L. A. Care Health Plan Step Therapy List Q1 2008 BRAND NAME ACTONEL ACTOPLUS MET ACTOS ADVAIR DISKUS ADVAIR HFA ALAMAST ALLEGRA-D 24 HOUR AMNESTEEM ANTARA APIDRA AZOR BENICAR BENICAR HCT BROVANA BYETTA CELEBREX CLARAVIS DETROL DETROL LA DIOVAN DIOVAN HCT ELIDEL ENTOCORT EC EXFORGE FAMCICLOVIR FENOFIBRATE FEXOFENADINE HCL FINASTERIDE FLOMAX HUMALOG INSULIN PEN HUMALOG MIX 50-50 INSULIN PEN HUMALOG MIX 75-25 INSULIN PEN HUMULIN 70-30 INSULIN PEN HUMULIN N INSULIN PEN JANUMET JANUVIA KETEK KETEK PAK LANTUS SOLOSTAR LEFLUNOMIDE LIPITOR LUNESTA MEGACE ES NAMENDA GENERIC NAME RISEDRONATE SODIUM PIOGLITAZONE HCL METFORMIN HCL PIOGLITAZONE HCL FLUTICASONE SALMETEROL FLUTICASONE SALMETEROL PEMIROLAST POTASSIUM P-EPHED HCL FEXOFENADINE HCL ISOTRETINOIN FENOFIBRATE, MICRONIZED INSULIN GLULISINE AMLODIPINE BES OLMESARTAN MED OLMESARTAN MEDOXOMIL OLMESARTAN HYDROCHLOROTHIAZIDE ARFORMOTEROL TARTRATE EXENATIDE CELECOXIB ISOTRETINOIN TOLTERODINE TARTRATE TOLTERODINE TARTRATE VALSARTAN VALSARTAN HYDROCHLOROTHIAZIDE PIMECROLIMUS BUDESONIDE AMLODIPINE VALSARTAN FAMCICLOVIR FENOFIBRATE, MICRONIZED FEXOFENADINE HCL FINASTERIDE TAMSULOSIN HCL INSULIN LISPRO INSULIN NPL INSULIN LISPRO INSULIN NPL INSULIN LISPRO HUM INSULIN NPH REG INSULIN HM NPH, HUMAN INSULIN ISOPHANE SITAGLIPTIN PHOS METFORMIN HCL SITAGLIPTIN PHOSPHATE TELITHROMYCIN TELITHROMYCIN INSULIN GLARGINE, HUM.REC.ANLOG LEFLUNOMIDE ATORVASTATIN CALCIUM ESZOPICLONE MEGESTROL ACETATE MEMANTINE HCL. We have also increased our collaborations with pharmaceutical companies to test new medications. Three active studies are underway, including two experimental medications--each with a different approach to helping smokers quit and treating tobacco dependence. We have used our knowledge and expertise in the policy arena. As chair of the Subcommittee on Cessation of the Interagency Committee on Smoking and Health, at the behest of Health and Human Services Secretary Tommy Thompson, we worked with experts in tobacco cessation to create a National Action Plan for Tobacco Cessation. This plan provides a roadmap for providing services and funding to prevent three million deaths from smoking by helping more Americans successfully quit. We have focused our Outreach Program on providing more and better training and materials for healthcare providers. We have expanded cooperation between the extremely successful Wisconsin Tobacco Quit Line and our outreach specialists through the Fax to Quit Program and the Free Patch Program for low-income populations. This provides just a sample of the variety of activities completed in 2003, some of which are detailed in this report. Our goal during this period has been to focus on doing the very best we can to promote smoking cessation. In that way, we have advanced our mission--to understand, treat and reduce tobacco dependence in the state and the nation through research, intervention and policy and actos.
Actoplus met approved by the fda for type 2 diabetes - diabetes health actoplus met will be available in two dosages of pioglitazone with. Phil Cogan, R.Ph, Editor STAFF: Eva Carey-Brown Joseph Paradis, PharmD, of Health Information Designs, Inc and avandamet. Last year was a remarkable year from a marketing and sales perspective. Sales growth was achieved, business was added from new products, the organization was expanded and strengthened, and preparations continued for the possible launch of breakthrough therapy for hepatitis C. Growth was achieved in 1997, with overall sales advancing 22%. This performance was led by the pharmaceutical segment where sales advanced to 1 million, up 24%, and at the regional level by Eastern Europe, with sales of 3 million, up 22%, and North America with sales of 3 million, up 30%. Other regions also contributed to growth as the company's focus on being a marketing-driven organization intensified and continued to generate meaningful results. At the product level, several noteworthy performances were turned in, and the ICN product portfolio was further enhanced through local product development efforts, product acquisition, in-licensing arrangements with other pharmaceutical companies, and aggressive registration of ICN products across new markets. The top 10 ICN products worldwide contributed 6 million to 1997 sales, 21% of total pharmaceutical sales. The company's leading product contributor became the myasthenia gravis product line Mestinon, Tensilon, Prostigmin ; with combined sales of million. Virazole continues to be sold in aerosolized form for the treatment. GenerIC DruGS are listed in italic lowercase letters and generally require a co-pay for a 33-day supply until expenses reach the Coverage Gap. branD-naMe DruGS are listed in CAPITAL LETTERS and generally require a co-pay for a 33-day supply until expenses reach the Coverage Gap. For a brand-name drug that has a generic equivalent available, your cost would be the generic co-pay plus the cost differential between the brand-name and generic drug. G: a generic is available for at least one or more strengths of the brandname drug. Per the previous item, you may have to pay the generic co-pay plus the cost differential between the brand-name and generic drug for the brand version of this drug. SP: considered a Specialty Drug, you pay 33% of the cost until expenses reach the Coverage Gap InJ: available in injectable form only Par: prior authorization may apply QLL: quantities dispensed may be limited for proper use St: Step Therapy may apply, which means you may be required to try a traditional treatment before the Plan will cover this medication acticin ACTIGALL G ACTIMMUNE InJ, SP ACTIQ G, SP, QLL, Par ACTIVELLA ACTONEL, -WITH CALCIUM QLL ACTOPLUS MET ACTOS QLL ACULAR, -LS, -PF acyclovir acyclovir sodium InJ ADACEL InJ ADAGEN InJ, SP ADALAT CC G ADDERALL G ADDERALL XR QLL ADOXA G ADOXA PAK 1 100 G ADOXA PAK 1 150 ADOXA PAK 1 75 G ADOXA PAK 2 100 G and avandia. Food aid programs targeting households affected by HIV AIDS should consider the particular nutritional needs of people living with HIV AIDS in designing rations. More information on planning food aid programs and rations for HIV AIDS-affected populations is available in Potential Uses of Food Aid to Support HIV AIDS Mitigation Activities in Sub-Saharan Africa FANTA 2000 ; and Module 6 of HIV AIDS: A Guide for Nutrition, Care and Support FANTA 2001 ; . Agricultural extension and introduction of new technologies to reduce labor requirements can help maintain or improve agricultural productivity in the face of declining labor. For example, a USAID project has developed a drip irrigation system for HIV AIDS-affected households in Zimbabwe that reduces the labor needed for irrigation by 50 percent.2 Microfinance can support the maintenance or purchase of productive assets, help smooth income flow, and enable households to meet key food, health care, and other basic expenditures. While small loans can enable affected households to increase income, savings, and food access, microfinance interventions may need to be designed with special features in the context of HIV AIDS to deal with challenges such as ill borrowers. For example, a microfinance program in Zimbabwe instituted a mandatory insurance fee to cover the cost of outstanding loans from borrowers who die Horizons 2002 ; . Capacity building of networks and community support organizations can help address the erosion of institutions, support linkages with services, and maintain knowledge. Often networks and organizations already exist, although they may be weakened by the spread of HIV AIDS in communities. Capacity building may involve training, strengthening the support that groups offer to HIV-affected households, developing coordination mechanisms between groups and services, and providing outreach to new community members and population groups. Nutritional care and support practitioners should be aware of services to help strengthen food access and availability and when possible link and refer clients to them. Session 5 discusses approaches other than formal services, such as household strategies and allocation of food expenditures. Is considered a first-line therapy for adults with Type 2 diabetes. FDA approval of metformin contains a black box warning for causing lactic acidosis. Mark Oley reviewed Meglitinides There are no significant changes in the class over the past year. Mark Oley reviewed Thiazolidinediones TZDs ; Many new studies were released over the past year related to this class and several new combination products were made available. The new combination products include: Takeda Pharmaceuticals released Pioglitazone metformin Acto0lus Met ; in August 2005 which is available in tablets 15 mg 500 mg, 15 mg 850 mg with dosing once twice daily ; and GlaxoSmithKline released Rosiglitazone glimepiride Avandaryl ; in November 2005 4 mg 1 mg; 4 mg 2 mg; 4 mg 4 mg with dosing once daily ; . There are currently two thiazolidinediones TZDs ; , rosiglitazone and pioglitazone, available in the United States. Both of these agents are available in combination with metformin. Rosiglitazone is also available in combination with glimepiride. The single TZD agents should be considered therapeutic alternatives based on their indications and adverse event profiles. However, a recent study, showed pioglitazone to be superior to rosiglitazone based on its effects on lipid profiles. Both TZDs have an approved FDA indication as an adjunct to diet and exercise to lower blood glucose concentrations in patients with type 2 diabetes mellitus for patients already stable on the agents and doses available in combination or for patients who have had inadequate response with either agent alone. Both TZDs can be used alone or in combination with metformin, sulfonylureas, or insulin. The issues concerning effects on lipids remain debated in patients with type 2 diabetes mellitus. A recent study reported that TZDs prevent restenosis after coronary artery stenting, thus implying that TZDs may diminish the risk of the development of atherosclerotic disease. The risk-to-benefit ratio of TZDs remains undefined in the population as a whole. The adverse events of both agents that occur with greater frequency compared to patients treated with placebo are fluid retention and edema. TZDs are not recommended for use in patients with NYHA Class III and IV heart failure. If a TZD is prescribed for a patient with heart failure NYHA Class II ; , therapy should be initiated at the lowest possible dose and the patient should be monitored closely for weight gain, edema, or signs and symptoms of congestive heart failure exacerbation. Cases of congestive heart failure have been reported in patients both with and without previously known heart disease. Lactic acidosis is a life-threatening adverse effect of metformin. In January 2006, the manufacturer and the FDA notified health care professionals of reports of new onset and worsening diabetic macular edema for patients receiving rosiglitazone. In the majority of these cases, the patients also reported concurrent peripheral edema. In some cases, the macular edema resolved or improved following discontinuation of therapy and in one case, macular edema resolved after dose reduction. Until further research is accomplished, it should be assumed that both rosiglitazone and pioglitazone might share the possibility for these reported events. Mr. Oley motioned that the diabetic agents reviewed be PDL eligible. Mr. Szalwinski seconded the motion. The Committee voted unanimously to consider all diabetic agents reviewed as PDL eligible. Mark Oley reviewed Leukotriene Modifiers Zileuton Zyflo ; 600mg tablet has returned to the market this year, it is a leukotriene inhibitor. It has no advantage over the leukotriene modifiers. It has to be dosed 4 times a day and has some significant drugto-drug interactions with propranolol, theophylline and warfarin. The FDA issued a warning letter on November 9, 2005 stating that the MOA sheet is false or misleading in that it presents efficacy claims for Zyflo, but fails to communicate any risks associated with its use and fails to present the approved and glucotrol.

POTASSIUM REPLACEMENT C1D ; POTASSIUM BICARBONATE POTASSIUM CHLORIDE POTASSIUM BICARBONATE-POTASSIUM CITRATE POTASSIUM EFFERVESCENT ; CALCIUM REPLACEMENT C1F ; CALCIUM-MAGNESIUM OTC ; CALCIUM CARBONATE OTC ; CALCIUM GLUCONATE 650 mg OTC ; CALCIUM LACTATE OTC ; GENETICAL ELECTROLYTES C1W ; PEDIATRIC ELECTROLYTE OTC ; IRON REPLACEMENT C3B ; FEROCON FEROTRINSIC FERREX 150 FORTE FERROCITE PLUS FERROCITE-F FERROGELS FORTE FERROUS GLUCONATE OTC ; FERROUS SULFATE OTC ; FOLITAB 500 FOLTRIN GENHEMAT HEMATINIC PLUS HEMATINIC W FOLIC ACID HEMATOGEN HEMATOGEN FA HEMATOGEN FORTE IFEREX 150 IFEREX 150 FORTE MULTIFOL MULTI-RET FOLIC 500 MYFERON-150 FORTE POLY-IRON 150 FORTE POLYSACCHARIDE IRON FORTE TRICON ZINC REPLACEMENT C3C ; ZINC SULFATE RX only ; IODINE CONTAINING AGENTS C3H ; STRONG IODINE INSULINS C4G ; APIDRA NEW ADDITION ; HUMALOG HUMALOG MIX 50 HUMALOG MIX 75 25 HUMULIN 50 OTC ; HUMULIN 70 30 OTC ; HUMULIN N OTC ; HUMULIN R OTC ; LANTUS LEVEMIR NOVOLIN 70 30 OTC ; NOVOLIN 70 30 INNOLET OTC ; PHENEX-1 OTC ; PHENYL-FREE 1 OTC ; PKU 1 OTC ; PKU GEL OTC ; XPHE ANALOG OTC ; XPHE, XTYR ANALOG OTC ; XPTM ANALOG OTC ; DIETARY SUPPLEMENT, MISCELLANEOUS C5F ; PHLEXY-10 OTC ; PHLEXY-VITS OTC ; XPHE MAXAMAID OTC ; NOVOLIN N OTC ; NOVOLIN N INNOLET OTC ; NOVOLIN R OTC ; NOVOLOG NOVOLOG MIX 70 30 ANTIHYPERGLYCEMIC, AMYLIN ANALOG-TYPE C4H ; SYMLIN ANTIHYPERGLY, INCRETIN MIMETIC GLP-1 RECEP.AGONIST ; C4I ; BYETTA PA required ; HYPOGLYCEMICS, INSULIN-RELEASE STIMULANT TYPE C4K ; ACETOHEXAMIDE CHLORPROPAMIDE GLIMEPIRIDE GLIPIZIDE GLIPIZIDE ER GLIPIZIDE XL GLIPIZIDE-METFORMIN HCL GLYBURIDE GLYBURIDE MICRONIZED GLYBURIDE-METFORMIN HCL PRANDIN STARLIX TOLAZAMIDE TOLBUTAMIDE HYPOGLYCEMICS, BIGUANIDE TYPE NON-SULFONYLUREAS ; C4L ; METFORMIN HCL METFORMIN HCL ER HYPOGLYCEMICS, ALPHA-GLUCOSIDASE INHIB TYPE N-S ; C4M ; GLYSET PRECOSE HYPOGLYCEMICS, INSULIN-RESPONSE ENHANCER N-S ; C4N & C4R ; ACTOPLUS MET new formulary addition ; ACTOS AVANDAMET AVANDARYL AVANDIA DUETACT new formulary addition ; PROTEIN REPLACEMENT C5B ; PHENYLADE OTC ; PHENYLADE AMINO ACID OTC ; PHLEXY-10 OTC ; INFANT FORMULAS C5C.
66 The content of the survey covers four areas; was the patient told to avoid pregnancy, has the patient received the educational materials, has the patient reviewed the education materials and from whom was birth-control counseling received. This survey is presented before the comprehension questions. The bottom line I would like to highlight to you is that we did not see any apparent difference between the non-pregnant and the pregnant patients in this part of the program but I would like to share with you the details. [Slide.] So, on this table, you can see a comparison again, as you have seen before, of the non-pregnant group which is a large group and the pregnancy females. What is summarized in the table are the positive responses to each one of the questions. In fact, there is no difference. I would like to and prandin!

Correct results in odor identification tests OIT ; and odor discrimination tests ODT ; .168 Thirtyseven of 80 PD patients had abnormal OIT results 46.3 percent ; , compared with five of 40 controls 12.5 percent ; . This difference was significant, but the percent of patients with abnormal ODT results did not differ significantly between PD patients and controls 28.0 vs. 16.4 percent ; . The authors concluded that PD patients have a defect in olfactory identification, but not in olfactory discrimination. Another study found that olfactory threshold and odor identification were significantly impaired in 21 PD patients compared with 19 controls, although there was no significant difference between the PD patients and 22 patients with AD.169 One study compared odor detection threshold and recognition threshold, and found both to be significantly impaired in 18 PD patients compared with 10 controls.163 Although all of the studies of olfactory function used different methods of measurement and reporting, they all were consistent in reporting that olfactory function is impaired in PD patients compared with healthy controls. There was not as much consistency in comparing results in patients with PD vs. atypical parkinsonism; therefore, there is insufficient evidence to support olfactory function testing to be used as a diagnostic tool at this time and starlix. Once-daily dosing with pioglitazone hydrochloride improves insulin resistance and reduces blood sugar levels, without placing any additional burdens on the pancreas. The drug is marketed in around 70 countries worldwide. In the United States, Actopllus Met, a fixeddose combination tablet of pioglitazone hydrochloride and metformin, as well as Duetact, a fixed-dose combination tablet of pioglitazone hydrochloride and glimepiride are also marketed. Establish a unification process by September 2005 Unify the pipeline priorities of both companies from October 2005 Concentrate global development resources more selectively Increase development speed by mutually utilizing infrastructure and expertise John C. Alexander * will chair the new committee, lead the unification and the Europe U.S. development organization and amaryl. Dean of the Medical School, Dr. Sherman Mellinkoff, provided a fund for publication costs for completed manuscripts, and the Institute agreed to transfer supervision to a committee entitled "UCLA Forum in the Medical Sciences, " appointed by Dean Mellinkoff, under the chairmanship of Institute member and Professor of Physiology, Victor E. Hall. The publication prepared by the unit which appeared during the under review was entitled: Brain Function. Cortical Excitability Steady Potentials; Relations of Basic Research to Space Biology. Ed. M. A. B. Brazier, 1963, University of California Press. Editorial Staff Editor III year and. Early epidemiological evidence has associated high levels of plasma fibrinogen with CVD incidence.20 Fibrinogen may contribute to CVD via a number of mechanisms, including increased fibrin formation, plasma viscosity and platelet aggregation.20 On the other hand, fibrinogen is an acute phase reactant, and the association of elevated fibrinogen and CRP levels with risk of arterial thrombotic disease suggests that inflammation that accompanies atherosclerosis may contribute to increased fibrinogen levels. This hypothesis was reinforced by the PRIME study, where the predictive ability of fibrinogen on the risk of CVD disappeared when CRP, IL-6 and fibrinogen were included in the same model.21 The increased concentration of fibrinogen is quite consistently described in individuals with MS. It is now considered that the fibrinogen level is determined by overall adiposity rather than insulin resistance.22 It is related to obesity per se and weakly related to abdominal obesity and insulin levels. IL-6 is thought to be at the basis of this abnormality. IL-6 is produced by adipose tissue23 and will directly stimulate the hepatic synthesis of fibrinogen. IL-6 could therefore represents a link between obesity and fibrinogen levels in plasma and lamisil. Chronic methamphetamine MA ; abuse is associated with cerebral deficits, involving frontostriatal regions that are important for inhibitory control. We used the Stop-Signal Task to measure response inhibition in 11 MA abusers 5 -7 days abstinent ; and two groups of control subjects who did not use MA 14 tobacco smokers and 29 non-smokers ; . Stop-Signal Reaction Time SSRT ; , which indicates the latency to inhibit an initiated motor response, was significantly higher for MA abusers than for either control group p's .01 ; . In contrast, the MA abusers did not differ from either group on Go trial reaction time RT ; or number of discrimination errors, which reflect decision-processes and motor speed, respectively. MA abuse in this study was therefore associated with a specific deficit in inhibiting a pre-potent response. To the extent that deficient response inhibition is related to compromised treatment outcome, it may be a useful target for therapeutic intervention. Supported by NIH Grant K01 DA0051-01A1 JM ; , NIH Grant 3R01 DA015179-02S1 EDL ; , and UCLA NIH-supported General Clinical Research Center 5M01RR000865-31.

1. 2. 3. National Institute for Health and Clinical Excellence public health intervention guidance how to help employees to stop smoking, April 2007. 5. Workplace health promotion.

Criteria available, and for these medications, the pharmacist will also receive the message to call a toll-free number. The Member will have the following options when the QLL is exceeded: 1 ; accept the established quantity limit and receive that quantity, 2 ; discuss the prescription with his or her physician, or 3 ; request coverage review for those drugs that do have coverage criteria. Medications affected by QLLs are designated by an asterisk * ; in the PDL available online at oxfordhealth . The following quantity limits have been implemented: Drug Name Actonel with calcium Actoplus Met Alphagan P Ambien CR Aricept ODT Asmanex Baraclude Byetta Cosopt Focalin XR Fortical Lumigan Omacor Razadyne Razadyne ER Revatio Rozerem Symlin Travatan Ventavis Xalatan Zemplar Zmax Therapeutic Use Osteoporosis therapy Diabetes therapy Glaucoma Sedative hypnotic Alzheimer's disease Asthma Hepatitis B Diabetes therapy Glaucoma Attention deficit hyperactivity disorder Osteoporosis therapy Glaucoma Lipid cholesterol lowering Alzheimer's disease Alzheimer's disease Pulmonary arterial hypertension Sedative Diabetes therapy Glaucoma Pulmonary arterial hypertension Glaucoma Hyperparathryoidism Anti-infective.

While AZT remains the only proven regimen for preventing vertical transmission, AZT as a single therapy has long been shown to be less effective than combination therapy for treating HIV disease. Thus, pregnant women are now encouraged to consider more powerful anti-HIV regimens that best benefit their own health, while refraining from certain drug use which may harm the developing baby. It is also recommended that regimens used in pregnancy include AZT, in addition to any other drugs. 4. Become familiar with First Choice procedures and if you have any questions or require additional information you should contact the First Choice Member Services Department. 5. See your doctor regularly for preventative services such as; prenatal care, well child visits, adult physicals, and well woman exams. 6. Provide, to the extent possible, information that First Choice and its practitioners and providers need in order to care for you. 7. Treat your PCP s ; and their staff s ; with kindness and respect. 8. Help your PCP s ; obtain all your medical records and fill out new ones. 9. Participate in understanding your health problems and follow the recommended treatment of care from your doctor or let the doctor know the reasons the treatment cannot be followed, as soon as possible. 10. Obtain a referral from your PCP s ; before you go to a specialist or to the hospital. Only go to the ones your PCP s ; recommended. 11. Not to go to the emergency room for routine care. 12. Call your PCP s ; as soon as you or a family member feels ill. Do not wait. If you feel you have a life-threatening emergency, go to your closest hospital. 13. Be on time for all appointments. If you cannot make an appointment, please cancel at least 24 hours in advance of your originally scheduled time. 14. Notify First Choice if your or your child children's name, address or phone number changes. 15. Inform First Choice of any change in your legal status regarding your authority to make decisions on behalf of your child or children. 16. Not change your PCP without approval from First Choice.

Actoplus dosing