All newly approved drugs will default to non-preferred status until a full clinical review by the national pharmacy and therap

CIGNA Drug List Changes – Second Quarter 2009
CIGNA periodically reviews its drug list to promote continued effectiveness. Based on that review, the following
changes have been made to the CIGNA drug list from April 1, 2009 to June 30, 2009. Drugs marked with an (*), (^),
or (~) indicate that prior authorization, quantity limit, or step therapy is required, respectively. Note: This list includes selected brand and generic drug changes and is subject to change. CIGNA does not take responsibility for any medication decisions made by prescriber and pharmacist. Selected New Generic Drugs Added to Drug List
Reference Brand Name
Generic Name
__________________________________________________________________________________________ Selected New Preferred Drugs Added to Drug List
Reference
__________________________________________________________________________________________
amlodipine/valsartan/hydrochlorothiazide Selected Non-Preferred Brands Switched to Preferred Brands
Brand Name
Generic Name
__________________________________________________________________________________________ Alcortin Kapidex*, ~
Treximet^

* Prior Authorization
^Quantity Limit
~Step Therapy
CIGNA Drug List Changes – Second Quarter 2009
Selected Preferred Brands Switched to Non-Preferred Brands
Brand Name
Generic Name
__________________________________________________________________________________________ Beconase Brand Drugs at Highest Copay with Generic Available
Brand Name
Generic Name
__________________________________________________________________________________________ Imitrex^
Protonix*, ~
Selected New Brand Drugs Added as Non-Preferred Brands1
Brand Name
Generic Name
____________________________________________________________________________________ Afinitor*
Besivance~
Cetraxal ciprofloxacin
Coartem^
Samsca* tolvaptan
Simponi* golimumab
Toviaz~
1All newly approved "priority" drugs and "non-priority" drugs as designated by the Food and Drug Administration ["FDA"]
will default to non-preferred status until review by the CIGNA Pharmacy and Therapeutics Committee (P&T Committee).
The P&T Committee reviews priority drugs within six months of FDA approval of the drug.
* Prior Authorization
^Quantity Limit
~Step Therapy

CIGNA Drug List Changes – Second Quarter 2009
Drug Recalls Removed from Drug List
Brand Name
Generic Name
____________________________________________________________________________________




CIGNA,” “CIGNA HealthCare,” “CIGNA Pharmacy Management” and the “Tree of Life” logo are registered service marks of CIGNA Intellectual Property, Inc.,
licensed for use by CIGNA Corporation and its operating subsidiaries. All products and services are provided exclusively by such operating subsidiaries and not by
CIGNA Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc. and its affiliates, CIGNA Behavioral Health,
Inc., Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc. In Arizona, HMO plans are offered by CIGNA
HealthCare of Arizona, Inc. In California, HMO plans are offered by CIGNA HealthCare of California, Inc. In Connecticut, HMO plans are offered by CIGNA
HealthCare of Connecticut, Inc. In Virginia, HMO plans are offered by CIGNA HealthCare Mid-Atlantic, Inc. In North Carolina, HMO plans are offered by CIGNA
HealthCare of North Carolina, Inc. All other medical plans in these states are insured or administered by Connecticut General Life Insurance Company.

Source: http://new.oberlin.edu/dotAsset/5245313.pdf