Introduction · Due to restricted space, only a summarised version of active ingredients can be published. · The formulary focuses on cost-effective medicine use and therefore will be particularly useful for members on low benefit options. · Where appropriate, please prescribe generics to avoid or limit generic co-payments or out of pocket expenses/ to the patient.
· Motivations may be considered for additional drugs/items not on the formulary, or the patient does not respond,
Purpose of the Go for Green formulary · The formulary was designed as communication tool to give the busy practitioner some indication of the likelyhood of payment. · Allows patients to receive rational, effective treatment at an affordable cost, without compromising care. · To ensure utilisation in line with Evidence Based Medicine (EBM) principles. Please note:
Only items marked with ‘ Mot ’ needs pre-authorisation for the following options: Optimum, Basic A and Classic options. Forms available by dialling 082 239 2815 from any tone-dialling fax machine - Form 3300 or contact General Practitioner Line: 0861 000 402 or Pharmacist Line: 0861 000 412 Pharmacists :
Please use the ICD10 code of Z76.8 to claim for Pharmacist Advised Therapy benefits. Classic & Optimum: Any medication that is schedule one or two can be claimed as an OTC by any Pharmacy provider. The PAT medicine limit is R120.00.
☻Green light means go as the medicine item marked is available with very few electronic checks and requirements to be met. Generic, quantity and ‘’refill- too-soon’ checks apply.
▼Yellow light means slow down, as there are more electronic checks and requirements to be met such as the above plus (1) clinical step therapy algorithms of more cost effective items to be used first, and (2) therapeutic pricing where the patient needs to pay in the difference between the more expensive non-formulary prescribed item and the formulary item
◘ Red light means that the medicine item is not on the formulary and you need to stop if you want to avoid out of pocket expenses for the patient. Patients who prefer this item are likely to incur a extra Maximum Allowed Co-payment.
█ No entry. Items marked like this may be prescribed, but the medical scheme will never pay for this medicine item – the patient needs to fund it him/herself. Some reasons for this could be that the specific medicine item falls outside of the scope of the Scheme Rules, or it may not adhere to Evidence Based Medicine.
‘=’ Means that there are generic equivalents available. Please remember to still check their prices to ensure you pay as little as possible for the same medicine
‘≈’ Means that there are alternatives available on the green list that have a similar effect that is more cost-effective.
T Means it needs to adhere to a specific clinical protocol, such as second line therapy (once an alternative first line item has been used in the recent past), OR it will only be funded if initiated by s specialist.
$ Indicates a certain MAC co-payment for that item which will lead to out of pocket expenses to the patient.
F Indicates a specific fill limitation per period for that item. sed Therapy Active ingredient Formulation linical rules Guideline for lower ANTIHISTAMINES
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f ANTI-NAUSIA CARDIO VASCULAR
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f CHOLESTEROL LOWERING COLD & FLU
COMBINATION TABLETS Paracetamol, Phenylephrine,
COMBINATION TABLETS Caffeine anhydrous, Chlorpheniramine, ORAL
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f COUGH & COLD
THEOPHEN ELIX /THEOPHYLLIN EXPECT / LINK DYNALEX /
Chlorpheniramine Codeine phosphate, Phenylephrine salicylate
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
EPHEDRINE, Cimicifugae tinc, Eucalyptus oil, Grindeliae tinc, Menthol,
Pimpinellae tinc, Primulae tinc, Quebracho tinc, Saponin, Thymi tinc
EAR NOSE & THROAT
SEPTADINE ORAL ANTISEPTIC / STERIDINE MOUTHWASH
ANTIBIOTIC & CORTISONE BENZOCAINE, Chloramphenicol
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f GASTRO INTESTINAL TRACT
BISMUTH SUBGALLATE, Balsam peru, Benzyl benzoate, Bismuth oxide,
Bismuth subiodide, Boric acid, Pramoxine, Resorcinol, Zinc oxide
peru, Benzyl benzoate, Bismuth oxide, TOP
BISMUTH SUBGALLATE, Balsam peru, Benzyl benzoate, Bismuth oxide,
Bismuth resorcinol compound, Bismuth subiodine, Boric acid, Zinc oxide
MAYOGEL SUSP / SPASMOGEL / COMPU-GEL /DICYCLOMINE CO GEL /
ACIDEX SUSPENSION ALUM HYDROXIDE GEL / AMPHOJEL /
MIST ALUMINIUM HYD / ALUMINIUM HYDROXIDE GEL
Yes ═ ≈
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
attapulgite, Aminopentamide, Bismuth ORAL
LOPERASTAT ROLAB-LOPERAMIDE / CIPLA-LOPERAMIDE /
HORMONES DIABETIC
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f HORMONES
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f INFECTIONS -CHRONIC INFECTIONS INFECTIONS - ANTIBIOTICS
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f INFECTIONS -ANTIFUNGAL METABOLIC MUSCULO SKELETAL
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
INZA / IBUMAX /RANFEN TAB / BETAPROFEN /
ROLAB-IBUPROFEN / BREN TABS / IBUSOR TABS
NEUROLOGY
═ ≈ Mot $ T
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f OPTHALMIC PAINKILLERS
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
ALUMINIUM ACETYLSALICYLATE, Caffeine, Chlorphenoxamine, Codeine
Phosphate, Paracetamol, Phenobarbitone, Vit C
DOSTIL, FAMCOD, NITROCOD, PARACODOL, PARAN, ROCODIN,
PSYCHIATRY
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f PULMONARY
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f
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sed Therapy Active ingredient Formulation linical rules Guideline for lower Guideline f VACCINES VITAMINS MINERALS & ELECTROLYTES
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Westwood Evaluation & Treatment Center, 11340 Olympic Boulevard, Suite 303, Los Angeles, California 90064, 310-444-3154, [email protected] “in order to diagnose a Posttraumatic Stress Disorder correctly the doctor must show that the individual meets the DSM-IV-TR criteria” One of the most frequently encountered diagnoses in personal injury and workers’ compensation litigation
The World Health Organization added "it" to an official list of known carcinogens in 2005. The Physicians' Desk Reference cited a link between it and breast cancer in 2006. Quietly, word is getting out, just not quickly enough for young women. They are being told in doctor's offices that it is safe. It is the pill, the oral contraceptive that over 80% of women have bee
Introduction