BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS

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1 BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS Benefits are subject to the following: Pre-authorisation BESTmed guidelines BESTmed protocols Mediscor Reference Price (MRP) The MRP sets a maximum price for a generic medicine product, of which the cost is normally lower than that of the original or ethical product. This means that, should you choose to use the original medicine product and a generic alternative for the product is available, you will be responsible for paying the difference between the price of the chosen original medicine product and that of the MRP. This formulary is effective from 1 January HYPERTENSION Platinum Gold Topcare Comprehensive Bonus Plus Beat Beat Beat MEDICINE NAME ACCUMAX 10MG YES YES ACCUMAX 20MG YES YES ACCUMAX CO 10/12.5MG YES YES ACCUMAX CO 20/12.5MG YES YES ACCUPRIL 10MG TAB YES YES ACCUPRIL 20MG TAB YES YES ACCUPRIL 40MG TAB YES YES ACCUPRIL 5MG TAB YES YES ACCURETIC 10/12.5 TAB YES YES ACCURETIC 20/12.5 TAB YES YES ADALAT RETARD 10MG YES NO ADALAT RETARD 20MG YES YES ADALAT XL 20MG TAB YES NO ADALAT XL 30MG TAB YES NO ADALAT XL 60MG TAB YES NO ADCO-ATENOLOL 50MG TAB YES YES ADCO-ATENOLOL 100MG TAB YES YES ADCO-BISOCOR 10MG TAB YES NO ADCO-BISOCOR 5MG TAB YES NO ADCO-CAPTOMAX 25MG TAB YES YES ADCO-CAPTOMAX 50MG TAB YES YES ADCO-DOXAZOSIN 1MG TAB YES YES ADCO-DOXAZOSIN 2MG TAB YES YES ADCO-DOXAZOSIN 4MG TAB YES YES ADCO-ENALAPRIL 5MG YES YES ADCO-ENALAPRIL 10MG YES YES 1

2 ADCO-ENALAPRIL 20MG YES YES ADCO-QUINARETIC 10/12.5 T YES YES ADCO-QUINARETIC 20/12.5 T YES YES ADCO-RETIC TAB YES YES ADCO-VASCARD 30 SR CAPS YES NO ADCO-ZETOMAX 10MG TAB YES YES ADCO-ZETOMAX 20MG TAB YES YES ADCO-ZETOMAX 5MG TAB YES YES ADCO-ZETOMAX-CO 10/12.5MG YES YES ADCO-ZETOMAX-CO 20/12.5MG YES YES ALAPREN 5MG TAB YES YES ALAPREN 10MG TAB YES YES ALAPREN 20MG TAB YES YES ALMADIN 10MG TAB YES YES ALMADIN 5MG TAB YES YES AMILORETIC HS TAB YES NO AMILORETIC TAB YES YES AMLATE 10MG TAB YES YES AMLATE 5MG TAB YES YES AMLOC 10MG TAB YES YES AMLOC 5MG TAB YES YES AMLODAC 10MG TAB YES YES AMLODAC 5MG TAB YES YES AMLOSYN 10MG TAB YES YES AMLOSYN 5MG TAB YES YES AMTAS 10MG TABLETS YES YES AMTAS 5MG TABLETS YES YES ASPEN-CARVEDILOL 12.5MG T YES NO ASPEN-CARVEDILOL 25MG TAB YES NO ASPEN-CARVEDILOL 6.25MG T YES NO AUSTELL AMLODIPINE 10MG T YES YES AUSTELL AMLODIPINE 5MG TA YES YES AUSTELL-LISINOPRIL 10MG T YES YES AUSTELL-LISINOPRIL 2.5MG YES YES AUSTELL-LISINOPRIL 20MG T YES YES B-BLOCK 100MG YES YES B-BLOCK 50MG YES YES BETARETIC TAB YES YES BILOCOR 10 TAB YES NO BILOCOR 5 TAB YES NO BIO-ATENOLOL 100 YES YES BIO-ATENOLOL 50 YES YES BIO-CAPTOPRIL 25MG YES YES BISOHEXAL 10MG TAB YES NO BISOHEXAL 5MG TAB YES NO CALBLOC 5MG TAB YES YES CALBLOC 10MG TAB YES YES CALCICARD SR 240MG YES YES 2

3 CAPACE 25MG TAB YES YES CAPOTEN 25MG TAB YES YES CAPOTEN HS 12.5MG TAB YES YES CAPTOHEXAL 12.5MG YES YES CAPTOHEXAL 25MG YES YES CAPTOHEXAL 50MG YES YES CARDICOR 10MG TAB YES NO CARDICOR 2.5MG TAB YES NO CARDICOR 5MG TAB YES NO CARDUGEN 1MG TAB YES YES CARDUGEN 4MG TAB YES YES CARDURA XL 4MG YES YES CARDURA XL 8MG YES NO CARLOC 12.5MG TAB YES NO CARLOC 25MG TAB YES NO CARLOC 6.25MG TAB YES NO CARVEDILOL-HEXAL 12.5MG YES NO CARVEDILOL-HEXAL 25MG TAB YES NO CARVEDILOL-HEXAL 6.25MG YES NO CARVETREND 12.5MG TAB YES NO CARVETREND 25MG TAB YES NO CARVETREND 6.25MG TAB YES NO CIPALAT RETARD 20MG YES YES CIPLA LOSARTAN 100MG TAB YES YES CIPLA LOSARTAN 50MG TAB YES YES CIPLA-INDAPAMIDE 2.5MG TA YES YES CIPLA-PERINDOPRIL 4MG TAB YES NO CIPLATEC 10MG YES YES CIPLATEC 20MG YES YES CIPLATEC 5MG YES YES CIPLAVASC 10MG TAB YES YES CIPLAVASC 5MG TAB YES YES CONCOR 10MG TAB YES NO CONCOR 5MG TAB YES NO CO-RENITEC TAB YES YES CORVADIL 10MG TAB YES YES CORVADIL 5MG TAB YES YES COVERSYL 4MG TAB YES NO COVERSYL PLUS TAB YES NO COZAAR 100MG TAB YES YES COZAAR 50MG TAB YES YES COZAAR COMP TAB YES YES CPL ALLIANCE AMLODIPINE 1 YES YES CPL ALLIANCE AMLODIPINE 5 YES YES DAPAMAX 2.5MG TAB YES YES DAPTRIL 2.5MG TAB YES YES DIACE CO 20/12.5 MG TAB YES YES DILATREND 12.5MG TAB YES NO 3

4 DILATREND 25MG TAB YES NO DILATREND 6.25MG TAB YES NO DYAZIDE TAB YES YES ENAP 10MG TAB YES YES ENAP 20MG TAB YES YES ENAP 5MG TAB YES YES ENAP CO 20MG/12.5MG TAB YES YES FEDALOC SR 30MG SRT YES NO FEDALOC SR 60MG SRT YES NO FELODIPINE-HEXAL 10MG TAB YES NO FELODIPINE-HEXAL 5MG TAB YES NO FORTZAAR TAB YES YES GULF AMLODIPINE 10MG TABL YES YES GULF AMLODIPINE 5MG TABLE YES YES HEXABLOK 50MG TAB YES YES HEXABLOK 100MG TAB YES YES HEXAL-LISINOPRIL 10MG TAB YES YES HEXAL-LISINOPRIL 20MG TAB YES YES HEXAL-LISINOPRIL 5MG TAB YES YES HEXAL-LISINOPRIL CO 10MG YES YES HEXAL-LISINOPRIL CO 20MG YES YES HEXAZIDE 25MG TAB YES YES HR-ENALAPRIL 10MG YES YES HR-ENALAPRIL 20MG YES YES HR-ENALAPRIL 5MG YES YES HYDRO-LESS 2.5MG TAB YES YES HY-PO-TONE 250MG TAB YES YES HY-PO-TONE 500MG TAB YES YES INDERAL 10MG TAB YES YES INDERAL 40MG TAB YES YES INDO AMLODIPINE 5MG TAB YES YES INDOBLOK 10MG YES YES INDOBLOK 40MG YES YES ISOPTIN 40MG TAB YES YES ISOPTIN SR 240MG TAB YES YES KLODIP-5 YES YES LASIX 40MG TAB YES YES LASIX 40MG TAB YES YES LEPITRIN 50MG TAB YES YES LISORETIC 10/12.5 YES YES LISORETIC 20/12.5 YES YES LISOZIDE 10MG/12.5MG TAB YES YES LISOZIDE 20MG/12.5MG TAB YES YES LOMANOR 10MG TAB YES YES LOMANOR 5MG TAB YES YES LOS-ARB 50MG TAB YES YES LOSARTAN-WINTHROP TAB YES YES MERCK-INDAPAMIDE 2.5 TAB YES YES 4

5 MODURETIC TAB YES YES MYLAN CAPTOPRIL 25MG YES YES MYLAN CAPTOPRIL 50MG YES YES MYLAN INDAPAMIDE 2.5MG YES YES MYLAN METHYLDOPA 250MG YES YES NIFEDALAT 20SR TAB YES YES NORVASC 10MG TAB YES YES NORVASC 5MG TAB YES YES PHARMA DYNAMICS AMLODIPIN YES YES PHARMAPRESS 10MG YES YES PHARMAPRESS 20MG YES YES PHARMAPRESS 5MG YES YES PHARMAPRESS CO YES YES PLENDIL 10MG TAB YES NO PLENDIL 2.5MG TAB YES NO PLENDIL 5MG TAB YES NO PRATSIOL 1MG TAB YES YES PRATSIOL 2MG TAB YES YES PRATSIOL 5MG TAB YES YES PREXUM 4MG TAB YES NO PREXUM PLUS TAB YES NO PRODOROL 10MG TAB YES YES PRODOROL 40MG TAB YES YES PUR-BLOKA 10MG TAB YES YES PUR-BLOKA 40MG TAB YES YES QUINACE 10MG TABLETS YES YES QUINACE 20MG TABLETS YES YES QUINACE CO 10/12.5MG TABL YES YES QUINACE CO 20/12.5MG TABL YES YES QUINAGEN 10MG TAB YES YES QUINAGEN 20MG TAB YES YES QUINAGEN 40MG TAB YES YES QUINAGEN 5MG TAB YES YES QUINASPEN 10MG TAB YES YES QUINASPEN 20MG TAB YES YES QUINAZIDE 10/12.5 TAB YES YES QUINAZIDE 20/12.5 TAB YES YES RAN-PERINDOPRIL 4MG TAB YES NO RAVAMIL SR 240MG TBCR YES YES RENEZIDE TAB YES YES RENITEC 10MG TAB YES YES RENITEC 2.5MG TAB YES YES RENITEC 20MG TAB YES YES RENITEC 5MG TAB YES YES RESERPINE 0.25MG TAB YES YES RIDAQ 12.5MG TAB YES YES RIDAQ 25MG TAB YES YES SANDOZ ATENOLOL 100 YES YES 5

6 SANDOZ ATENOLOL 50 YES YES SANDOZ CAPTOPRIL 25MG YES YES SANDOZ CAPTOPRIL 50MG YES YES SANDOZ CO-TENIDONE 100/25 YES YES SANDOZ CO-TENIDONE 50/12. YES YES SANDOZ INDAPAMIDE 2.5MG T YES YES SANDOZ METHYLDOPA 250MG YES YES SIMAYLA LISINOPRIL 10MG T YES YES SIMAYLA LISINOPRIL 20MG T YES YES SINOPREN 10MG TAB YES YES SINOPREN 20MG TAB YES YES SINOPREN 5MG TAB YES YES SLOW-K 600MG TAB YES YES SPEC-CO-AMILORIDE TAB YES YES STAMLO 10MG TAB YES YES STAMLO 5MG TAB YES YES TEN-BLOKA 100MG TAB YES YES TEN-BLOKA 50MG TAB YES YES TENCHLOR TAB YES YES TENCHLOR-HS TAB YES YES TENOPRESS 100MG TAB YES YES TENOPRESS 25MG TAB YES YES TENOPRESS 50MG TAB YES YES TENORET TAB YES YES TENORETIC TAB YES YES TENORMIN 100MG TAB YES YES TENORMIN 25MG TAB YES YES TENORMIN 50MG TAB YES YES TILAZEM 180 CR YES NO TILAZEM 240 CR YES NO URIREX-K TAB YES NO VASOMIL 40MG TAB YES YES VASOMIL 80MG TAB YES YES VECTORYL 4MG TABLETS YES NO VECTORYL PLUS TABLETS YES NO VEDIBLOK 12.5MG TAB YES NO VEDIBLOK 25MG TAB YES NO VEDIBLOK 6.25MG TAB YES NO VERAHEXAL 240 SR YES YES ZAPTO 25MG TAB YES YES ZAPTO 50MG TAB YES YES ZARTAN 100MG TAB YES YES ZARTAN 50MG TAB YES YES ZEMAX 10MG TAB YES YES ZEMAX 20MG TAB YES YES ZEMAX 5MG TAB YES YES ZESTORETIC 10MG TAB YES YES ZESTORETIC 20MG TAB YES YES 6

7 ZESTOZIDE 20MG TAB YES YES ZESTRIL 10MG TAB YES YES ZESTRIL 20MG TAB YES YES ZESTRIL 5MG TAB YES YES ZIAK 10MG TAB YES NO ZIAK 2.5MG TAB YES NO ZIAK 5MG TAB YES NO ZILDEM 180MG SR YES NO ZILDEM 240MG SR YES NO ZILDEM 60MG TAB YES NO ZILDEM 90MG TAB YES NO The formulary is subject to change without notice. 7