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Preferred Brand Name Drug List

 

Preferred Brand Name Drugs ( BCBSVT/TVHP Tier 2)

 Updated 08-20-10  ( # = New to List)

 

A

ACIPHEX

ACTONEL

ACTOPLUS MET

ACTOS

AGENERASE

ALINIA
ANDRODERM
ARICEPT
ARIMIDEX
AROMASIN
ASACOL
ASTELIN
AVANDAMET

AVANDARYL
AVANDIA
AVONEX
AZILECT

B
BD INSULIN NEEDLES

BD INSULIN SYRINGES

BENICAR
BENICAR HCT
BETASERON
BRAVELLE

C
CANASA
CARAC
CASODEX
CEENU
CELEBREX
CETROTIDE
CIPRODEX
CLIMARA PRO
COMBIVENT
COMBIVIR
COMTAN
CONCERTA
CONDYLOX GEL
COPAXONE
CORTIFOAM
CREON

CRESTOR
CRIXIVAN
CUPRIMINE

D
DAPSONE
DEPAKOTE SPRINKLE CAP 125MG

DETROL

DETROL LA
DILANTIN KAPSEALS
DIOVAN #

DUAC CS KIT

E
ELMIRON
EMCYT
ENBREL
ENTOCORT EC
EPIPEN
EPIVIR
EPIVIR -HBV
EPZICOM
ERGAMISOL
ESTRADERM
ESTRATEST
ESTRATEST HS
EVISTA
EVOXAC
EXELON

F
FARESTON
FEMARA
FINACEA
FLOVENT
FORTOVASE

FREESTYLE GLUCOMETER
FREESTYLE TEST STRIPS

G
GENOTROPIN
GLEEVEC
GLUCAGON

GOLYTELY

H
HEPSERA
HEXALEN
HIVID
HUMALOG
HUMIRA
HUMULIN

I
INNOPRAN XL
INTAL INHALER
INTRON A
INVIRASE

K
KALETRA, capsule and solution

L

LANTUS

LETARIS
LEUKERAN
LEVEMIR
LEXAPRO
LEXIVA
LIDODERM
LIPITOR
LOTEMAX
LOVENOX
LYSODREN

M
MAXALT
MEPHYTON
METHERGINE
METROGEL VAGINAL
MIGRANAL
MIRAPEX
MYLERAN

N
NAMENDA
NARDIL
NASONEX
NEUPOGEN
NEXAVAR
NEXIUM
NIASPAN
NILANDRON
NORDITROPIN
NORVIR
NOVOLIN
NOVOLOG
NOVOLOG MIX 70/30
NUVARING

O
ONE TOUCH GLUCOMETER
ONE TOUCH TEST STRIP
ORTHOVISC
OVIDE
OXSORALEN ULTRA
OXYTROL

P
PEGASYS
PEG-INTRON
PLAN B
PLAVIX
PRANDIN
PRECISION GLUCOMETER
PRECISION TEST STRIPS
PRED MILD
PREMARIN
PREMARIN CREAM
PREMPHASE
PREMPRO
PREVEN
PREZISTA

PROAIR HFA
PROCRIT
PROVIGIL
PULMICORT RESPULES
PULMOZYME

Q
QUIXIN
QVAR

R
RAPAMUNE
REBETRON
REBIF
RENAGEL

RESCRIPTOR
RESTASIS
REVATIO
REVLIMID
RIDAURA

RYTHMOL SR

S
SEREVENT
SEROQUEL
SINGULAIR
SPIRIVA
SPRYCEL
STALEVO
SUSTIVA
SUTENT

SYMBICORT

T
TARCEVA

TARGRETIN
TAZORAC
TEMODAR
TESLAC
THIOGUANINE I
TOBI

TRACLEER
TREXALL

TRICOR TABS (48MG & 145MG)

TRIZIVIR
TRUVADA

TYKERB
TYZEKA

U
ULTRASE
ULTRASE MT

V
VENTOLIN HFA

VEPESID
VIAGRA
VIDEX
VIRACEPT
VIRAMUNE
VIREAD
VIVELLE
VOLTAREN OPTHALMIC SOLUTION


W
WELCHOL

X
XALATAN
XELODA
XENICAL

Y

Z
ZIAGEN

ZOLADEX
ZOLINZA
ZYPREXA