Drug List Changes
2010 Aetna Medicare Rx Plan (PDP)
Here are changes from a recent review of Aetna Medicare's Preferred Drug List (formulary). They are based on findings from the Food and Drug Administration (FDA) and drug makers, and other factors including cost. Changes occur, for example, because new drugs come on the market, we may learn that a prescription drug should now have a lower dose, it's moved to a different cost-sharing level (tier), or a generic version becomes available. We change our list to help provide you with appropriate, affordable drug benefits.
Carefully review the monthly changes below and their effective dates. If you are affected by preferred drug list changes, you will receive a letter explaining the changes. You can also speak with your doctor or pharmacist about the preferred drug list changes.
View full Aetna Medicare Rx Plan (PDP) 2010 Comprehensive Formulary 
(93 pages, 342 KB)
| Key: | |
|---|---|
| UPPERCASE = Brand-name medications | QL = Quantity limits |
| lower case italics = generic medications | ST = Step therapy |
| Tier 1, 2, 3, 4, 5 = Copay tier level | PR = Precertification |
Date of Change: January 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| ULORIC | Addition | Tier 3, ST |
Date of Change: March 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| AMINOSYN IIM INJ 3.5%/D5W | Addition | Tier 4 | |
| ARZERRA | Addition | Tier 5, PR | |
| augmented betamethasone dipropionate lotion 0.05% | Addition | Tier 2 | |
| azelastine ophth soln 0.05% | Addition | Tier 2 | |
| clindamycin phosphate-benzoyl peroxide gel 1-5% |
Addition | Tier 1 | |
| FANAPT | Addition | Tier 4, ST, QL=2/1 day | |
| FANAPT PAK | Addition | Tier 4, ST, QL=16/365 days | |
| HALFLYTELY KIT BWL-PREP | Addition | Tier 4 | |
| INVEGA 1.5MG TABLETS | Addition | Tier 4, ST, QL=1/1 day | |
| LIPOSYN II INJ 10,20,30% | Addition | Tier 4 | |
| piperacillin sodium-tazobactam sodium for inj 3-0.375 gm | Addition | Tier 2 | |
| polyethylene glycol 3350 | Addition | Tier 1 | |
| timolol ophth gel | Addition | Tier 1 | |
| tramadol er | Addition | Tier 1, QL=1/1 day | |
| valacyclovir | Addition | Tier 1 | |
| VIBATIV | Addition | Tier 5, QL=233.3mg/1 day | |
| VOTRIENT | Addition | Tier 5, PR, QL=1/1 day |
Date of Change: April 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| ACTEMRA | Addition | Tier 5, PR | |
| CREON | Addition | Tier 3 | |
| MORPHINE SULFATE SOLUTION 20MG/ML | Addition | Tier 4, QL=9/1 day | |
| MOZOBIL | Addition | Tier 5, PR | |
| nizatidine solution | Addition | Tier 2 | |
| pramipexole | Addition | Tier 2 | |
| SAMSCA | Addition | Tier 5, QL=4/1 day | |
| SAVELLA | Addition | Tier 3, QL=2/1 day | |
| SAVELLA PAK | Addition | Tier 3,QL=1 Pak/365 days |
Date of Change: May 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| ALREX 0.2% | Tier Reduction, ST removal | Tier 3 | |
| budesonide | Addition | Tier 2, PR | |
| ISTODAX | Addition | Tier 5, PR | |
| LOTEMAX 0.5% | Tier Reduction, ST removal | Tier 3 | |
| phenytoin cap 200, 300mg | Addition | Tier 2 | |
| PRIVIGEN | Addition | Tier 5, PR | |
| SOTALOL INJ | Addition | Tier 4 | |
| STELARA | Addition | Tier 5, PR | |
| VALTURNA | Addition | Tier 3, QL=1/1 day |
Date of Change: June 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| amantadine syrup 50mg/5ml | Addition | Tier 2 | |
| AMPYRA TAB 10MG | Addition | Tier 5, PR, QL=2/1 day(s) | |
| ASMANEX 30 110MCG | Addition | Tier 3 | |
| GOLYTELY | Addition | Tier 4 | |
| imiquimod cream 5% | Addition | Tier 2 | |
| INVEGA SUST INJ 39/0.25 | Addition | Tier 4 | |
| INVEGA SUST INJ 78/0.5ML | Addition | Tier 4 | |
| minocycline tablet 135mg er | Addition | Tier 2, PR | |
| minocycline tablet 45mg er | Addition | Tier 2, PR | |
| minocycline tablet 90mg er | Addition | Tier 2, PR | |
| RELISTOR INJ 12/0.6ML | Addition | Tier 4, QL=1/1 day(s) | |
| ZIRGAN GEL 0.15% | Addition | Tier 4 | |
| ZYPREXA RELP INJ 405MG | Addition | Tier 5, QL=15/1 day(s) |
Date of Change: July 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| amoxicillin and clavulanic acid er | Addition | Tier 2 | |
| clindamycin foam 1% | Addition | Tier 2 | |
| DEXILANT CAP 30MG DR | Addition | Tier 3, QL=1/1day(s) | |
| DEXILANT CAP 60MG DR | Addition | Tier 3, QL=1/1day(s) | |
| FEMARA TAB 2.5MG | Tier Reduction | Tier 3 | |
| metaxalone tab 800mg | Addition | Tier 2, PR | |
| NEVANAC | Step Removal | Tier 4 | |
| VPRIV INJ 400UNIT | Addition | Tier 5 |
Date of Change: August 1, 2010
| Drug Name | Change Type | Alternative | What You Need to Know |
|---|---|---|---|
| methamphetamine tab 5mg | Addition | Tier 2, PR, QL=5/1day(s) | |
| NORVIR TAB 100MG | Addition | Tier 4 | |
| torsemide inj 20mg/2ml | Addition | Tier 2 |
See the Aetna Medicare Glossary for unfamiliar terms.
See the Aetna Medicare Rx Find Prescriptions page for more information about Aetna Medicare's preferred drug list (formulary).
(Last updated 7/30/2010)
FID: 10232 version 39
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