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Table 1. Study Medications (Selected from Clinic X 2003 Sample Medications Log)*

Name Brand Medication Formulary Status General Pharmacy Index 4 Category

Aciphex B tier brand Proton pump inhibitors
Actonel B tier brand—maintenance benefit Calcium regulators
Allegra B tier brand Antihistamine-non-sedating
Amaryl B tier brand—maintenance benefit Sulfonylureas
Augmentin B tier brand Penicillin combinations
Avandia C tier non-preferred Insulin-sensitizing agents
Avelox C tier non-preferred Fluoroquinolones
Clarinex Not listed Antihistamine-non-sedating
Cozaar B tier brand—maintenance benefit Angiotensin II receptor antagonists
Detrol La C tier non-preferred Urinary antispasmodics
Ditropan Xl Not listed Urinary antispasmodics
Elidel Not listed Immunomodulating agents—dermatitis
Imitrex B tier brand Serotonin agonists
Lexapro Unlisted Selective serotonin reuptake inhibitors
Maxalt B tier brand Serotonin agonists
Nasacort B tier brand Nasal steroids
Nexium Not listed Proton pump inhibitors
Oxytrol Not listed Urinary antispasmodics
Paxil B tier brand Selective serotonin reuptake inhibitors
Protonix B tier brand Proton pump inhibitors
Toprol Xl B tier brand—maintenance benefit Beta blockers cardioselective
Valtrex C tier non-preferred Herpes agents
Vioxx C tier non-preferred Nonsteroidal anti-inflammatory drugs
Wellbutrin Unlisted (SR is listed) Miscellaneous antidepressants
Zocor B tier brand—maintenance benefit HMG CoA reductase inhibitors

* Formulary Scott & White Health Plan (SWHP) preference in descending order: (1) A tier = non-name brand generic; (2) B tier—maintenance benefit = specific name brand with quantity discounts for SWHP pharmacies; (3) B tier = specific name brand; (4) C tier = non-preferred name brand; (5) unlisted.





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