PBM Plus, Inc. Monroe County School Board
An Omnicare Company 2008 Preferred Drug List
Medication Medication Medication Medication Medication Medication
A APHTHASOL BIAXIN XL COMBIVIR DIOVAN HCT EURAX
ABILIFY ARANESP BIAXIN XL PAC COMTAN TABS DIPENTUM EVISTA
ACCOLATE ARAVA BILTRICIDE CONDYLOX GEL DITROPAN XL EVOXAC
ACLOVATE ARICEPT BLEPHAMIDE COPAXONE P DIURIL SUSP EXELDERM
S.O.P DONNATAL
ACTIQ ARICEPT ODT COPEGUS EXELON
BREVOXYL EXTENTABS
ACTIVELLA ARIMIDEX CORDRAN F
ARTHROTEC 50
C COREG
DOVONEX
ACTONEL DRITHO-SCALP FANSIDAR
CANASA
ACTOS ARTHROTEC 75 CORTANE-B LOT CRM FARESTON
CAPITAL/CODEINE
ACULAR ASACOL CORTIFOAM DROXIA FEMARA
CAPITROL 2%
ACULAR PF ASTELIN SHAMPOO COSOPT DUAC FEMHRT
ADDERALL XR ATACAND CARBATROL COZAAR DUONEB FINACEA GEL
ADVAIR DISKUS ATACAND-HCT CASODEX CRESTOR DYNACIRC CR FLOMAX
ADVICOR AUGMENTIN XR CATAPRES-TTS CRIXIVAN DYRENIUM FLONASE
AGGRENOX AVANDAMET CEENU CUPRIMINE E FLOVENT HFA
AKINETON AVANDIA CELEBREX CUTIVATE CRM EFFEXOR FLOXIN OTIC
ALBENZA AVELOX CELESTONE SYR CYCLOGYL EFFEXOR XR FORADIL
ALDARA AVINZA CELLCEPT CYCLOMYDRIL ELIDEL FORTEO
ALKERAN AVODART CELONTIN CYTADREN TABS EMADINE FORTOVASE D
ALLEGRA D AVONEX 30 CENESTIN CYTOMEL EMCYT FOSAMAX
AZELEX CYTOVENE
ALORA CERUMENEX D EMEND G
ALTACE AZMACORT CETAPRED OINT D D EMLA GABITRIL
ALUPENT AZO-GANTRISIN D CETROTIDE DANTRIUM EMTRIVA GANTRISIN D
INHALER AZOPT ENBREL P
CILOXAN DECADRON OINT D GASTROCROM
AMBIEN B CIPRO HC DEPAKOTE EPIPEN GEODON
AMBIEN CR BACTROBAN CLIMARA DEPEN EPIPEN JR GLUCAGON
CREAM TITRATABS
AMERGE CLINDAGEL EPIVIR GLYSET
BACTROBAN DERMATOP
ANA-KIT D NASAL CLODERM EPIVIR HBV GYNAZOLE
DETROL LA
BECONASE AQ COLAZAL EPOGEN P
ANDRODERM
DIASTAT H
BENZACLIN COLESTID ERGOMAR HEPSERA
ANDROGEL DIFFERIN
BENZAMYCIN PAK COLY-MYCIN S ESTRADERM HEXALEN
ANDROGEL PUMP DILANTIN
BETASERON P COMBIPATCH ESTRATAB D HIVID
ANEMAGEN OB D DILATRATE SR
BETOPTIC-S COMBIVENT ESTRING HUMALOG
ANTABUSE DIOVAN
P – Requires Prior Approval Page 1 of 3 Effective 1-1-2008
D – Discontinued Item All strengths of any listed product are covered As products become available generically, they will require substitution
PBM Plus, Inc. Monroe County School Board
An Omnicare Company 2008 Preferred Drug List
Medication Medication Medication Medication Medication Medication
HUMULIN LEXAPRO MOBAN OXISTAT PRONESTYL SANTYL
HYZAAR LEXXEL MYCOBUTIN OXSORALEN PROSCAR SEASONALE
I LIPITOR MYLERAN OXYTROL PROSTIGMIN SERENTIL D
IMITREX LIVOSTIN D MYTELASE P PROTONIX SEREVENT
DISKUS
INDERAL LA LODOSYN N PANCREASE PROTOPIC
SEROQUEL
INFERGEN P LOFIBRA NAMENDA PANCRECARB PROTROPIN P
SEROQUEL XR
INNOHEP P LORABID NASACORT AQ PARNATE PROVIGIL
SINGULAIR
INNOPRAN XL LOTREL NASONEX PATANOL PULMICORT
SKELAXIN
INSPRA LOVENOX P NEBUPENT PCE PULMOZYME
SLO-BID
D
INSULINS - All LUMIGAN NEGGRAM D PEGASYS P Q GYROCAPS
INTAL LUPRON DEPOT NEULASTA P PEG-INTRON P QUIXIN SONATA
INTRON-A P LYBREL NEUPOGEN P PENTASA QVAR SORIATANE
INVIRASE LYSODREN NEXIUM PHOSLO R SPECTRACEF
ISOPTO
D M NIASPAN PHOSPHOLINE RAPTIVA P SPORANOX
CETAMIDE SOLN IODIDE STALEVO
MATULANE NILANDRON REBIF P
ISTALOL SOLN PLAVIX
MAXAIR NIMOTOP REGRANEX STARLIX
K MAXALT NITRO-BID
PRANDIN
RELPAX STRATTERA
KADIAN PRAVACHOL
MAXIDEX NITRO-DUR REMINYL D SUPRAX
KALETRA PRECOSE
MAXIDONE NITROLINGUAL RENAGEL SURMONTIL
KEPPRA PRED-G
MENEST NORVASC REQUIP SUSTIVA
KINERET P PREMARIN SYMBICORT
MENTAX NORVIR RESCRIPTOR
K-PHOS PREMESIS RX SYNAREL
MEPHYTON NOVOLIN RESTASIS
KU-ZYME HP
MEPRON NOVOLOG PREMPHASE RETROVIR T
L MESTINON NUTROPIN P PREMPRO RHINOCORT AQ TARGRETIN
LAMICTAL METADATE CD PRO-BANTHINE D RIDAURA TAZORAC
NUVARING
LAMISIL PROCANBID
METHERGINE O RIFATER TEGRETOL-XR
LANOXICAPS METROGEL PROCHIEVE RISPERDAL TEQUIN
OLUX
LANTUS METROLOTION PROCRIT P TESLAC
OMNICEF RITALIN LA
LESCOL MIACALCIN TESTIM
ORACIT PROCTOFOAM
LESCOL XL ROBINUL
MIGRANAL ORAP TEV-TROPIN P
PROGLYCEM ROFERON-A P
LEUKERAN MINTEZOL THALITONE
ORTHO-EVRA PROGRAF
LEVALL MIRAPEX ORTHO-
S THEO-24
D PROMETRIUM
LEVAQUIN DIENESTROL SAL-TROPINE
P – Requires Prior Approval Page 2 of 3 Effective 1-1-2008
D – Discontinued Item All strengths of any listed product are covered As products become available generically, they will require substitution
PBM Plus, Inc. Monroe County School Board
An Omnicare Company 2008 Preferred Drug List
Medication Medication Medication Medication Medication Medication
TILADE TRICOR UROCIT-K VIGAMOX XALATAN ZOLOFT
TOBRADEX TRILEPTAL URSO VIOKASE XELODA ZOMIG
TOPAMAX TRIZIVIR V VIRACEPT XERAC AC ZOVIRAX
TOPICORT LP TRUSOPT VAGIFEM VIRAMUNE XOLAIR ZTUSS
TOPROL XL TRUE TRACK VALCYTE VIREAD XYREM ZYMINE
GLUCOSE METERS
TORECAN D
TRUETRACK
VALTREX VITAFOL-PN Y ZYPREXA
TRAC GLUCOSE TEST VANCOCIN VIVELLE YODOXIN ZYPREXA ZYDIS
TRACLEER STRIPS VASOSULF D VIVELLE DOT Z ZYRTEC
TRANSDERM- TUSS-DA NR VAZOL VOSPIRE ER ZYRTEC-D
ZADITOR
SCOP TUSSIONEX
TRANXENE-SD
VENTOLIN HFA W ZERIT ZYVOX
TUSS-S D VERELAN PM WELCHOL ZIAGEN
TRAVATAN
U VFEND WELLBUTRIN XL ZOFRAN
TREXALL ULTRAVATE VIDEX X ZOFRAN ODT
The above is a list of preferred brand name medications. It represents the drug list that is the core of your pharmacy benefit. The inclusion of any drug on the list does not guarantee
coverage. The actual benefit is determined at the time the prescription is processed by PBM Plus . You are encouraged to share this list with your physician and to
encourage your physician to prescribe products on this list and/or generic drugs whenever possible and appropriate.
Products highlighted in yellow are available generically. When a product is generically available and the member receives the brand name product, the member will pay
the difference in cost between the brand name product and the generic product plus the copayment applicable to the brand name product hat was dispensed. As
products become available generically, they will require substitution regardless of their status on this list.
Products THAT ARE BOLDED are new additions to the preferred list.
P – Requires Prior Approval Page 3 of 3 Effective 1-1-2008
D – Discontinued Item All strengths of any listed product are covered As products become available generically, they will require substitution