Durham County Indigent Pharmacy Program (DCIPP) Formulary · 2020. 1. 29. · Abilify Maintena...
Transcript of Durham County Indigent Pharmacy Program (DCIPP) Formulary · 2020. 1. 29. · Abilify Maintena...
Durham County Indigent Pharmacy Program (DCIPP) Formulary
A N T I D E P R E S S A N T S amitriptyline 10 mg 25 mg 50 mg 75 mg 100 mg
bupropion SR 100 mg 150 mg 200 mg
bupropion XL 150mg 300mg
citalopram 10 mg 20 mg 40 mg
doxepin 25 mg 50 mg 100 mg
duloxetine 20 mg 30 mg 60mg
escitalopram 10mg 20 mg
fluoxetine 10 mg 20 mg 40 mg
imipramine 25 mg 50 mg
mirtazapine 15 mg 30 mg
nortriptyline 10 mg 25 mg 75 mg
paroxetine 10 mg 20 mg
sertraline 25 mg 50 mg 100 mg
venlafaxine XR (capsule) 37.5 mg 75 mg 150 mg
M O O D S T A B I L I Z E R S
carbamazepine 200 mg
lithium carbonate 300 mg
divalproex sodium DR 250 mg 500 mg
divalproex ER 250mg 500mg
lamotrigine tablets 25 mg 100 mg 150 mg 200 mg
oxcarbazepine 300 mg 600 mg
A N T I P S Y C H O T I C S aripiprazole 2 mg 5 mg 10 mg 15 mg 20 mg 30 mg
clozapine (bridge to patient assistance) 25mg 50mg 100mg 200mg
fluphenazine* 1 mg 2.5 mg 5 mg 10 mg
haloperidol 0.5 mg 1 mg 2 mg 5 mg
olanzapine 2.5 mg 5 mg 7.5 mg 10 mg 15 mg 20 mg
perphenazine* 2 mg 4 mg 8 mg
quetiapine 25 mg 50 mg 100 mg 200 mg 300 mg 400 mg
quetiapine ER 150mg 200mg 300mg
risperidone 0.25 mg .50 mg 1 mg 2 mg 3 mg 4 mg
thiothixene 2 mg 5 mg 10 mg
trifluoperazine* 2 mg 5 mg 10 mg
fluphenazine (inj) 5 ml 25 ml
fluphenazine decanoate 25 mg/cc 5 cc
haloperidol decanoate 50 mg 100 mg
S L E E P A I D S , A N T I A N X I E T Y , M I S C E L L A N E O U S
amlodipine 2.5mg 5mg 10mg
atenolol 25 mg 50 mg 100 mg
benztropine .5 mg 1 mg 2 mg
buspirone 5 mg 10 mg 15 mg
diphenhydramine 25 mg 50 mg
hydrochlorothiazide 25mg
hydoxyzine 25mg 50mg
levothyroxine 25µg 50µg 75 µg 100 µg 112 µg 125 µg 137 µg 150 µg 175µg 200 µg 300 µg
metformin 500 mg 750 mg 1000 mg
metoprolol 25 mg 50 mg 100 mg
prazosin 1 mg 2 mg 5 mg
propranolol 10 mg 20 mg 40 mg 80 mg
trazodone 50 mg 100 mg 150 mg
trihexyphenidyl 2 mg 5 mg
S U B S T A N C E U S E D I S O R D E R S
naltrexone oral tablets 50mg
buprenorphine /naloxone SL tablets 8mg/2mg
*No new starts; current DCIP users as of 7/1/16 (fluphenazine) or 2/20/17 (perphenazine, trifluoperazine) are grandfathered in.
1/15/2020
Durham County* Medication Assistance Program (MAP) Formulary
ORAL MEDICATIONS
Clozapine 25mg, 50mg, 100 mg, 200mg
Latuda 20 mg, 40mg, 60 mg, 80mg ,120mg
Saphris 2.5mg, 5mg and10mg
Rexulti 2mg, 4mg
Trintellix 10mg, 20mg
Vibryd 10mg, 20mg, 40mg
LAI MEDICATIONS
Aristada 441mg , 662mg, 882mg, 1064mg
Aristada Initio 675mg
Abilify Maintena 300mg, 400mg
Invega Sustenna 39mg, 78mg, 117mg, 156mg, 234mg,
Invega Trinza 273mg, 410mg, 546mg, 819mg
Risperdal Consta 12.5mg, 25mg, 37.5mg, 50mg
Zyprexxa Relprevv 210mg, 300mg and 405mg
*The Durham County MAP site is Gurleys Pharmacy. For other North Carolina counties’ MAP sites, please visit https://files.nc.gov/ncdhhs/documents/Medication%20Assistance%20Program%20Sites%203.docx
MEDICATION RESOURCES
Patient Advocacy Foundation (PAF) Co-Pay Relief Program (CPF) : Provides direct financial assistance to qualified individuals, assisting them with prescription drug co-payments, coinsurances and deductibles. PHARMACIES (Non-Profit)
NC Med Assist : Non-profit pharmacy program for North Carolina (NC) residents that provides FREE access to lifesaving prescription medications, patient support, advocacy and related services to poor, vulnerable, and uninsured NC residents. The pharmacy mails the prescriptions to non-Mecklenberg County NC residents..
Rx Outreach: Non-profit mail order pharmacy in St Louis that ships directly to individuals’ homes. It is available to qualifying individuals and families. Patients can be on Medicaid, Medicare or other health insurance and still receive medications from Rx Outreach. There are no enrollment or membership fees.
PHARMACY DISCOUNT PROGRAMS :
FamilyWize: A huge consumer group buying service for the uninsured and underinsured. The discounts and savings on medications are provided voluntarily by the more than 61,000 participating pharmacies that have agreed to provide prices similar to what they give large insurance companies and employers.
NCMS Discount Prescription Drug Card : Touts savings of up to 75% (discounts average roughly 30%) at more than 68,000 national and regional pharmacies. This card can be used as the primary plan and/or it can be used on prescriptions not covered by an insurance plan.
Needy Meds : Non-profit clearinghouse that provides information on all medical needs, including medications. It collects data on patient assistance programs, drug coupons and rebates, and offers its own drug discount card.
For profit programs (these mostly exclude independent pharmacies which may match chain pharmacies’ discount prices)
o Blink Health offers a free app that finds the cheapest price for a drug and locks it in for individuals who can then pay on-line and fill their prescriptions at one of 60,000 pharmacies in the United States.
o Good Rx : collects and compares prices and then offers consumers a coupon to get the best rate. The company has information on every FDA approved medication at more than 70,000 US pharmacies (mostly chains). Once the individual finds the best price at a local pharmacy, they can either print a coupon or show it on their smart phone.
To see more information about patient assistance programs described above, please visit
https://www.alliancehealthplan.org/consumers-families/help-paying-medications/