TRICARE Uniform Formulary Update Announced

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Military.com | TRICARE | May 09, 2007

FALLS CHURCH, Va. – Selected medications are continuing on the TRICARE Uniform Formulary and 10 others have been designated as nonformulary (or third tier) effective August 1, 2007, announced Army Maj. Gen. Elder Granger, TRICARE Management Activity deputy director. The following chart shows the medications and their status as formulary, either tier-one generics or tier-two brand names, or their status as non-formulary (third tier) and the effective date.

Medication	Tier	Implementation Date of Nonformulary Status
Newer Sedative Hypnotic Agents
Ambien (generics available)	1	**
Lunesta	2	**
Sonata	3	August 1, 2007
Rozerem	3	August 1, 2007
Ambien CR	3	August 1, 2007
Narcotic Analgesics
High-Potency Opioids – Single Analgesic Ingredient
MSIR (generics available)	1	**
MS Contin (generics available)	1	**
Duramorph (generics available)	1	**
codeine phosphate	1	**
codeine sulfate	1	**
Duragesic (generics available)	1	**
Actiq (generics available)	1	**
Dilaudid (generics available)	1	**
Levo-Dromoran (generics available)	1	**
Demerol (generics available)	1	**
Mepergan Fortis (generics available)	1	**
Dolophine (generics available)	1	**
Opium (tincture)	1	**
B&O Supprettes (generics available)	1	**
OxyIR (generics available)	1	**
Fentora	2	**
Levo-Dromoran	2	**
Oramorph SR	2	**
Avinza	2	**
Kadian	2	**
Oxycontin	2	**
Opana	2	**
Opana ER	2	**
High-Potency Opioids – Analgesic Combination Drugs
Percocet, Tylox (generics available)	1	**
Percodan (generics available)	1	**
Lower Potency Opioids – Single Analgesic Ingredient
Ultram (generics available)	1	**
Buprenex (generics available)	1	**
Butorphanol (generics available)	1	**
Stadol (generics available)	1	**
Nubain (generics available)	1	**
Talwin NX (generics available)	1	**
Darvon (generics available)	1	**
Darvon-N	2	**
Ultram ER	3	August 1, 2007
Lower Potency Opioids – Analgesic Combination Drugs
Tylenol with Codeine tablets/elixir/suspension (generics available)	1	**
Vicodin, Lorcet (generics available)	1	**
Lortab elixir (generics available)	1	**
aspirin with codeine	1	**
Soma Compound with Codeine (generics available)	1	**
Fioricet with Codeine (generics available)	1	**
Fiorinal with Codeine (generics available)	1	**
Panlor DC (generics available)	1	**
Talacen (generics available)	1	**
Darvon Compound 65 (generics available)	1	**
Darvocet N-100 (generics available)	1	**
Ultracet (generics available)	1	**
Panlor SS	2	**
Synalgos-DC	2	**
Topical Glaucoma Agents
Prostaglandins
Xalatan	2	**
Lumigan	2	**
Travatan	3	August 1, 2007
Travatan Z	3	August 1, 2007
Beta Blockers
Timoptic (generics available)	1	**
Timoptic XE (generics available)	1	**
Betoptic (generics available)	1	**
Ocupress (generics available)	1	**
Betagan (generics available)	1	**
Optipranolol (generics available)	1	**
Betoptic-S	2	**
Timoptic Ocudose	2	**
Istalol	3	August 1, 2007
Betimol	3	August 1, 2007
Alpha 2 Adrenergic Agonists
brimonidine 0.2%	1	**
Alphagan P 0.15%	2	**
Alphagan P 0.1%	2	**
Iopidine	2	**
Carbonic Anhydrase Inhibitors
Trusopt	2
Azopt	3	August 1, 2007
Carbonic Anhydrase Inhibitors/Beta Blocker
Cosopt	2	**
Adrenergics
Propine (generics available)	1	**
Cholinergics
Pilocar (generics available)	1	**
Pilopine HS	2	**
Miochol-E	2	**
Isopto Carbachol	2	**
Cholinesterase Inhibitor
Phospholine Iodine	2	**
MAOI – Antidepressants
Parnate (generics available)	1	**
Nardil	2	**
Marplan	2	**
Emsam	3	August 1, 2007

** Does not apply

First-tier medications (formulary generics) are available through a TRICARE Retail Pharmacy for $3 copays for up to a 30-day supply, and through the TRICARE Mail Order Pharmacy for $3 copays for up to a 90-day supply. Beneficiaries may purchase second-tier medications (formulary brand-name) for $9 for up to the same number of days through a TRICARE Retail Network Pharmacy or through the TRICARE Mail Order Pharmacy. By using the mail-order pharmacy, beneficiaries may save up to 66 percent on prescriptions. Beneficiary cost-shares in non-network pharmacies are higher.

Beneficiaries taking third-tier medications may consult their health care providers about changing to a first- or second-tier alternative. When providers prescribe medications, beneficiaries should ask if a generic alternative is available that would provide the same clinical results in that drug class.

Beneficiaries can also ask providers if establishing medical necessity for the third-tier medication is appropriate. If medical necessity is established for a third-tier medication, the copayment is reduced to $9. Third-tier medications aren’t available at military treatment facility (MTF) pharmacies unless an MTF provider establishes medical necessity and writes the prescription. Medical necessity forms and criteria are available at www.tricare.mil/pharmacy/medical-nonformulary.cfm.

For a complete list of medications, their formulary status and where they are available, beneficiaries may visit the Formulary Search Tool webpage.

Beneficiaries may find more information on the TRICARE Retail Pharmacy and locations, and the TRICARE Mail Order Pharmacy. They may also call 866-363-8779 for the retail pharmacy or 866-363-8667 for the mail order pharmacy.

For more information about the Uniform Formulary Beneficiary Advisory Panel review process, visit http://www.tricare.mil/pharmacy/BAP.

Contact: Carolyn Wheeler
(703) 681-1765

About TRICARE Management Activity
TRICARE Management Activity, the Defense Department agency that administers the health care plan for the uniformed services, retirees and their families, serves more than 9.1 million eligible beneficiaries worldwide.

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