April 15th, 2013, Abbott initiated a voluntary recall for the FreeStyle InsuLinx Blood Glucose Meter with an NDC number of 99073-0711-43. This voluntary, user-level recall was initiated because the FreeStyle InsuLinx Blood Glucose Meter may display and store in memory an incorrect result at extremely high blood glucose levels (≥ 1,024 mg/dL).


Effective March 25, 2013

On March 25, 2013, LifeScan initiated a voluntary recall for the OneTouch Verio IQ blood glucose meters. This recall was initiated because OneTouch Verio IQ blood glucose meters will turn off instead of displaying the message “EXTREME HIGH GLUCOSE above 600 mg/dL” when blood glucose level is 1,024 mg/dL or greater. When the meter is turned back on, the meter enters the set-up mode and requires the user to confirm the date and time settings before being able to test again. However, if the glucose level is still 1,024 mg/dL or greater when testing, the meter will shut down again.

 
Effective January 1, 2013

Effective January 1, 2013, the following changes will apply to HealthSpring Formulary (list of covered drugs).

Name of Affected Drug
Reason for
Change
Alternative
Drug
ALKERAN Removed from formulary; Generic available melphalan
AMPYRA Quantity limit added (60 tablets per 30 days)
ANCOBON Removed from formulary; Generic available flucytosine
AROMASIN Removed from formulary; Generic available exemestane
AZITHROMYCIN 1GM Quantity limit changed (3 packs per 30 days)
BACITRACIN Removed from formulary; Generic available Baciim
BUDEPRION SR 150MG Quantity limit changed (60 tablets per 30 days)
BYSTOLIC Removed from formulary; Generic alternatives available metoprolol, carvedilol, atenolol/chlorthalidone
CARBATROL Removed from formulary; Generic available carbamazepine
CHANTIX 0.5MG Quantity limit changed (340 tablets per 365 days)
COUMADIN Removed from formulary; Generic available warfarin, Jantoven
DEPADE Prior Authorization added
DOVONEX Quantity limit added (120 grams per 30 days)
ELLENCE Removed from formulary; Generic available epirubicin
FELBATOL Removed from formulary; Generic available felbamate
FEMARA Removed from formulary; Generic available letrozole
FLOVENT HFA Quantity limit changed (22 grams per 30 days)
FLUDARA Removed from formulary; Generic available fludarabine
FORTICAL Removed from formulary; Generic available calcitonin (salmon)
FRAGMIN Removed from formulary; Generic alternatives available enoxaparin, fondaparinux
FURADANTIN Removed from formulary; Generic available nitrofurantoin
FUZEON 90MG/ML Quantity limit changed (1 kit per 30 days)
GEMZAR Removed from formulary; Generic available gemcitabine
GENOTROPIN Removed from formulary Saizen
GEODON 20MG SOLR Quantity limit changed (60 per 30 days)
MODAFINIL 100MG Quantity limit added (30 tablets per 30 days)
MODAFINIL 200MG Quantity limit added (30 tablets per 30 days)
NARDIL Removed from formulary; Generic available phenelzine
POTIGA 50MG Quantity limit changed (90 tablets per 30 days)
POTIGA 200MG Quantity limit changed (30 tablets per 30 days)
POTIGA 300MG Quantity limit changed (30 tablets per 30 days)
POTIGA 400MG Quantity limit changed (30 tablets per 30 days)
PRED FORTE Removed from formulary; Generic available prednisolone acetate
REBIF TITRATION PACK Quantity limit changed (4.2 per 28 days)
REVLIMID Prior Authroization added for new starts
TAZORAC GEL Quantity limit changed (100 grams per 30 days)
TEGRETOL XR Removed from formulary; Generic available carbamazepine
VENTOLIN HFA Removed from formulary; alternative available ProAir
ZINACEF Removed from formulary; Generic available cefuroxime

 
Effective January 1, 2013, these additional changes will apply to the Prescription Drug Plan only.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
ANTABUSE Generic Available disulfiram
ARIXTRA Generic Available fondaparinux sodium
COMBIVIR Generic Available lamivudine/zidovudine
DERMOTIC Generic Available fluocinolone/acetonide
ENTOCORT EC Generic Available budesonide capsule
EPIVIR Generic Available lamivudine
GASTROCROM ORAL SOLUTION Generic Available cromolyn sodium
LEVAQUIN Generic Available levofloxacin
LIPITOR Generic Available atorvastatin
NEURONTIN ORAL SOLUTION Generic Available gabapentin


Effective November 15, 2012

Recently, Ranbaxy, a manufacturer of Atorvastatin Calcium, announced a voluntary, nationwide, retail-level of Atorvastatin Calcium 10mg, 20mg, and 40mg for 41 lots of numbers. Atorvastatin is the generic for the branded product LIPITOR, marked by Pfizer. This recall was initiated because the affected Atorvastatin tablet may contain a foreign substance described as small glass particles less than 1mm in size. Ranbaxy announces the recall proactively out of an abundance of caution.
Lot numbers affected are:

Atorvastatin calcium 10mg, 90 count bottle:  2436144; 2436582; 2441567; 2441567

Atorvastatin calcium 20mg, 90 count bottle:  2436731; 2437381; 2437940; 2437942; 2437945; 2437947; 2437952; 2437953; 2437960; 2440676; 2440677; 2440680; 2440681

Atorvastatin calcium 40mg; 500 count bottle: 243958; 2437957; 2440675

Atorvastatin calcium 40mg, 90 count bottle:  2434265; 2434824; 2434827; 2434829; 2434831; 2436725; 2436729; 2437380; 2437943; 2437949; 2434266; 2434826; 2434828; 2434830; 2436580; 2436727; 2437377; 2437941; 2437944; 2437950; 2437955


Effective November 1, 2012

Effective November 1, 2012, the following changes will apply to HealthSpring Formulary (list of covered drugs).

Name of Affected Drug
Reason for
Change
Alternative
Drug
Zyprexa 2.5mg Tablet Generic Available Olanzapine 2.5mg Tablet
Zyprexa 10mg Tablet Generic Available Olanzapine 10mg Tablet
Zyprexa 20mg Tablet Generic Available Olanzapine 20mg Tablet
Zyprexa Zydis 10mg Tablet Generic Available Olanzapine ODT 10mg Tablet
Zyprexa 10mg IM Solution Generic Available Olanzapine 10mg IM Solution
Zyprexa 7.5mg Tablet Generic Available Olanzapine 7.5mg Tablet
Zyprexa 5mg Tablet Generic Available Olanzapine 5mg Tablet
Zyprexa 15mg Tablet Generic Available Olanzapine 15mg Tablet
Zyprexa Zydis 15mg Tablet Generic Available Olanzapine ODT 15mg Tablet
Zyprexa Zydis 5mg Tablet Generic Available Olanzapine ODT 5mg Tablet
Zyprexa Zydis 20mg Tablet Generic Available Olanzapine ODT 20mg Tablet
Avapro 300mg Tablet Generic Available IRBESARTAN 300mg Tablet
Avapro 75mg Tablet Generic Available IRBESARTAN 75mg Tablet
Avapro 150mg Tablet Generic Available IRBESARTAN 150mg Tablet
Avalide 12.5mg/150mg Tablet Generic Available HYDROCHLOROTHIAZIDE; IRBESARTAN 12.5mg/150mg Tablet
Avalide 12.5mg/300mg Tablet Generic Available HYDROCHLOROTHIAZIDE; IRBESARTAN 12.5mg/300mg Tablet
Seroquel 50mg Tablet Generic Available QUETIAPINE FUMARATE 50mg Tablet
Seroquel 100mg Tablet Generic Available QUETIAPINE FUMARATE 100mg Tablet
Seroquel 200mg Tablet Generic Available QUETIAPINE FUMARATE 200mg Tablet
Seroquel 400mg Tablet Generic Available QUETIAPINE FUMARATE 400mg Tablet
Seroquel 300mg Tablet Generic Available QUETIAPINE FUMARATE 300mg Tablet
Seroquel 25mg Tablet Generic Available QUETIAPINE FUMARATE 25mg Tablet
Provigil 100mg Tablet Generic Available MODAFINIL 100mg Tablet
Provigil 200mg Tablet Generic Available MODAFINIL 200mg Tablet
Vancocin 125mg Capsule Generic Available Vancomycin 125mg Capsule
Vancocin 250mg Capsule Generic Available Vancomycin 250mg Capsule
Geodon 60mg Capsule Generic Available ZIPRASIDONE 60mg Capsule
Geodon 20mg Capsule Generic Available ZIPRASIDONE 20mg Capsule
Geodon 80mg Capsule Generic Available ZIPRASIDONE 80mg Capsule
Geodon 40mg Capsule Generic Available ZIPRASIDONE 40mg Capsule
Surmontil 25mg Capsule Generic Available TRIMIPRAMINE 25mg Capsule
Surmontil 50mg Capsule Generic Available TRIMIPRAMINE 50mg Capsule
Surmontil 100mg Capsule Generic Available TRIMIPRAMINE 100mg Capsule

Effective August 1, 2012

Effective August 1, 2012, the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.  Note: The following deletes apply to all plans except for the Prescription Drug Plan.
 
Name of
Affected Drug
Reasons for Change Alternative Drugs
ANTABUSE Generic Available DISULFIRAM
ARIXTRA Generic Available FONDAPARINUX SODIUM
COMBIVIR Generic Available

LAMIVUDINE/ ZIDOVUDINE

DERMOTIC Generic Available

FLUOCINOLONE/ ACETONIDE

ENTOCORT EC Generic Available BUDESONIDE CAP
EPIVIR Generic Available LAMIVUDINE
GASTROCROM Generic Available CROMOLYN SODIUM
LEVAQUIN Generic Available LEVOFLOXACIN
LIPITOR Generic Available ATORVASTATIN
NEURONTIN Generic Available GABAPENTIN


Effective April 19, 2012

On April 19, 2012, Novartis announced that they will cease marketing Valturna® (aliskiren and valsartan, USP) tablets in the US. This announcement was made after consultations with the FDA due to preliminary results of the halted ALTITUDE study.

Valturna® has been used for controlling high blood pressure and to ensure an orderly transition of patients to alternate therapies. Novartis will make Valturna available until July 20, 2012 to allow physicians to transition patients to another medication. Patients taking Valturna should not stop their high blood pressure treatment without consulting their prescribing healthcare provider.

If you are a patient on Valturna®, we encourage you to discuss this information with your prescribing healthcare provider at your next (non-urgent) visit, prior to July 20, 2012, or to make an appointment before this time, to determine the appropriate alternate medication for you.


Effective February 24, 2012

On February 24, 2012, Glenmark Generics announced a voluntary, lot-specific recall of Norgestimate/Ethinyl Estradiol tablets, 0.18mg/0.035 mg, 0.215mg/0.035 mg, 0.25mg/0.035mg:

Norgestimate/Ethinyl Estradiol Tablets, NDC 68462-565-29
  • Lot Numbers 04110101, 04110106, 04110107, Expiration date: 7/31/2013
  • Lot Numbers 04110114, 04110124, 04110129, Expiration date: 8/31/2013
  • Lot Number 04110134, Expiration date: 9/31/2013

This recall was initiated because of a packaging error, where select blisters were rotated 180 degrees within the card, reversing the weekly tablet orientation and making the lot number and expiry date visible only on the outer pouch.  Any blister for which the lot number and expiry date is not visible is subject to recall.


Effective January 31, 2012

On January 31, 2012, Pfizer Inc. initiated a voluntary recall of 14 lots of Lo/Ovral®-28 (norgestrel/ethinyl estradiol) Tablets, NDC 24090-801-84, and 14 Lots of Norgestrel and Ethinyl Estradiol Tablets (generic) because some blister packs may contain an inexact count of inert or active ingredient tablets and the tablets may be out of sequence.  Click here for more information. 

 Effective September 1, 2011

Effective September 1, 2011, the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.

Name of Affected Drug

Reasons for Change

Alternative Drugs

ACCOLATE Generic Available ZAFIRLUKAST
ARICEPT Generic Availalbe DONEPEZIL HYDROCHLORIDE
ARIMIDEX Generic Available ANASTROZOLE
EFFEXOR Generic Available VENLAFAXINE
EXELON Generic Available RIVASTIGMINE
HYCAMTIN Generic Available TOPOTECAN
KEPPRA Generic Available LEVETIRACETAM
LOTREL Generic Available AMLODIPINE / BENAZEPRIL HYDROCHLORIDE
LOVENOX Generic Available ENOXAPARIN SODIUM
MERREM Generic Available MEROPENEM
PREVACID Generic Available LANSOPRAZOLE


Effective June 22, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that Endocet (oxycodone/acetaminophen, USP) Tablets, 10 mg/325 mg would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled Endocet (oxycodone/acetaminophen, USP) Tablets, 10 mg/325 mg drugs for the following reason: some bottles may contain a different strength within tablets than stated on the product label, resulting in patients taking more than the intended acetaminophen dose.


Effective June 15, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that Glyburide Tablets, USP 2.5mg; NDC 64720-0124-10 Lot; 105912; Exp. Date 11/2013 Ropinirole Hydrochloride Tablets, 1mg; NDC: 64720-0203-10; Lot; 105912; Exp. Date 11/2013 would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled Glyburide tablets and Ropinirole Hydrochloride tablets for the following reason: A single bottle of Glyburide Tablets was found to be incorrectly labeled with a Ropinirone Hydrochloride label. 

Please talk to your physician or pharmacist about your alternatives.


Effective May 2, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that one lot of 1,000 count bottles of Coumadin (warfarin sodium) 5mg Tablets  (lot number affected in the United States is 9H49374A with an expiration date of September 30, 2012) would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled this drug for the following reason: a single tablet was found to be higher in potency than expected during testing and is a precautionary measure. 

Effective April 1, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that single-ingredient oral colchicine products that have not been evaluated by the FDA would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled these drugs for the following reason(s): Unapproved single-ingredient oral colchicine products have never been evaluated by the U.S. Food and Drug Administration (FDA) to ensure they are safe and effective.

The therapeutic options on HealthSpring’s formulary are listed below:

  • Colcrys (colchicine), which received FDA approval in 2009.  Prior Authorization is required.


Effective January 1, 2011

Effective January 1, 2011, the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.

Name of Affected Drug

Reasons for Change

Alternative Drugs

ACULAR, LS

Generic Available

ketorolac tromethamine

ADRENACLICK

Brand /Generic Alternative(s) Available

EPIPEN; epinephrine

ADVICOR

Brand /Generic Alternative(s) Available

NIASPAN; lovastatin; niacor

ALDARA

Generic Available

imiquimod

AMEVIVE

Brand Alternative(s) Available

HUMIRA(Prior Authorization Required); ENBREL (Prior Authorization Required)

ANDRODERM

Brand /Generic Alternative(s) Available

ANDROGEL; testosterone enanthate

APIDRA

Brand Alternative(s) Available

HUMALOG; HUMULIN

APRISO

Brand /Generic Alternatives(s) Available

ASACOL; LIALDA; PENTASA; mesalamine

ASTELIN

Generic Available

azelastine

AVINZA

Generic Alternative(s) Available

fentanyl patch; morphine sulfate er; methadone

AZILECT

Generic Alternative(s) Available

selegiline

AZOPT

Generic Alternative(s) Available

 dorzolamide

BETASERON

Brand Alternative Available

REBIF (Prior Authorization Required); AVONEX (Prior Authorization Required)

BONIVA TABS

Brand /Generic Alternative(s) Available

ACTONEL; alendronate

BUPRENEX

Generic Available

buprenorphine

CANASA

Brand /Generic Alternative(s) Available

ASACOL; LIALDA; PENTASA; mesalamine

CARDENE I.V.

Generic Available

nicardipine (Prior Authorization Required)

CARNITOR INJ

Generic Available

levocarnitine INJ (Prior Authorization Required)

CATAPRES-TTS

Generic Available

clonidine

CLARINEX SYP, TAB, RDT

Generic Alternative(s) Available

fexofenadine; clemastine

COGENTIN

Generic Available

benztropine mesylate

CUTIVATE

Generic Available

fluticasone propionate

     
     

DEPO-TESTOST

Generic Available

testosterone cypionate

DIURIL I.V.

Generic Available

chlorothiazide sodium (Prior Authorization Required)

ELOXATIN

Generic Available

oxaliplatin (Prior Authorization Required)

FLOMAX

Generic Available

tamsulosin

FORTAZ

Generic Available

ceftazidime

GLUCAGON

Brand Alternative(s) Available

GLUCAGEN; PROGLYCEM

HUMATROPE

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

IQUIX

Brand /Generic Alternative(s) Available

VIGAMOX; ciprofloxacin; ofloxacin

ISTALOL

Generic Available

timolol maleate

LAC-HYDRIN

Generic Available

ammonium lactate

LEVEMIR

Brand Alternative(s) Available

LANTUS

LUNESTA

Generic Alternative(s) Available

zaleplon; zolpidem

MESTINON

Generic Available

pyridostigmine bromide

MIRAPEX

Generic Available

pramipexole

NIPENT

Generic Available

pentostatin (Prior Authorization Required)

NORDITROPIN

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

NOVOLIN, N, R

Brand Alternative(s) Available

HUMALOG; HUMULIN

NOVOLOG, MIX

Brand Alternative(s) Available

HUMALOG; HUMULIN

Name of Affected Drug

Reasons for Change

Alternative Drugs

NUTROPIN, AQ

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

OPTIVAR

Brand Alternative(s) Available

PATADAY; PATANOL

ORAMORPH

Generic Available

morphine sulfate er

OVIDE

Generic Available

malathion

PANCREASE MT

Brand Alternative(s) Available

CREON

PANCRECARB

Brand Alternative(s) Available

CREON

PANCRELIPASE

Brand Alternative(s) Available

CREON

PROTONIX PAK

Brand Alternative(s) Available

PREVACID SOLUTAB; NEXIUM PACK

PULMICORT

Brand Alternative(s) Available

FLOVENT; QVAR

QUIXIN

Brand /Generic Alternative(s) Available

VIGAMOX; ciprofloxacin; ofloxacin

RIFAMATE

Generic Available

isonarif

RISPERDAL M

Generic Available

risperidone odt

SAIZEN

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

SEROSTIM

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

SIMCOR

Brand /Generic Alternative(s) Available

NIASPAN; niacor; simvastatin

SKELAXIN

Generic Available

metaxalone

SOLARAZE

Brand /Generic Alternative(s) Available

ZYCLARA; imiquimod

SOLU-MEDROL

Generic Available

methylprednisolone sodium succinate

SUBUTEX

Generic Available

buprenorphine HCL (Prior Authorization Required)

TRIGLIDE

Brand /Generic Alternative(s) Available

TRILIPIX; TRICOR; fenofibrate

UROCIT-K

Generic Available

potassium citrate

VENLAFAXINE ER TABS

Brand /Generic Alternative(s) Available

EFFEXOR ER; venlafaxine er cp24

VESICARE

Brand /Generic Alternative(s) Available

ENABLEX; TOVIAZ; oxybutynin

VYTORIN

Brand /Generic Alternative(s) Available

ZETIA; simvastatin

ZORBTIVE

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

Name of Affected Drug

Reasons for Change

Alternative Drugs

ZOSYN

Generic Available

piperacillin sodium/ tazobactam sodium

ZYMAR

Brand /Generic Alternative(s) Available

VIGAMOX; ciprofloxacin; ofloxacin

 

Effective July 1, 2010

Effective July 1, 2010 the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.

Name of Affected Drug

Reason for Change

Alternative Drug

ACULAR

Generic now available

Ketorolac

DOVONEX

Generic now available

Calcipotriene

PROGRAF

Generic now available

Tacrolimus

STARLIX

Generic now available

Nateglinide

TRILEPTAL

Generic now available

Oxcarbazepine

VALTREX

Generic now available

Valacyclovir

 

Effective January 1, 2010

Effective January 1, 2010 the drugs listed in the following table will be removed from all of the HealthSpring formularies. Changes to the formulary have been approved by Medicare. Please contact your physicians and ask them to prescribe alternative formulary medications.

Name of Affected Drug

Reasons for Change

Alternative Drugs

ACEON

Generic Alternative(s) Available

benazepril; enalapril maleate; lisinopril hcl

ADDERALL XR

Generic Available

amphetamine salt combo

ALTACE

Generic Available

ramipril

BALACET

Safety Concerns

acetaminophen; NSAIDS; tramadol

BENICAR HCT

Brand Alternative Available

AVALIDE; DIOVAN HCT

BENICAR

Brand Alternative Available

AVAPRO; DIOVAN

CASODEX

Generic Available

bicalutamide

CELLCEPT

Generic Available

mycophenolate

COSOPT

Generic Available

dorzolamide hcl/timolol maleate

CUTIVATE

Generic Available

fluticasone

DECLOMYCIN

Generic Available

demeclocycline

DEPAKOTE

Generic Available

divalproex sodium

DEPAKOTE ER

Generic Available

divalproex sodium

DEPAKOTE SPRINKLE

Generic Available

divalproex sodium

DETROL LA

Brand Alternative Available

ENABLEX; VESICARE

DETROL

Brand Alternative Available

ENABLEX; VESICARE

DIAMOX

Generic Available

acetazolamide

EFUDEX

Generic Available

fluorouracil

ETHYOL

Generic Available

amifostine

IMITREX

Generic Available

sumatriptan

KEPPRA

Generic Available

levetiracetam

KINERET

Brand Alternative(s) Available

ENBREL (PA); HUMIRA (PA)

LAMICTAL

Generic Available

lamotrigine

MEDROL

Generic Available

methylprednisolone

NOR-QD 28 DAY

Generic Available

norethindrone

PARCOPA

Generic Available

carbidopa/levodopa

PHOSLO

Generic Available

calcium acetate

PRECOSE

Generic Available

acarbose

PREVACID NAPRAPAC KIT

Brand /Generic Alternative(s) Available

NEXIUM/naproxen; omeprazole/naproxen

PROAIR HFA

Brand Alternative Available

VENTOLIN HFA

PROPOXYPHENE HCL

Safety Concerns

acetaminophen; NSAIDS; tramadol

PROPOXYPHENE-N /ACETAMINOPHEN

Safety Concerns

acetaminophen; NSAIDS; tramadol

PROTONIX

Generic Available

pantoprazole sodium

RISPERDAL

Generic Available

risperidone

RISPERDAL M-TAB

Generic Available

risperidone

SULAR

Generic Available

nisoldipine

TOBRADEX

Generic Available

tobramycin

TOPAMAX

Generic Available

topiramate

TOPAMAX SPRINKLE

Generic Available

topiramate

TRUSOPT

Generic Available

dorzolamide hcl

URSO

Generic Available

ursodiol

URSO FORTE

Generic Available

ursodiol

VESANOID

Generic Available

tretinoin

VIDEX EC

Generic Available

didanosine

VIVACTIL

Generic Available

protriptyline

WELLBUTRIN

Generic Available

bupropion

ZERIT

Generic Available

stavudine

ZINECARD

Generic Available

dexrazoxane

HealthSpring Formulary Change Notification

HealthSpring may add or remove drugs from our formulary during the year. If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug (and/or move a drug to a higher cost-sharing tier), we will notify you of the change at least 60 days before the date that the change becomes effective. However, if the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market or Medicare no longer covers a drug previously covered, we will immediately remove the drug from our formulary.

Prospective (60-day) Formulary Change Notification for National Prescription Drug Plan, Medicare Advantage Prescription Drug Plans, and TotalCare Plans.  Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.


Effective August 1, 2013
 
Effective August 1, 2013, the following changes will apply to the HealthSpring Formulary list of covered drugs.
 
Name of Affected Drug
Changes
amitriptyline 100mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 10mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 150mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 25mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 50mg Requires Prior Authorization for members 65 years of age and older
amitriptyline 75mg Requires Prior Authorization for members 65 years of age and older
benzotropine 0.5mg tab Requires Prior Authorization for members 65 years of age and older
benzotropine 1mg tab Requires Prior Authorization for members 65 years of age and older
benzotropine 1mg/ml injection Requires Prior Authorization for members 65 years of age and older
benzotropine 2mg tab Requires Prior Authorization for members 65 years of age and older
Benztropine 2mg Requires Prior Authorization for members 65 years of age and older
clomipramine 25mg tab Requires Prior Authorization for members 65 years of age and older
clomipramine 50mg tab Requires Prior Authorization for members 65 years of age and older
clomipramine 75mg tab Requires Prior Authorization for members 65 years of age and older
Digoxin 0.125mg Quantity Limit #30 per 30 days added
Digoxin 0.25mg Requires Prior Authorization for members 65 years of age and older
doxepin 100mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 10mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 10mg/ml solution Requires Prior Authorization for members 65 years of age and older
doxepin 150mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 25mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 50mg tab Requires Prior Authorization for members 65 years of age and older
doxepin 75mg tab Requires Prior Authorization for members 65 years of age and older
Estradiol 0.5mg Requires Prior Authorization for members 65 years of age and older
Estradiol 1mg Requires Prior Authorization for members 65 years of age and older
Estradiol 2mg Requires Prior Authorization for members 65 years of age and older
Glyburide 1.25mg tab Requires Prior Authorization for members 65 years of age and older
Glyburide 1.5mg tab micronized Requires Prior Authorization for members 65 years of age and older
Glyburide 2.5 mg tab Requires Prior Authorization for members 65 years of age and older
Glyburide 3mg tab micronized Requires Prior Authorization for members 65 years of age and older
Glyburide 5mg tab Requires Prior Authorization for members 65 years of age and older
Glyburide 6mg tab micronized Requires Prior Authorization for members 65 years of age and older
glyburide/metformin 1.25/250 tab Requires Prior Authorization for members 65 years of age and older
glyburide/metformin 2.5/500 tab Requires Prior Authorization for members 65 years of age and older
glyburide/metformin 5/500 tab Requires Prior Authorization for members 65 years of age and older
Guanfacine 1mg tab Requires Prior Authorization for members 65 years of age and older
Guanfacine 2mg tab Requires Prior Authorization for members 65 years of age and older
imipramine  25mg Requires Prior Authorization for members 65 years of age and older
imipramine 50mg Requires Prior Authorization for members 65 years of age and older
megestrol acetate 20mg tab Requires Prior Authorization for members 65 years of age and older
megestrol acetate 40mg tab Requires Prior Authorization for members 65 years of age and older
megestrol acetate 40mg/ml suspension Requires Prior Authorization for members 65 years of age and older
Nitrofurantoin 100mg cap
Quantity Limit 90 days’ supply per 365 days was added
Nitrofurantoin 50mg cap
Quantity Limit 90 days’ supply per 365 days was added
Premarin 0.3mg tab  Requires Prior Authorization for members 65 years of age and older
Premarin 0.45mg tab Requires Prior Authorization for members 65 years of age and older
Premarin 0.625mg tab Requires Prior Authorization for members 65 years of age and older
Premarin 0.9 mg tab Requires Prior Authorization for members 65 years of age and older
Premarin 1.25mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 1.25mg/ml soln Requires Prior Authorization for members 65 years of age and older
Promethazine 12.5mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 25mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 50mg tab Requires Prior Authorization for members 65 years of age and older
Promethazine 50mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 100mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 10mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 25mg tab Requires Prior Authorization for members 65 years of age and older
Thioridazine 50mg tab Requires Prior Authorization for members 65 years of age and older
trihexyphenidyl 0.4mg mg/ml
solution
Requires Prior Authorization for members 65 years of age and older
trihexyphenidyl 2mg tab Requires Prior Authorization for members 65 years of age and older
trihexyphenidyl 5mg tab Requires Prior Authorization for members 65 years of age and older
Trimipramine 100mg tab Requires Prior Authorization for members 65 years of age and older
Trimipramine 25mg tab Requires Prior Authorization for members 65 years of age and older
Trimipramine 50mg tab Requires Prior Authorization for members 65 years of age and older
Zaleplon 10mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zaleplon 10mg tab Requires Prior Authorization for members 65 years of age and older
Zaleplon 5mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zaleplon 5mg tab Requires Prior Authorization for members 65 years of age and older
Zolpidem 10mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zolpidem 10mg tab Requires Prior Authorization for members 65 years of age and older
Zolpidem 5mg Requires Prior Authorization for members 65 years of age and older. Also Quantity Limit #90 per 365 days added
Zolpidem 5mg tab Requires Prior Authorization for members 65 years of age and older


Effective July 1, 2013
Effective July 1, 2013 the listed changes below will apply to the following HS plans:

HealthSpring Preferred (HMO-POS) HealthSpring Premier (HMO-POS)
HealthSpring Preferred DFW (PPO) HealthSpring Premier Bay (HMO-POS)
HealthSpring Preferred (HMO) HealthSpring Premier SMS (HMO-POS)
HealthSpring Preferred Bay (HMO) HealthSpring Premier (HMO-POS)
HealthSpring Preferred SMS (HMO) HealthSpring Premier KNX (HMO-POS)
HealthSpring Preferred (HMO) HealthSpring Premier NGA (HMO-POS)
HealthSpring Preferred KNX (HMO) HealthSpring Premier NMS (HMO-POS)
HealthSpring Preferred NGA (HMO) HealthSpring Premier WVA (HMO-POS)
HealthSpring Preferred WVA (HMO) HealthSpring Achieve (HMO SNP)


Name of Affected
Drug
Reason for Change Alternative Drug
Seroquel 300 tab Generic Available quetiapine 300mg tab
Seroquel 400 tab Generic Available quetiapine 400mg tab
Seroquel 100 tab Generic Available quetiapine 100mg tab
Seroquel 25 tab Generic Available quetiapine 25mg tab
Seroquel 50 tab Generic Available quetiapine 50mg tab
Seroquel 200 tab Generic Available quetiapine 200mg tab
Geodon 20mg tab Generic Available ziprasidone 20mg tab
Geodon 40mg tab Generic Available ziprasidone 40mg tab
Geodon 60 mg tab Generic Available ziprasidone 60mg tab
Geodon 80mg tab Generic Available ziprasidone 80mg tab
Zyprexa 10mg Vial Generic Available olanzapine 10mg vial
Symbyax 50/6 Generic Available olanzapine/fluoxetine 50/6 tab
Symbyax 25/12 Generic Available olanzapine/fluoxetine 25/12 tab
Symbyax 25/6 Generic Available olanzapine/fluoxetine 25/6 tab
Symbyax 50/12 Generic Available olanzapine/fluoxetine 50/12 tab
Symbyax 25/3 Generic Available olanzapine/fluoxetine 25/3 tab
Viramune tab 200mg Generic Available nevirapine 200mg
Vancocin 125mg Generic Available vancomycin 125mg tab
Vancocin 250mg tab Generic Available vancomycin 250mg tab
Actos 15mg Generic Available pioglitazone 15mg tab
Actos 30mg Generic Available pioglitazone 30mg tab
Actos 45mg Generic Available pioglitazone 45mg tab
Actoplus met 500/15 Generic Available metformin/pioglitazone 500/15
Actoplus met 850/15 Generic Available metformin/pioglitazone 850/15
Singulair 10mg tab Generic Available montelukast 10mg tab
Singulair 5mg chew Generic Available montelukast 5mg chew
Singulair 4mg chew Generic Available montelukast 4mg chew
Revatio 20mg tab Generic Available sildenafil 20mg tab
Gabitril 2mg Generic Available tiagabine 2mg tab
Gabitril 4mg Generic Available tiagabine 4mg tab
Dovonex cream 0.0005% Generic Available calcipotriene cream 0.0005%
Ziagen tab 300mg Generic Available abacavir 300mg tab
Vfend 200mg vial Generic Available voriconazole 200mg vial
Prometrium 100mg tab Generic Available progesterone 100mg tab
Prometrium 200mg tab Generic Available progesterone 200mg tab
Plavix 75mg Generic Available clopidogrel 75mg tab
Plavix 300mg Generic Available clopidogrel 300 mg tab
Surmontil 25mg Generic Available trimipramine 25mg cap
Surmontil 50mg Generic Available trimipramine 50mg cap
Surmontil 100mg Generic Available trimipramine 100 mg cap
 
 
Effective July 1, 2013, the following changes will apply to the HealthSpring Formulary list of covered drugs.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Seroquel 300mg Generic Available Quetiapine
Provigil 200mg Generic Available Modafinil
Tricor 48mg Generic Available Fenofibrate
Actoplus Met 15/850mg Generic Available Metformin HCL/
Pioglitazone HCL


Effective June 1, 2013
 
Effective June 1, 2013, the following changes will apply to the HealthSpring Formulary list of covered drugs. Click here for Arkansas, Oklahoma, Texarkana formulary changes or for Retiree formulary changes.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Seroquel 300 tab Generic Available quetiapine 300mg tab
Seroquel 400 tab Generic Available quetiapine 400mg tab
Seroquel 100 tab Generic Available quetiapine 100mg tab
Seroquel 25 tab Generic Available quetiapine 25mg tab
Seroquel 50 tab Generic Available quetiapine 50mg tab
Seroquel 200 tab Generic Available quetiapine 200mg tab
Geodon 20mg tab Generic Available ziprasidone 20mg tab
Geodon 40mg tab Generic Available ziprasidone 40mg tab
Geodon 60 mg tab Generic Available ziprasidone 60mg tab
Geodon 80mg tab Generic Available ziprasidone 80mg tab
Zyprexa 10mg Vial Generic Available olanzapine 10mg vial
Symbyax 50/6 Generic Available olanzapine/fluoxetine 50/6 tab
Symbyax 25/12 Generic Available olanzapine/fluoxetine 25/12 tab
Symbyax 25/6 Generic Available olanzapine/fluoxetine 25/6 tab
Symbyax 50/12 Generic Available olanzapine/fluoxetine 50/12 tab
Symbyax 25/3 Generic Available olanzapine/fluoxetine 25/3 tab
Viramune tab 200mg Generic Available nevirapine 200mg
Vancocin 125mg Generic Available vancomycin 125mg tab
Vancocin 250mg tab Generic Available vancomycin 250mg tab
Actos 15mg Generic Available pioglitazone 15mg tab
Actos 30mg Generic Available pioglitazone 30mg tab
Actos 45mg Generic Available pioglitazone 45mg tab
Actoplus met 500/15 Generic Available metformin/pioglitazone 500/15
Actoplus met 850/15 Generic Available metformin/pioglitazone 850/15
Singulair 10mg tab Generic Available montelukast 10mg tab
Singulair 5mg chew Generic Available montelukast 5mg chew
Singulair 4mg chew Generic Available montelukast 4mg chew
Revatio 20mg tab Generic Available sildenafil 20mg tab
Gabitril 2mg Generic Available tiagabine 2mg tab
Gabitril 4mg Generic Available tiagabine 4mg tab
Dovonex cream 0.0005% Generic Available calcipotriene cream 0.0005%
Ziagen tab 300mg Generic Available abacavir 300mg tab
Vfend 200mg vial Generic Available voriconazole 200mg vial
Prometrium 100mg tab Generic Available progesterone 100mg tab
Prometrium 200mg tab Generic Available progesterone 200mg tab
Plavix 75mg Generic Available clopidogrel 75mg tab
Plavix 300mg Generic Available clopidogrel 300 mg ta
Surmontil 25mg Generic Available trimipramine 25mg cap
Surmontil 50mg Generic Available trimipramine 50mg cap
Surmontil 100mg Generic Available trimipramine 100 mg cap

Effective June 1, 2013, the following changes will apply to the Arkansas, Oklahoma and Texarkana Formulary list of covered drugs (affecting contracts: H1266, H2038, H2676, H4125, H4871, H6972, H7811).
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Lexapro Soln 5mg/ml Generic Available escitalopram soln 5mg/ml
Zyprexa 10mg Vial Generic Available olanzapine 10mg vial
Actos 15mg Generic Available pioglitazone 15mg
Actos 30mg Generic Available pioglitazone 30mg
Actoplus met 500/15 Generic Available pioglitazone/metformin 500/15
Actoplus met 850/15 Generic Available pioglitazone/metformin 850/15
Singular 10mg tab Generic Available montelukast 10mg tab
Singular 5mg chew Generic Available montelukast 5mg chew
Singular 4mg chew Generic Available montelukast 4mg chew
VFEND IV 200mg Generic Available voriconazole 200mg vial
Revatio 20MG Generic Available sildenafil 20mg
Tricor 145mg Generic Available fenofibrate 145mg
Tricor 48mg Generic Available fenofibrate 48mg
Gabitril 2mg Generic Available tiagabine 2mg
Gabitril 4mg Generic Available tiagabine 4mg
Ziagen 300mg Generic Available abacavir 300mg
Vancocin 125 mg Generic Available vancomycin 125mg
Vancocin 250 mg Generic Available vancomycin 250mg
 
 
Effective June 1, 2013, the following changes will apply to the HealthSpring Retiree Formulary list of covered drugs.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
Symbyax 50/6 Generic Available olanzapine/fluoxetine 50/6 tab
Symbyax 25/12 Generic Available olanzapine/fluoxetine 25/12 tab
Symbyax 25/6 Generic Available olanzapine/fluoxetine 25/6 tab
Symbyax 50/12 Generic Available olanzapine/fluoxetine 50/12 tab
Symbyax 25/3 Generic Available olanzapine/fluoxetine 25/3 tab
Viramune tab 200mg Generic Available nevirapine 200mg
Vancocin 125mg Generic Available vancomycin 125mg tab
Vancocin 250mg tab Generic Available vancomycin 250mg tab
Actos 15mg Generic Available pioglitazone 15mg tab
Actos 30mg Generic Available pioglitazone 30mg tab
Actos 45mg Generic Available pioglitazone 45mg tab
Actoplus met 500/15 Generic Available metformin/pioglitazone 500/15
Actoplus met 850/15 Generic Available metformin/pioglitazone 850/15
Singulair 4mg chew Generic Available montelukast 4mg chew
Singulair 10mg tab Generic Available montelukast 10mg tab
Singulair 5mg tab Generic Available montelukast 5mg tab
Revatio 20mg tab Generic Available sildenafil 20mg tab
Gabitril 2mg Generic Available tiagabine 2mg tab
Gabitril 4mg Generic Available tiagabine 4mg tab
Dovonex cream 0.005% Generic Available calcipotriene cream 0.005%
Ziagen tab 300mg Generic Available abacavir 300mg tab
Vfend 200mg vial Generic Available voriconazole 200mg vial
Prometrium 100mg tab Generic Available progesterone 100mg tab
Prometrium 200mg tab Generic Available progesterone 200mg tab
 


Effective April 15, 2013
 
On April 15th, 2013, Abbott initiated a voluntary recall for the FreeStyle InsuLinx Blood Glucose Meter with an NDC number of 99073-0711-43. This voluntary, user-level recall was initiated because the FreeStyle InsuLinx Blood Glucose Meter may display and store in memory an incorrect result at extremely high blood glucose levels (≥ 1,024 mg/dL).


Effective March 25, 2013

On March 25, 2013, LifeScan initiated a voluntary recall for the OneTouch Verio IQ blood glucose meters. This recall was initiated because OneTouch Verio IQ blood glucose meters will turn off instead of displaying the message “EXTREME HIGH GLUCOSE above 600 mg/dL” when blood glucose level is 1,024 mg/dL or greater. When the meter is turned back on, the meter enters the set-up mode and requires the user to confirm the date and time settings before being able to test again. However, if the glucose level is still 1,024 mg/dL or greater when testing, the meter will shut down again.

 
Effective January 1, 2013

Effective January 1, 2013, the following changes will apply to HealthSpring Formulary (list of covered drugs).

Name of Affected Drug
Reason for
Change
Alternative
Drug
ALKERAN Removed from formulary; Generic available melphalan
AMPYRA Quantity limit added (60 tablets per 30 days)
ANCOBON Removed from formulary; Generic available flucytosine
AROMASIN Removed from formulary; Generic available exemestane
AZITHROMYCIN 1GM Quantity limit changed (3 packs per 30 days)
BACITRACIN Removed from formulary; Generic available Baciim
BUDEPRION SR 150MG Quantity limit changed (60 tablets per 30 days)
BYSTOLIC Removed from formulary; Generic alternatives available metoprolol, carvedilol, atenolol/chlorthalidone
CARBATROL Removed from formulary; Generic available carbamazepine
CHANTIX 0.5MG Quantity limit changed (340 tablets per 365 days)
COUMADIN Removed from formulary; Generic available warfarin, Jantoven
DEPADE Prior Authorization added
DOVONEX Quantity limit added (120 grams per 30 days)
ELLENCE Removed from formulary; Generic available epirubicin
FELBATOL Removed from formulary; Generic available felbamate
FEMARA Removed from formulary; Generic available letrozole
FLOVENT HFA Quantity limit changed (22 grams per 30 days)
FLUDARA Removed from formulary; Generic available fludarabine
FORTICAL Removed from formulary; Generic available calcitonin (salmon)
FRAGMIN Removed from formulary; Generic alternatives available enoxaparin, fondaparinux
FURADANTIN Removed from formulary; Generic available nitrofurantoin
FUZEON 90MG/ML Quantity limit changed (1 kit per 30 days)
GEMZAR Removed from formulary; Generic available gemcitabine
GENOTROPIN Removed from formulary Saizen
GEODON 20MG SOLR Quantity limit changed (60 per 30 days)
MODAFINIL 100MG Quantity limit added (30 tablets per 30 days)
MODAFINIL 200MG Quantity limit added (30 tablets per 30 days)
NARDIL Removed from formulary; Generic available phenelzine
POTIGA 50MG Quantity limit changed (90 tablets per 30 days)
POTIGA 200MG Quantity limit changed (30 tablets per 30 days)
POTIGA 300MG Quantity limit changed (30 tablets per 30 days)
POTIGA 400MG Quantity limit changed (30 tablets per 30 days)
PRED FORTE Removed from formulary; Generic available prednisolone acetate
REBIF TITRATION PACK Quantity limit changed (4.2 per 28 days)
REVLIMID Prior Authroization added for new starts
TAZORAC GEL Quantity limit changed (100 grams per 30 days)
TEGRETOL XR Removed from formulary; Generic available carbamazepine
VENTOLIN HFA Removed from formulary; alternative available ProAir
ZINACEF Removed from formulary; Generic available cefuroxime

 
Effective January 1, 2013, these additional changes will apply to the Prescription Drug Plan only.
 
Name of Affected
Drug
Reason for
Change
Alternative
Drug
ANTABUSE Generic Available disulfiram
ARIXTRA Generic Available fondaparinux sodium
COMBIVIR Generic Available lamivudine/zidovudine
DERMOTIC Generic Available fluocinolone/acetonide
ENTOCORT EC Generic Available budesonide capsule
EPIVIR Generic Available lamivudine
GASTROCROM ORAL SOLUTION Generic Available cromolyn sodium
LEVAQUIN Generic Available levofloxacin
LIPITOR Generic Available atorvastatin
NEURONTIN ORAL SOLUTION Generic Available gabapentin


Effective November 15, 2012

Recently, Ranbaxy, a manufacturer of Atorvastatin Calcium, announced a voluntary, nationwide, retail-level of Atorvastatin Calcium 10mg, 20mg, and 40mg for 41 lots of numbers. Atorvastatin is the generic for the branded product LIPITOR, marked by Pfizer. This recall was initiated because the affected Atorvastatin tablet may contain a foreign substance described as small glass particles less than 1mm in size. Ranbaxy announces the recall proactively out of an abundance of caution.
Lot numbers affected are:

Atorvastatin calcium 10mg, 90 count bottle:  2436144; 2436582; 2441567; 2441567

Atorvastatin calcium 20mg, 90 count bottle:  2436731; 2437381; 2437940; 2437942; 2437945; 2437947; 2437952; 2437953; 2437960; 2440676; 2440677; 2440680; 2440681

Atorvastatin calcium 40mg; 500 count bottle: 243958; 2437957; 2440675

Atorvastatin calcium 40mg, 90 count bottle:  2434265; 2434824; 2434827; 2434829; 2434831; 2436725; 2436729; 2437380; 2437943; 2437949; 2434266; 2434826; 2434828; 2434830; 2436580; 2436727; 2437377; 2437941; 2437944; 2437950; 2437955


Effective November 1, 2012

Effective November 1, 2012, the following changes will apply to HealthSpring Formulary (list of covered drugs).

Name of Affected Drug
Reason for
Change
Alternative
Drug
Zyprexa 2.5mg Tablet Generic Available Olanzapine 2.5mg Tablet
Zyprexa 10mg Tablet Generic Available Olanzapine 10mg Tablet
Zyprexa 20mg Tablet Generic Available Olanzapine 20mg Tablet
Zyprexa Zydis 10mg Tablet Generic Available Olanzapine ODT 10mg Tablet
Zyprexa 10mg IM Solution Generic Available Olanzapine 10mg IM Solution
Zyprexa 7.5mg Tablet Generic Available Olanzapine 7.5mg Tablet
Zyprexa 5mg Tablet Generic Available Olanzapine 5mg Tablet
Zyprexa 15mg Tablet Generic Available Olanzapine 15mg Tablet
Zyprexa Zydis 15mg Tablet Generic Available Olanzapine ODT 15mg Tablet
Zyprexa Zydis 5mg Tablet Generic Available Olanzapine ODT 5mg Tablet
Zyprexa Zydis 20mg Tablet Generic Available Olanzapine ODT 20mg Tablet
Avapro 300mg Tablet Generic Available IRBESARTAN 300mg Tablet
Avapro 75mg Tablet Generic Available IRBESARTAN 75mg Tablet
Avapro 150mg Tablet Generic Available IRBESARTAN 150mg Tablet
Avalide 12.5mg/150mg Tablet Generic Available HYDROCHLOROTHIAZIDE; IRBESARTAN 12.5mg/150mg Tablet
Avalide 12.5mg/300mg Tablet Generic Available HYDROCHLOROTHIAZIDE; IRBESARTAN 12.5mg/300mg Tablet
Seroquel 50mg Tablet Generic Available QUETIAPINE FUMARATE 50mg Tablet
Seroquel 100mg Tablet Generic Available QUETIAPINE FUMARATE 100mg Tablet
Seroquel 200mg Tablet Generic Available QUETIAPINE FUMARATE 200mg Tablet
Seroquel 400mg Tablet Generic Available QUETIAPINE FUMARATE 400mg Tablet
Seroquel 300mg Tablet Generic Available QUETIAPINE FUMARATE 300mg Tablet
Seroquel 25mg Tablet Generic Available QUETIAPINE FUMARATE 25mg Tablet
Provigil 100mg Tablet Generic Available MODAFINIL 100mg Tablet
Provigil 200mg Tablet Generic Available MODAFINIL 200mg Tablet
Vancocin 125mg Capsule Generic Available Vancomycin 125mg Capsule
Vancocin 250mg Capsule Generic Available Vancomycin 250mg Capsule
Geodon 60mg Capsule Generic Available ZIPRASIDONE 60mg Capsule
Geodon 20mg Capsule Generic Available ZIPRASIDONE 20mg Capsule
Geodon 80mg Capsule Generic Available ZIPRASIDONE 80mg Capsule
Geodon 40mg Capsule Generic Available ZIPRASIDONE 40mg Capsule
Surmontil 25mg Capsule Generic Available TRIMIPRAMINE 25mg Capsule
Surmontil 50mg Capsule Generic Available TRIMIPRAMINE 50mg Capsule
Surmontil 100mg Capsule Generic Available TRIMIPRAMINE 100mg Capsule

Effective August 1, 2012

Effective August 1, 2012, the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.  Note: The following deletes apply to all plans except for the Prescription Drug Plan.
 
Name of
Affected Drug
Reasons for Change Alternative Drugs
ANTABUSE Generic Available DISULFIRAM
ARIXTRA Generic Available FONDAPARINUX SODIUM
COMBIVIR Generic Available

LAMIVUDINE/ ZIDOVUDINE

DERMOTIC Generic Available

FLUOCINOLONE/ ACETONIDE

ENTOCORT EC Generic Available BUDESONIDE CAP
EPIVIR Generic Available LAMIVUDINE
GASTROCROM Generic Available CROMOLYN SODIUM
LEVAQUIN Generic Available LEVOFLOXACIN
LIPITOR Generic Available ATORVASTATIN
NEURONTIN Generic Available GABAPENTIN


Effective April 19, 2012

On April 19, 2012, Novartis announced that they will cease marketing Valturna® (aliskiren and valsartan, USP) tablets in the US. This announcement was made after consultations with the FDA due to preliminary results of the halted ALTITUDE study.

Valturna® has been used for controlling high blood pressure and to ensure an orderly transition of patients to alternate therapies. Novartis will make Valturna available until July 20, 2012 to allow physicians to transition patients to another medication. Patients taking Valturna should not stop their high blood pressure treatment without consulting their prescribing healthcare provider.

If you are a patient on Valturna®, we encourage you to discuss this information with your prescribing healthcare provider at your next (non-urgent) visit, prior to July 20, 2012, or to make an appointment before this time, to determine the appropriate alternate medication for you.


Effective February 24, 2012

On February 24, 2012, Glenmark Generics announced a voluntary, lot-specific recall of Norgestimate/Ethinyl Estradiol tablets, 0.18mg/0.035 mg, 0.215mg/0.035 mg, 0.25mg/0.035mg:

Norgestimate/Ethinyl Estradiol Tablets, NDC 68462-565-29
  • Lot Numbers 04110101, 04110106, 04110107, Expiration date: 7/31/2013
  • Lot Numbers 04110114, 04110124, 04110129, Expiration date: 8/31/2013
  • Lot Number 04110134, Expiration date: 9/31/2013

This recall was initiated because of a packaging error, where select blisters were rotated 180 degrees within the card, reversing the weekly tablet orientation and making the lot number and expiry date visible only on the outer pouch.  Any blister for which the lot number and expiry date is not visible is subject to recall.


Effective January 31, 2012

On January 31, 2012, Pfizer Inc. initiated a voluntary recall of 14 lots of Lo/Ovral®-28 (norgestrel/ethinyl estradiol) Tablets, NDC 24090-801-84, and 14 Lots of Norgestrel and Ethinyl Estradiol Tablets (generic) because some blister packs may contain an inexact count of inert or active ingredient tablets and the tablets may be out of sequence.  Click here for more information. 

 Effective September 1, 2011

Effective September 1, 2011, the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.

Name of Affected Drug

Reasons for Change

Alternative Drugs

ACCOLATE Generic Available ZAFIRLUKAST
ARICEPT Generic Availalbe DONEPEZIL HYDROCHLORIDE
ARIMIDEX Generic Available ANASTROZOLE
EFFEXOR Generic Available VENLAFAXINE
EXELON Generic Available RIVASTIGMINE
HYCAMTIN Generic Available TOPOTECAN
KEPPRA Generic Available LEVETIRACETAM
LOTREL Generic Available AMLODIPINE / BENAZEPRIL HYDROCHLORIDE
LOVENOX Generic Available ENOXAPARIN SODIUM
MERREM Generic Available MEROPENEM
PREVACID Generic Available LANSOPRAZOLE


Effective June 22, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that Endocet (oxycodone/acetaminophen, USP) Tablets, 10 mg/325 mg would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled Endocet (oxycodone/acetaminophen, USP) Tablets, 10 mg/325 mg drugs for the following reason: some bottles may contain a different strength within tablets than stated on the product label, resulting in patients taking more than the intended acetaminophen dose.


Effective June 15, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that Glyburide Tablets, USP 2.5mg; NDC 64720-0124-10 Lot; 105912; Exp. Date 11/2013 Ropinirole Hydrochloride Tablets, 1mg; NDC: 64720-0203-10; Lot; 105912; Exp. Date 11/2013 would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled Glyburide tablets and Ropinirole Hydrochloride tablets for the following reason: A single bottle of Glyburide Tablets was found to be incorrectly labeled with a Ropinirone Hydrochloride label. 

Please talk to your physician or pharmacist about your alternatives.


Effective May 2, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that one lot of 1,000 count bottles of Coumadin (warfarin sodium) 5mg Tablets  (lot number affected in the United States is 9H49374A with an expiration date of September 30, 2012) would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled this drug for the following reason: a single tablet was found to be higher in potency than expected during testing and is a precautionary measure. 

Effective April 1, 2011

Recently the U.S. Food and Drug Administration (FDA) issued a public health advisory alerting patients, caregivers, and health care professionals that single-ingredient oral colchicine products that have not been evaluated by the FDA would be withdrawn from the market. The U.S. Food and Drug Administration (FDA) recalled these drugs for the following reason(s): Unapproved single-ingredient oral colchicine products have never been evaluated by the U.S. Food and Drug Administration (FDA) to ensure they are safe and effective.

The therapeutic options on HealthSpring’s formulary are listed below:

  • Colcrys (colchicine), which received FDA approval in 2009.  Prior Authorization is required.


Effective January 1, 2011

Effective January 1, 2011, the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.

Name of Affected Drug

Reasons for Change

Alternative Drugs

ACULAR, LS

Generic Available

ketorolac tromethamine

ADRENACLICK

Brand /Generic Alternative(s) Available

EPIPEN; epinephrine

ADVICOR

Brand /Generic Alternative(s) Available

NIASPAN; lovastatin; niacor

ALDARA

Generic Available

imiquimod

AMEVIVE

Brand Alternative(s) Available

HUMIRA(Prior Authorization Required); ENBREL (Prior Authorization Required)

ANDRODERM

Brand /Generic Alternative(s) Available

ANDROGEL; testosterone enanthate

APIDRA

Brand Alternative(s) Available

HUMALOG; HUMULIN

APRISO

Brand /Generic Alternatives(s) Available

ASACOL; LIALDA; PENTASA; mesalamine

ASTELIN

Generic Available

azelastine

AVINZA

Generic Alternative(s) Available

fentanyl patch; morphine sulfate er; methadone

AZILECT

Generic Alternative(s) Available

selegiline

AZOPT

Generic Alternative(s) Available

 dorzolamide

BETASERON

Brand Alternative Available

REBIF (Prior Authorization Required); AVONEX (Prior Authorization Required)

BONIVA TABS

Brand /Generic Alternative(s) Available

ACTONEL; alendronate

BUPRENEX

Generic Available

buprenorphine

CANASA

Brand /Generic Alternative(s) Available

ASACOL; LIALDA; PENTASA; mesalamine

CARDENE I.V.

Generic Available

nicardipine (Prior Authorization Required)

CARNITOR INJ

Generic Available

levocarnitine INJ (Prior Authorization Required)

CATAPRES-TTS

Generic Available

clonidine

CLARINEX SYP, TAB, RDT

Generic Alternative(s) Available

fexofenadine; clemastine

COGENTIN

Generic Available

benztropine mesylate

CUTIVATE

Generic Available

fluticasone propionate

     
     

DEPO-TESTOST

Generic Available

testosterone cypionate

DIURIL I.V.

Generic Available

chlorothiazide sodium (Prior Authorization Required)

ELOXATIN

Generic Available

oxaliplatin (Prior Authorization Required)

FLOMAX

Generic Available

tamsulosin

FORTAZ

Generic Available

ceftazidime

GLUCAGON

Brand Alternative(s) Available

GLUCAGEN; PROGLYCEM

HUMATROPE

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

IQUIX

Brand /Generic Alternative(s) Available

VIGAMOX; ciprofloxacin; ofloxacin

ISTALOL

Generic Available

timolol maleate

LAC-HYDRIN

Generic Available

ammonium lactate

LEVEMIR

Brand Alternative(s) Available

LANTUS

LUNESTA

Generic Alternative(s) Available

zaleplon; zolpidem

MESTINON

Generic Available

pyridostigmine bromide

MIRAPEX

Generic Available

pramipexole

NIPENT

Generic Available

pentostatin (Prior Authorization Required)

NORDITROPIN

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

NOVOLIN, N, R

Brand Alternative(s) Available

HUMALOG; HUMULIN

NOVOLOG, MIX

Brand Alternative(s) Available

HUMALOG; HUMULIN

Name of Affected Drug

Reasons for Change

Alternative Drugs

NUTROPIN, AQ

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

OPTIVAR

Brand Alternative(s) Available

PATADAY; PATANOL

ORAMORPH

Generic Available

morphine sulfate er

OVIDE

Generic Available

malathion

PANCREASE MT

Brand Alternative(s) Available

CREON

PANCRECARB

Brand Alternative(s) Available

CREON

PANCRELIPASE

Brand Alternative(s) Available

CREON

PROTONIX PAK

Brand Alternative(s) Available

PREVACID SOLUTAB; NEXIUM PACK

PULMICORT

Brand Alternative(s) Available

FLOVENT; QVAR

QUIXIN

Brand /Generic Alternative(s) Available

VIGAMOX; ciprofloxacin; ofloxacin

RIFAMATE

Generic Available

isonarif

RISPERDAL M

Generic Available

risperidone odt

SAIZEN

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

SEROSTIM

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

SIMCOR

Brand /Generic Alternative(s) Available

NIASPAN; niacor; simvastatin

SKELAXIN

Generic Available

metaxalone

SOLARAZE

Brand /Generic Alternative(s) Available

ZYCLARA; imiquimod

SOLU-MEDROL

Generic Available

methylprednisolone sodium succinate

SUBUTEX

Generic Available

buprenorphine HCL (Prior Authorization Required)

TRIGLIDE

Brand /Generic Alternative(s) Available

TRILIPIX; TRICOR; fenofibrate

UROCIT-K

Generic Available

potassium citrate

VENLAFAXINE ER TABS

Brand /Generic Alternative(s) Available

EFFEXOR ER; venlafaxine er cp24

VESICARE

Brand /Generic Alternative(s) Available

ENABLEX; TOVIAZ; oxybutynin

VYTORIN

Brand /Generic Alternative(s) Available

ZETIA; simvastatin

ZORBTIVE

Brand Alternative(s) Available

GENOTROPIN (Prior Authorization Required)

Name of Affected Drug

Reasons for Change

Alternative Drugs

ZOSYN

Generic Available

piperacillin sodium/ tazobactam sodium

ZYMAR

Brand /Generic Alternative(s) Available

VIGAMOX; ciprofloxacin; ofloxacin

 

Effective July 1, 2010

Effective July 1, 2010 the HealthSpring formulary (list of covered drugs) will be changing. Every month, the Preferred Drug List (formulary) is updated. Medications on the preferred drug list include both generic and brand-name drugs.

Name of Affected Drug

Reason for Change

Alternative Drug

ACULAR

Generic now available

Ketorolac

DOVONEX

Generic now available

Calcipotriene

PROGRAF

Generic now available

Tacrolimus

STARLIX

Generic now available

Nateglinide

TRILEPTAL

Generic now available

Oxcarbazepine

VALTREX

Generic now available

Valacyclovir

 

Effective January 1, 2010

Effective January 1, 2010 the drugs listed in the following table will be removed from all of the HealthSpring formularies. Changes to the formulary have been approved by Medicare. Please contact your physicians and ask them to prescribe alternative formulary medications.

Name of Affected Drug

Reasons for Change

Alternative Drugs

ACEON

Generic Alternative(s) Available

benazepril; enalapril maleate; lisinopril hcl

ADDERALL XR

Generic Available

amphetamine salt combo

ALTACE

Generic Available

ramipril

BALACET

Safety Concerns

acetaminophen; NSAIDS; tramadol

BENICAR HCT

Brand Alternative Available

AVALIDE; DIOVAN HCT

BENICAR

Brand Alternative Available

AVAPRO; DIOVAN

CASODEX

Generic Available

bicalutamide

CELLCEPT

Generic Available

mycophenolate

COSOPT

Generic Available

dorzolamide hcl/timolol maleate

CUTIVATE

Generic Available

fluticasone

DECLOMYCIN

Generic Available

demeclocycline

DEPAKOTE

Generic Available

divalproex sodium

DEPAKOTE ER

Generic Available

divalproex sodium

DEPAKOTE SPRINKLE

Generic Available

divalproex sodium

DETROL LA

Brand Alternative Available

ENABLEX; VESICARE

DETROL

Brand Alternative Available

ENABLEX; VESICARE

DIAMOX

Generic Available

acetazolamide

EFUDEX

Generic Available

fluorouracil

ETHYOL

Generic Available

amifostine

IMITREX

Generic Available

sumatriptan

KEPPRA

Generic Available

levetiracetam

KINERET

Brand Alternative(s) Available

ENBREL (PA); HUMIRA (PA)

LAMICTAL

Generic Available

lamotrigine

MEDROL

Generic Available

methylprednisolone

NOR-QD 28 DAY

Generic Available

norethindrone

PARCOPA

Generic Available

carbidopa/levodopa

PHOSLO

Generic Available

calcium acetate

PRECOSE

Generic Available

acarbose

PREVACID NAPRAPAC KIT

Brand /Generic Alternative(s) Available

NEXIUM/naproxen; omeprazole/naproxen

PROAIR HFA

Brand Alternative Available

VENTOLIN HFA

PROPOXYPHENE HCL

Safety Concerns

acetaminophen; NSAIDS; tramadol

PROPOXYPHENE-N /ACETAMINOPHEN

Safety Concerns

acetaminophen; NSAIDS; tramadol

PROTONIX

Generic Available

pantoprazole sodium

RISPERDAL

Generic Available

risperidone

RISPERDAL M-TAB

Generic Available

risperidone

SULAR

Generic Available

nisoldipine

TOBRADEX

Generic Available

tobramycin

TOPAMAX

Generic Available

topiramate

TOPAMAX SPRINKLE

Generic Available

topiramate

TRUSOPT

Generic Available

dorzolamide hcl

URSO

Generic Available

ursodiol

URSO FORTE

Generic Available

ursodiol

VESANOID

Generic Available

tretinoin

VIDEX EC

Generic Available

didanosine

VIVACTIL

Generic Available

protriptyline

WELLBUTRIN

Generic Available

bupropion

ZERIT

Generic Available

stavudine

ZINECARD

Generic Available

dexrazoxane