Quarterly Preferred Drug Formulary changes (2)

The Symbria Rx Services Preferred Drug Formulary is a valuable tool that can help your community manage its prescription costs. We update our Preferred Drug Formulary every quarter to help physicians choose medications that will effectively treat your residents' health conditions while controlling for cost.

This quarter, we made the following significant updates to our Preferred Drug Formulary:

  • New generic Alzheimer's Agent. We added Namzeric, which combines Namenda and Aricept into one tablet, as a non-preferred drug because both agents are available individually as less expensive generics.

  • New categories for oral and injectable Anticoagulants Post Hip/Knee DVT Prophylaxis agents. Because switching between oral and injectable agents is not widely accepted, we created two new categories. The new oral agents category includes Xarelto as preferred (Eliquis and Savaysa are non-preferred) and the new injectable category includes enoxaparin as preferred (fondaparinux and Fragmin are non-preferred).

  • New lower-cost drug in Antidiabetic Agents – GLP-1 Receptor Agonists category. Tanzeum has replaced Victoza as the preferred drug because it is now the lowest-priced agent in this category.

  • Reclassifications in Antidiabetic Agents – Other category. Glyburide and glyburide/metformin are now non-preferred because they were recently classified as "drugs to avoid" for elderly patients.

  • New higher-cost, brand-name, non-preferred drugs in three categories: Antiparkinson Agents, Antipsychotics – 2nd generation, and Cox-2 Inhibitors. Rytary (an extended-release version of carbidopa-levodopa) is a non-preferred Antiparkinson Agent. Rexulti and Vraylar are non-preferred Antipsychotic drugs. And Vivlodex (an extended-release version of meloxicam) is a non-preferred Cox-2 inhibitor.

  • Erythropoietins category removed. We removed this category because price fluctuations between Procrit and Aranesp resulted in neither drug providing cost or efficacy benefits.

  • New category for Inhaled Long-Acting Beta-Adrenergic (LABA) and Long-Acting Muscarinic Antagonist (LAMA) Agents. To address a new treatment focus for COPD, we added a category for drugs that combine LABA and LAMA (which is similar to combining Serevent and Spiriva inhalers in one unit). Stiolto is the preferred drug because it costs significantly less than the non-preferred drugs (Anoro Ellipta and Utibron Neohaler). Please share the Stiolto datasheet with physicians to let them know about this medication.

  • New non-preferred Insulins agent. A new long-acting basal insulin called Tresiba, which is similar to Lantus, Toujeo, and Levemir, is a non-preferred drug due to a lack of clinical data in the LTC market – and the larger volume of units that the pen contains, which can increase waste for short-stay residents.

  • New Muscle Relaxants category. We created this category to address a very expensive new agent called Amrix, which is simply a branded, extended-release version of cyclobenzaprine. Due to its excessive cost, Amrix is a non-preferred drug and the much lower-priced cyclobenzaprine 10 mg is preferred.

  • Preferred drug changes in Ulcerative Colitis Agents category. We added mesalamine 800 mg as a preferred drug because it provides significant cost savings, and we reclassified sulfasalazine as non-preferred due to the results of a clinical review and the risk of serious side effects (compared to newer agents).

  • "Designer drugs." We reclassified several newer, brand-name drugs as non-preferred in existing categories (such as Belsomra in the Sedative-Hypnotics category) to help physicians choose more established – and affordable – drugs.

For more information
Our Preferred Drug Formulary, which is accessible via MySymbria – and at for the convenience of the physicians who serve your community – includes a redlined version that allows you to easily see all of the changes we made this quarter. If you have any questions or concerns about any of the updates to our Preferred Drug Formulary this quarter, please contact our pharmacists at (800) 462-5760.


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