ScripNet Workers’ Compensation Drug List
The ScripNet Workers’ Compensation Drug List is a guide within select therapeutic categories for clients, plan participants and health care providers. Generics should be considered the first line of prescribing. If there is no generic available, there may be more than one brand-name medicine to treat a condition. These preferred brand-name medicines are listed to help identify products that are clinically appropriate and cost-effective. Generics listed in therapeutic categories are for representational purposes only. This is not an all-inclusive list. This list represents brand products in CAPS, branded generics in upper- and lowercase Italics, and generic products in lowercase italics. PLAN PARTICIPANT HEALTH CARE PROVIDER
Your benefit plan provides you with a prescription benefit program. Ask
Your patient is covered under a prescription benefit plan. As a way to help
your doctor to consider prescribing, when medically appropriate, a
manage health care costs, authorize generic substitution whenever
preferred medicine from this list. Take this list along when you see a doctor.
possible. If you believe a brand-name product is necessary, consider
Please note:
● Your specific prescription benefit plan design may not cover certain
Please note:
categories, regardless of their appearance in this document.
● Generics should be considered the first line of prescribing.
● Some medications may require prior authorization to insure relationship
● This drug list represents a summary of prescription coverage. It is
to the workplace incident. Eligibility questions should be referred to
not inclusive and does not guarantee coverage.
your workers’ compensation benefits coordinator.
● Some medications may require prior authorization to insure relationship
● ScripNet may contact your doctor after receiving your prescription to
to the workplace incident. Eligibility questions should be referred to the
request consideration of a drug list product or generic equivalent. This
workers’ compensation benefits coordinator.
may result in your doctor prescribing, when medically appropriate, a
● Unless specifically indicated, drug list products will include all
different brand-name product or generic equivalent in place of your
ANALGESICS ANTI-INFECTIVES § MISCELLANEOUS § ACE INHIBITOR/ § HMG-CoA REDUCTASE INHIBITORS § NSAIDs ANTIBACTERIALS DIURETIC COMBINATIONS § CEPHALOSPORINS § ANTIFUNGALS COX-2 INHIBITORS NIACINS/COMBINATIONS § ERYTHROMYCINS/ § NARCOTIC ANALGESICS MACROLIDES ANTIVIRALS § ACE INHIBITOR/CALCIUM CHANNEL BLOCKERS § HERPES AGENTS § BETA-BLOCKERS § NARCOTIC ANALGESICS, CII ANGIOTENSIN II § INFLUENZA AGENTS RECEPTOR ANTAGONISTS/ § FLUOROQUINOLONES COMBINATIONS CARDIOVASCULAR § ACE INHIBITORS § CALCIUM CHANNEL ANTILIPEMICS § PENICILLINS BLOCKERS § BILE ACID RESINS § NON-NARCOTIC ANALGESICS CHOLESTEROL ABSORPTION § TETRACYCLINES INHIBITORS VISCOSUPPLEMENTS § FIBRATES
Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document.
Visit our Web site at www.scripnet.com for specific information. CALCIUM CHANNEL § ATTENTION DEFICIT INSULINS TRANSDERMAL § URINARY BLOCKER/ANTILIPEMIC HYPERACTIVITY ANTISPASMODICS COMBINATIONS DISORDER § DIGITALIS GLYCOSIDES ESTROGENS § DIURETICS INSULIN SENSITIZERS INSULIN SENSITIZER/ § HYPNOTICS, HEMATOLOGIC BIGUANIDE § TRANSDERMAL, NONBENZODIAZEPINES COMBINATIONS ESTROGENS § ANTICOAGULANTS INSULIN SENSITIZER/ SULFONYLUREA MIGRAINE COMBINATIONS RESPIRATORY CENTRAL NERVOUS § ORAL ESTROGEN/ § SELECTIVE SEROTONIN ANAPHYLAXIS AGONISTS MEGLITINIDES PROGESTINS TREATMENT AGENTS § ANTICONVULSANTS § SULFONYLUREAS § ANTICHOLINERGICS MULTIPLE SCLEROSIS § PROGESTINS § ANTIDEMENTIA § SULFONYLUREA/ § ANTICHOLINERGIC/ BETA AGONISTS BIGUANIDE SELECTIVE ESTROGEN COMBINATIONS § MUSCULOSKELETAL RECEPTOR MODULATORS THERAPY AGENTS SUPPLIES ANTIDEPRESSANTS § THYROID SUPPLEMENTS § ANTIHISTAMINES, § MISCELLANEOUS AGENTS NONSEDATING GASTROINTESTINAL ENDOCRINE AND § ANTIHISTAMINE/ § SELECTIVE SEROTONIN METABOLIC DECONGESTANTS 2 RECEPTOR REUPTAKE INHIBITORS ANTAGONISTS ANDROGENS CALCIUM REGULATORS BETA AGONISTS § BISPHOSPHONATES § PROTON PUMP § SHORT ACTING INHIBITORS ANTIDIABETICS § CALCITONINS AMYLIN ANALOGS PARATHYROID HORMONES § SEROTONIN § BIGUANIDES GENITOURINARY NOREPINEPHRINE LONG ACTING CONTRACEPTIVES REUPTAKE INHIBITORS § BENIGN PROSTATIC (SNRIs) 3 DIPEPTIDYL PEPTIDASE-4 § MONOPHASIC HYPERPLASIA (DPP-4) INHIBITORS LEUKOTRIENE RECEPTOR ANTAGONISTS DIPEPTIDYL PEPTIDASE-4 § ANTIPSYCHOTICS (DPP-4) INHIBITOR/ § TRIPHASIC BIGUANIDE COMBINATIONS NASAL ANTIHISTAMINES § EXTENDED CYCLE ERECTILE DYSFUNCTION INCRETIN MIMETIC AGENTS PHOSPHODIESTERASE INHIBITORS § NASAL STEROIDS CONTINUOUS
Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document. Visit our Web site at www.scripnet.com for specific information. § LOCAL ANALGESICS STEROID/BETA AGONISTS BETA-BLOCKERS, § SYMPATHOMIMETICS SELECTIVE DERMATOLOGY OPHTHALMIC PROSTAGLANDINS STEROID INHALANTS § BETA-BLOCKERS, NONSELECTIVE QUICK REFERENCE DRUG LIST
Your specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document. Visit our Web site at www.scripnet.com for specific information. PREFERRED ALTERNATIVES LIST DRUG NAME PREFERRED ALTERNATIVE(S)* DRUG NAME PREFERRED ALTERNATIVE(S)*
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
ASMANEX, FLOVENT, FLOVENT HFA, PULMICORT, QVAR
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
CLIMARA, ESTRADERM, estradiol, VIVELLE-DOT
CRESTOR, LIPITOR, pravastatin, simvastatin
ASMANEX, FLOVENT, FLOVENT HFA, PULMICORT, QVAR
CLIMARA, ESTRADERM, estradiol, VIVELLE-DOT
estradiol-norethindrone, PREMPHASE, PREMPRO
ENJUVIA, estradiol, estropipate, PREMARIN
CLIMARA, ESTRADERM, estradiol, VIVELLE-DOT
estradiol-norethindrone, PREMPHASE, PREMPRO
ENJUVIA, estradiol, estropipate, PREMARIN
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
ASMANEX, FLOVENT, FLOVENT HFA, PULMICORT, QVAR
flunisolide, fluticasone, NASACORT AQ, NASONEX,
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
GLUCOMETER DEX, GLUCOMETER ELITE, ACCU-CHEK products, ONETOUCH products
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
CRESTOR, LIPITOR, pravastatin, simvastatin
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoyl
ENJUVIA, estradiol, estropipate, PREMARIN
peroxide, RETIN-A MICRO, tretinoin, ZIANA
CLIMARA, ESTRADERM, estradiol, VIVELLE-DOT
AVODART, doxazosin, finasteride, FLOMAX, terazosin
ENJUVIA, estradiol, estropipate, PREMARIN
fluticasone, NASACORT AQ, NASONEX,
* The preferred alternative products in this list are a broad representation within therapeutic categories of available treatment options and do not necessarily represent clinical equivalency.
Your specific prescription benefit plan design may not cover certain products, regardless of their appearance in this document. Visit our Web site at www.scripnet.com for specific information. DRUG NAME PREFERRED ALTERNATIVE(S)* DRUG NAME PREFERRED ALTERNATIVE(S)*
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
citalopram, fluoxetine, LEXAPRO, paroxetine, paroxetine
AVALIDE, AVAPRO, BENICAR, BENICAR HCT, MICARDIS,
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
estradiol-norethindrone, PREMPHASE, PREMPRO
AVODART, doxazosin, finasteride, FLOMAX, terazosin
BENZACLIN, DIFFERIN, DUAC CS, erythromycin-benzoylperoxide, RETIN-A MICRO, tretinoin, ZIANA
* The preferred alternative products in this list are a broad representation within therapeutic categories of available treatment options and do not necessarily represent clinical equivalency. FOR YOUR INFORMATION: Generics should be considered the first line of prescribing. This drug list represents a summary of prescription coverage. It is not inclusive and does not guarantee
coverage. Specific prescription benefit plan design may not cover certain categories, regardless of their appearance in this document. The plan participant’s prescription benefit plan may have a
different copay 1 for specific products on the list. Unless specifically indicated, drug list products will include all dosage forms. This list represents brand products in CAPS, branded generics in upper-
and lowercase Italics, and generic products in lowercase italics. Generics listed in therapeutic categories are for representational purposes only. This is not an all-inclusive list. Listed products may be available generically in certain strengths or dosage forms. Dosage forms on this list will be consistent with the category and use where listed. Log in to www.scripnet.com to check coverage and
copay information for a specific medicine.
§ Generics are available in this class and should be considered the first line of prescribing.
1 Copayment, copay or coinsurance means the amount a plan participant is required to pay for a prescription in accordance with a Plan, which may be a deductible, a percentage of the prescription
price, a fixed amount or other charge, with the balance, if any, paid by a Plan.
2 Atacand should be reserved for patients who meet CHARM (Candesartan in Heart Failure - Assessment of Reduction in Mortality and Morbidity) trial criteria. 3 Indicates the proposed mechanism of action, based on the American Psychiatric Association Summary of Treatment Recommendations.
This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers.
Listed products are for informational purposes only and are not intended to replace the clinical judgment of the prescriber.
2009. All rights reserved. 14584-1-0409
www.scripnet.com
PIONEER VALLEY REGIONAL SCHOOL DISTRICT NORTHFIELD, BERNARDSTON, LEYDEN, WARWICK SCHOOL HEALTH SERVICES INTERVAL HEALTH HISTORY 2010-2011 NAME: _______________________________________________ GRADE: _______ Dear Parent/Guardian: In order to keep your child’s health record up to date and to provide better health services to your child, we ask that you complete the following qu
Available online at www.sciencedirect.comCognitive and Behavioral Practice 17 (2010) 290–300Current Treatment Practices for Children and Adults With Trichotillomania:Christopher A. Flessner, Bradley/Hasbro Child Research Center/Warren Alpert School of Medicine at Brown UniversityFred Penzel, Western Suffolk Psychological Services, Huntington, NYTrichotillomania Learning Center–Scienti
ScripNet Workers’ Compensation Drug List