Sheet1 - Mediscor PBM - Excel

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					                                                                                 Mediscor Standard Formul
                                                                                     Publication date : 08/0


                Medicine Name                    Active Ingredient


      BREVOXYL 4%                 Benzoyl Peroxide Cream 4%
      PANOXYL ACNE 10% GEL        Benzoyl Peroxide Gel 10%
      BENZAC AC 5 GEL             Benzoyl Peroxide Gel 5%
      CREME CLASSIQUE ACNE 5 GE   Benzoyl Peroxide Gel 5%
      PANOXYL ACNE 5% GEL         Benzoyl Peroxide Gel 5%
      DALACIN T DRY LOTN          Clindamycin Phosphate Lotion 1%
      DALACIN T TOPICAL SOL       Clindamycin Phosphate Soln 1%
      ERYDERM 20MG/ML LOTN        Erythromycin Lotion 2%
      ILOTYCIN ACNE SOLN          Erythromycin Soln 2%
      STIEMACIN 2GM/100ML SOL     Erythromycin Soln 2%
      ACNETANE 10 CAPS            Isotretinoin Cap 10 MG
      APEX-ISOTRETINOIN 10MG CA   Isotretinoin Cap 10 MG
      ORATANE 10MG                Isotretinoin Cap 10 MG
      ROACCUTANE 10MG CAPS        Isotretinoin Cap 10 MG
      ACNETANE 20 CAPS            Isotretinoin Cap 20 MG
      APEX-ISOTRETINOIN 20MG CA   Isotretinoin Cap 20 MG
      ORATANE 20MG CAPS           Isotretinoin Cap 20 MG
      ROACCUTANE 20MG CAPS        Isotretinoin Cap 20 MG
      ISOTREX GEL                 Isotretinoin Gel 0.05%
      ILOTYCIN-A CREAM            Tretinoin Cream 0.05%
      RETIN A 0.5MG/GM CREAM      Tretinoin Cream 0.05%
      RETIN A 0.25MG/GM GEL       Tretinoin Gel 0.025%
      ILOTYCIN-A GEL              Tretinoin Gel 0.05%
      ADCO-ERYTHROMYCIN 250 CAP   Erythromycin Estolate Cap 250 MG
      PURMYCIN 250MG CAPS         Erythromycin Estolate Cap 250 MG
      SPECTRASONE 250MG CAPS      Erythromycin Estolate Cap 250 MG
      XERAMEL 250MG CAPS          Erythromycin Estolate Cap 250 MG
      ERYMYCIN AF 250MG CAPS      Erythromycin Stearate Cap 250 MG
      BETAMYCIN 250MG TABS        Erythromycin Stearate Tab 250 MG
      ERYKO 250MG TABS            Erythromycin Stearate Tab 250 MG
      MERCK-ERYTHROMYCIN 250MG    Erythromycin Stearate Tab 250 MG
      RUBIMYCIN 250MG TABS        Erythromycin Stearate Tab 250 MG
      BETAPEN 250MG TAB           Penicillin V Potassium Tab 250 MG
      ADCO-CO-TRIMOXAZOLE TABS    Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      BACTRIM TABS                Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      CASICOT TABS                Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      COZOLE TABS                 Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      DUROBAC TABS                Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      ILVITRIM TABS               Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      LAGATRIM TABS               Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      MICRO CO-TRIMOXAZOLE        Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      NUCOTRIM 480MG TABS         Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      PURBAC TABS                 Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      TRIMETHOX TABS              Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      TRIXAZOLE 480MG TABS        Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      XEROPRIM 480MG TABS         Sulfamethoxazole-Trimethoprim Tab 400-80 MG
      BACTRIM DS TABS             Sulfamethoxazole-Trimethoprim Tab 800-160 MG
      DUROBAC DS TABS             Sulfamethoxazole-Trimethoprim Tab 800-160 MG
      PURBAC DS TABS              Sulfamethoxazole-Trimethoprim Tab 800-160 MG
      SANDOZ CO-TRIMOXAZOLE       Sulfamethoxazole-Trimethoprim Tab 800-160 MG




Mediscor PBM Copyright
      A-LENNON DOXYCYCLINE HCL              Doxycycline Hyclate Cap 100 MG
      CYCLIDOX 100MG CAPS                   Doxycycline Hyclate Cap 100 MG
      DOXYCYL 100MG CAPS                    Doxycycline Hyclate Cap 100 MG
      DOXYTET 100MG CAPS                    Doxycycline Hyclate Cap 100 MG
      CYCLIDOX EC 100MG CAPS                Doxycycline Hyclate Cap DR Particles 100 MG
      CYCLIDOX EC 200MG CAPS                Doxycycline Hyclate Cap DR Particles 200 MG
      DOXITAB                               Doxycycline Hyclate Tab 100 MG
      BE-OXYTET 250MG CAPS                  Oxytetracycline HCl Cap 250 MG
      NUCOTET                               Oxytetracycline HCl Cap 250 MG
      O-4 CYCLINE 250MG CAPS                Oxytetracycline HCl Cap 250 MG
      OXY 250MG CAPS                        Oxytetracycline HCl Cap 250 MG
      OXYPAN 250MG CAPS                     Oxytetracycline HCl Cap 250 MG
      PHARMATET 250MG CAPS                  Oxytetracycline HCl Cap 250 MG
      ROXY 250MG CAPS                       Oxytetracycline HCl Cap 250 MG
      TETRACEM 250MG CAPS                   Oxytetracycline HCl Cap 250 MG

      DISCLAIMER: Please note that these formularies are reviewed regularly by the Mediscor Pharmaceutical and Therapeutics Commi
      to ensure that they comply with the latest industry norms for the treatment of the listed conditions. Mediscor PBM Pty Ltd reserves
      the right to change medicines to comply with the latest industry norms for the treatment of the listed conditions. Mediscor PBM Pty L
      reserves the right to change medicines included in the formulary when important or new information is made available,
      e.g. on new findings regarding the safety of medicine.

      COPYRIGHT: Mediscor PBM reserves its copyright and all its other rights in or in respect of the Mediscor Formularies.
      No part of the Mediscor Formularies may be reproduced, photocopied, recorded or stored in any retrieval system, or transmitted by
      any means, electronic, mechanical or otherwise, without the written permission of Mediscor PBM.




Mediscor PBM Copyright
                 Mediscor Standard Formulary : Acne
                     Publication date : 08/07/2011
                                                                      SEP Unit
                                                            Product            MRP Unit
                                                                        Cost
                    Therapeutic Group             NAPPI Code Auth              Cost (Incl
                                                                        (Incl
                                                              Req                VAT)
                                                                       VAT)
      ACNE                                            700221   No       2.64      N/A
      ACNE                                            835358   No       2.17      N/A
      ACNE                                            807842   No       3.24     2.01
      ACNE                                            896079   No         2      2.01
      ACNE                                            835366   No       1.85     2.01
      ACNE                                            828718   No       3.81      N/A
      ACNE                                            835757   No       3.24      N/A
      ACNE                                            828769   No       1.82      N/A
      ACNE                                            828874   No       2.53      N/A
      ACNE                                            828971   No       2.42      N/A
      ACNE                                            701667   No       3.27     3.27
      ACNE                                            711877   No       3.27     3.27
      ACNE                                            701469   No       3.27     3.27
      ACNE                                            761125   No       5.76     3.27
      ACNE                                            701656   No       6.43     6.43
      ACNE                                            711876   No       6.43     6.43
      ACNE                                            701471   No       6.43     6.43
      ACNE                                            761133   No      10.47     6.43
      ACNE                                            821853   No        2.9      N/A
      ACNE                                            842605   No        4.2     4.18
      ACNE                                            760242   No      10.94     4.18
      ACNE                                            760250   No      10.96      N/A
      ACNE                                            842591   No       2.46      N/A
      ERYTHROMYCIN AND OTHER MACROLIDES               780561   No       0.88     0.79
      ERYTHROMYCIN AND OTHER MACROLIDES               758388   No       0.76     0.79
      ERYTHROMYCIN AND OTHER MACROLIDES               765651   No       0.78     0.79
      ERYTHROMYCIN AND OTHER MACROLIDES               824682   No       0.73     0.79
      ERYTHROMYCIN AND OTHER MACROLIDES               724076   No       2.06     1.09
      ERYTHROMYCIN AND OTHER MACROLIDES               707437   No       0.88     1.09
      ERYTHROMYCIN AND OTHER MACROLIDES               710310   No       0.72     1.09
      ERYTHROMYCIN AND OTHER MACROLIDES               709334   No       1.37     1.09
      ERYTHROMYCIN AND OTHER MACROLIDES               761613   No       1.08     1.09
      PENICILLINS                                     780081   No       0.22      N/A
      SULPHONAMIDES AND COMBINATIONS                  780464   No       0.27     0.23
      SULPHONAMIDES AND COMBINATIONS                  706434   No       3.24     0.23
      SULPHONAMIDES AND COMBINATIONS                  706948   No       0.19     0.23
      SULPHONAMIDES AND COMBINATIONS                  716731   No       0.15     0.23
      SULPHONAMIDES AND COMBINATIONS                  721751   No       0.83     0.23
      SULPHONAMIDES AND COMBINATIONS                  704095   No       0.13     0.23
      SULPHONAMIDES AND COMBINATIONS                  735698   No       0.15     0.23
      SULPHONAMIDES AND COMBINATIONS                  701754   No       0.16     0.23
      SULPHONAMIDES AND COMBINATIONS                  867977   No       0.11     0.23
      SULPHONAMIDES AND COMBINATIONS                  758248   No       0.22     0.23
      SULPHONAMIDES AND COMBINATIONS                  789836   No       0.17     0.23
      SULPHONAMIDES AND COMBINATIONS                  715609   No       0.15     0.23
      SULPHONAMIDES AND COMBINATIONS                  793698   No        0.6     0.23
      SULPHONAMIDES AND COMBINATIONS                  706442   No       6.92     0.87
      SULPHONAMIDES AND COMBINATIONS                  721778   No       1.66     0.87
      SULPHONAMIDES AND COMBINATIONS                  758256   No       0.87     0.87
      SULPHONAMIDES AND COMBINATIONS                  782793   No       0.66     0.87




Mediscor PBM Copyright
                       TETRACYCLINES                                 893402   No   0.39   0.46
                       TETRACYCLINES                                 716944   No   0.38   0.46
                       TETRACYCLINES                                 809667   No   0.46   0.46
                       TETRACYCLINES                                 714192   No   0.35   0.46
                       TETRACYCLINES                                 812692   No   1.86   0.46
                       TETRACYCLINES                                 825727   No   8.42   N/A
                       TETRACYCLINES                                 838691   No   0.88   0.46
                       TETRACYCLINES                                 787434   No   0.15   0.22
                       TETRACYCLINES                                 884167   No   0.11   0.22
                       TETRACYCLINES                                 752045   No   0.62   0.22
                       TETRACYCLINES                                 895029   No   4.56   0.22
                       TETRACYCLINES                                 751987   No   0.22   0.22
                       TETRACYCLINES                                 703224   No   0.14   0.22
                       TETRACYCLINES                                 761532   No   2.23   0.22
                       TETRACYCLINES                                 812072   No   0.4    0.22

arly by the Mediscor Pharmaceutical and Therapeutics Committee
ment of the listed conditions. Mediscor PBM Pty Ltd reserves
s for the treatment of the listed conditions. Mediscor PBM Pty Ltd
n important or new information is made available,


 ghts in or in respect of the Mediscor Formularies.
d, recorded or stored in any retrieval system, or transmitted by
ermission of Mediscor PBM.




               Mediscor PBM Copyright
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