Transcript How Discovery Health will pay medicines from the day-to-day

Dear Pharmacist
How Discovery Health will pay medicines from the day-to-day benefit in 2015
Since January 2014, Discovery Health has been funding medicines from the day-to-day benefit differently.
This document will update you on the changes for 2015.
Discovery Health has always promoted the use of generic substitutes over original brand items to members
as a cost saving mechanism. Discovery Health Medical Scheme has now developed a list of preferentially
priced medicines, called the Preferred Medicine List. The Preferred Medicine List includes schedule 3 and
above medicines as treatment for both chronic and acute conditions. It offers real value for money because
we will pay the medicine in full up to the Discovery Health Rate for medicines on all plans when paid from the
day-to-day benefits subject to available funds.
The list comprises predominantly generic medicines, however we have added certain preferentially priced
original brand medicines to the Preferred Medicine List for 2015 (as per the attached list). In addition, we
have not included certain non-preferentially priced generic medicines on the Preferred Medicine List.
We encourage our members to consult their pharmacist on the use of preferentially priced generics that are
available and are included in our Preferred Medicine List.
We have included these lists for your information. Please go to the MedAdvisor tool on www.discovery.co.za
to make sure you view the latest version.
Regards
Suzanne van der Walt
Discovery Health
Page 1 of 2
Original brand items that have been added to the Preferred Medicine List
This list is a summary of the non-generic medicine that will be covered in full at all pharmacies in
addition to all preferentially priced generic medicine.
Preferred Medicine List
6-digit
NAPPI code Product name
Strength
Form
Manufacturer
701211
Adrenaline tart 1ml fresenius 1;1000
1mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
701807
Aldactone
100mg
TAB
Pfizer Laboratories (Pty) Ltd
701793
Aldactone
25mg
TAB
Pfizer Laboratories (Pty) Ltd
708121
Aspavor
10mg
TAB
Pfizer Laboratories (Pty) Ltd
708122
Aspavor
20mg
TAB
Pfizer Laboratories (Pty) Ltd
710912
Aspavor
40mg
TAB
Pfizer Laboratories (Pty) Ltd
705632
Atropine 5ml
1%
OPD
Adcock Ingram - Restan Laboratories
705578
Atropine sulphate fresenius 1ml
1mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
705551
Atropine sulphate-fresenius 1ml
0,5mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
705624
Atropine sulphate-fresenius 1ml
0,6mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
853542
Augmentin
1000mg
TAB
Glaxo Smithkline (Pty) Ltd
779644
Bezalip retard
400mg
SRT
Akacia Medical (Thebe Medical (Pty) Ltd)
898689
Cefazolin-fresenius powder for injection
500mg
INJ
Fresenius Kabi (Pty) Ltd
710079
Cozaar
100mg
TAB
MSD (Pty) Ltd
818739
Cozaar
50mg
TAB
MSD (Pty) Ltd
718718
Dermovate
CRE
New Promex Corporation (Pty) Ltd
718726
Dermovate
OIN
New Promex Corporation (Pty) Ltd
725838
Gentamycin - fresenius 1ml amp
40mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
805505
Lamictin
25mg
TAB
Glaxo Smithkline (Pty) Ltd
735752
Lanoxin
0,25mg
TAB
Aspen Pharmacare (Pty) Ltd
709414
Lignocaine ampoule 20ml
1%
INJ
B Braun - Hospital Care & OPM
709420
Lignocaine ampoule 20ml
2%
INJ
B Braun - Hospital Care & OPM
898666
Lignocaine hcl-fresenius 20ml
1%
INJ
Fresenius Kabi (Pty) Ltd
898674
Lignocaine hcl-fresenius 20ml
2%
INJ
Fresenius Kabi (Pty) Ltd
825956
Logynon ed
TAB
Bayer (Pty) Ltd
717492
Nevir
200mg
TAB
Emcure Pharmaceuticals SA (Pty) Ltd
732966
Norstan isoniazid
100mg
TAB
Sanofi-Aventis (Pty) Ltd
805548
Plendil
5mg
SRT
Astra Zeneca Pharmaceuticals (Pty) Ltd
756164
Ponstan forte
500mg
TAB
Pfizer Laboratories (Pty) Ltd
791431
Pulmicort turbuhaler 200dose
200mcg
TBH
Astra Zeneca Pharmaceuticals (Pty) Ltd
758612
Pyrazide
500mg
TAB
Sanofi-Aventis (Pty) Ltd
867926
Quinine dihydrochloride-fresenius 1ml
300mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
810355
Renitec
2,5mg
TAB
MSD (Pty) Ltd
759767
Renitec
20mg
TAB
MSD (Pty) Ltd
Page 2 of 2
Preferred Medicine List
6-digit
NAPPI code Product name
Strength
Form
Manufacturer
837350
Retrovir (azt)
250mg
CAP
Glaxo Smithkline (Pty) Ltd
712616
Spec-perindopril
8mg
TAB
767212
Sudafed sinus (was Sudafed)
60mg
TAB
Specpharm (Pty) Ltd
Johnson & Johnson - Consumer East
London
720239
Tavanic
750mg
TAB
Sanofi-Aventis (Pty) Ltd
813125
Tilazem 180 cr
180mg
SRC
Pfizer Laboratories (Pty) Ltd
710925
Vectoryl
8mg
TAB
Biogaran SS (Pty) Ltd
840645
Viramune
200mg
TAB
Ingelheim Pharmaceuticals (Pty) Ltd
861855
Viramune oral
50mg/5mL
SUS
Ingelheim Pharmaceuticals (Pty) Ltd
778249
Voltaren 3ml
25mg/1mL
INJ
Novartis SA (Pty) Ltd
833223
Xalatan 2.5ml
50mcg/1mL
OPD
Pfizer Laboratories (Pty) Ltd
817848
Zestoretic 10mg/12.5mg
10mg;12,5mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
797685
Zestoretic 20mg/12.5mg
20mg;12,5mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
Page 2 of 2
Generic medicines that are not on the Preferred Medicine List
Discovery Health Medical Scheme covers these medicines at 75% of the Discovery Health Rate for
medicines, from the available day-to-day benefits (90% for the Executive Plan), subject to the annual
prescribed medicine benefit limit.
Non-Preferred Medicine List
6-digit
NAPPI code
Product name
Strength
Form
Manufacturer
782548
Abitrexate vial 2ml
25mg/1mL
INJ
Pharmachemie (Pty) Ltd (ta Teva)
715649
Acesyl
4mg
TAB
Akacia Health Care (Pty) (was Thebe Phar
715651
Acesyl co 4mg/1.25mg
TAB
Akacia Health Care (Pty) (was Thebe Phar
708509
Adco-cefotaxime vial
1000mg
INJ
Adcock Ingram - Critical Care Ltd
886835
Adco-enalapril
5mg
TAB
Adcock-Ingram Laboratories Limited (Pty)
707192
Adco-roznal
15mg
CAP
Adcock-Ingram Laboratories Limited (Pty)
839183
Adco-zildem sr
180mg
SRC
Adcock-Ingram Laboratories Limited (Pty)
707668
Apex-meloxicam
15mg
TAB
Camox Pharmaceuticals (Pty) Ltd
711325
Arrow meloxicam
15mg
TAB
Arrow Pharma South Africa
707374
Arthrocox
15mg
TAB
Sandoz SA (Pty) Ltd
707373
Arthrocox
7,5mg
TAB
Sandoz SA (Pty) Ltd
715828
Aspen atazanavir
150mg
CAP
Aspen Pharmacare (Pty) Ltd
889199
Aspen cefotaxime
1g
INJ
Aspen Pharmacare (Pty) Ltd
703715
Aspen lamivudine
10mg/1mL
SOL
Aspen Pharmacare (Pty) Ltd
717377
Aspen pantoprazole
40mg
ECT
Aspen Pharmacare (Pty) Ltd
701174
30mg
CAP
Aspen Pharmacare (Pty) Ltd
774758
Aspen stavudine
Aspen vancomycin 500 pfi-10ml
reconstit
500mg
INJ
Aspen Pharmacare (Pty) Ltd
714372
Atolip
40mg
TAB
Ranbaxy SA (Pty) Ltd
716617
Atorvastatin winthrop
40mg
TAB
Winthrop Pharmaceuticals (Pty) Ltd
716506
Auro perindopril
8mg
TAB
Aurobindo Pharma (Pty) Ltd
716120
Auro-lisinopril co
10mg
TAB
Actor Pharma
716121
Auro-lisinopril co
20mg
TAB
Actor Pharma
707789
Austell-lamotrigine
100mg
TAB
Austell Laboratories (Pty) Ltd
707790
Austell-lamotrigine
200mg
TAB
Austell Laboratories (Pty) Ltd
707788
Austell-lamotrigine
50mg
TAB
Austell Laboratories (Pty) Ltd
720431
Belair
10mg
TAB
Camox Pharmaceuticals (Pty) Ltd
717888
Belair
4mg
CHU
Camox Pharmaceuticals (Pty) Ltd
717889
Belair
5mg
CHU
Camox Pharmaceuticals (Pty) Ltd
717294
8mg
TAB
Aurobindo Pharma (Pty) Ltd
718082
Bindace
Bisoprolol hydrochlorothiazide
zydus 2.5mg/6.25mg
2.5mg/6.25mg
TAB
Zydus Healthcare SA (Pty) Ltd
704441
Cardicor
10mg
TAB
Merck Pharmaceuticals (Pty) Ltd
704440
Cardicor
5mg
TAB
Merck Pharmaceuticals (Pty) Ltd
780502
Cardifen
10mg
CAP
Aspen Pharmacare (Pty) Ltd
Page 2 of 2
Non-Preferred Medicine List
6-digit
NAPPI code
Product name
Strength
Form
Manufacturer
780499
5mg
CAP
Aspen Pharmacare (Pty) Ltd
714470
Cardifen
Cefotaxime-fresenius powder for
inj
1g
INJ
Fresenius Kabi (Pty) Ltd
709337
Cipla-lamivudine
300mg
TAB
Cipla-Medpro (Pty) Ltd
710302
Cipla-perindopril
4mg
TAB
Cipla-Medpro (Pty) Ltd
710510
Cipla-perindopril
8mg
TAB
Cipla-Medpro (Pty) Ltd
709243
Ciprofloxacin-safeline 100ml
200mg
INF
SAFELINE
714836
Clopamon 2ml
10mg
INJ
Aspen Pharmacare (Pty) Ltd
715571
Co-migroben 160mg/12.5mg
TAB
Novartis SA (Pty) Ltd
715672
Co-tareg 160mg/12.5mg
160/12.5mg
TAB
Novartis SA (Pty) Ltd
899070
Coxflam
15mg
TAB
Cipla-Medpro (Pty) Ltd
899066
Coxflam
7,5mg
TAB
Cipla-Medpro (Pty) Ltd
715559
Co-zomevek 160mg/12.5mg
TAB
Novartis SA (Pty) Ltd
704792
Deparoc
TAB
Aspen Pharmacare (Pty) Ltd
710978
Diace co 20/12.5
TAB
Zydus Healthcare SA (Pty) Ltd
714582
Diaglucide mr
30mg
SRT
Biogaran SS (Pty) Ltd
718274
Epilizine cr
200mg
SRT
Winthrop Pharmaceuticals (Pty) Ltd
718275
Epilizine cr
300mg
SRT
Winthrop Pharmaceuticals (Pty) Ltd
718276
Epilizine cr
500mg
SRT
Winthrop Pharmaceuticals (Pty) Ltd
850926
Eposin vial 5ml
100mg/5mL
INF
Pharmachemie (Pty) Ltd (ta Teva)
710592
Erige (auro-efavirenz)
50mg
CAP
Aurobindo Pharma (Pty) Ltd
822477
Estro-pause
1mg
TAB
Adcock Ingram - Covan Pharmaceuticals
822485
Estro-pause
2mg
TAB
Adcock Ingram - Covan Pharmaceuticals
720417
Famynor
TAB
Trinity Pharma (Pty) Ltd
711682
Fedaloc sr
30mg
SRT
Pharma Dynamics (Pty) Ltd
703221
Felodipine-hexal
5mg
SRT
Sandoz SA (Pty) Ltd
707463
Finderm
250mg
TAB
Dr Reddy's Laboratories (Pty)
715009
Foxair accuhaler 60 dose 50/100
ACC
Glaxo Smithkline (Pty) Ltd
715008
Foxair accuhaler 60 dose 50/250
ACC
Glaxo Smithkline (Pty) Ltd
715007
Foxair accuhaler 60 dose 50/500
ACC
Glaxo Smithkline (Pty) Ltd
892291
Gastriwin
20mg
ECT
Nycomed (Pty) Ltd
812153
Gastriwin (was Controloc)
40mg
ECT
Nycomed (Pty) Ltd
707420
Gastriwin i.v.
40mg
INJ
Nycomed (Pty) Ltd
719449
Gitsalat
30mg
SRT
Bayer Consumer Care
719450
Gitsalat
60mg
SRT
Bayer Consumer Care
718305
Glenmark meloxicam
15mg
TAB
Glenmark Pharmaceuticals SA (PTY)LTD
718306
Glenmark meloxicam
7,5mg
TAB
Glenmark Pharmaceuticals SA (PTY)LTD
704703
Hexal-lisinopril co 10/12.5mg
TAB
Sandoz SA (Pty) Ltd
704704
Hexal-lisinopril co 20/12.5mg
TAB
Sandoz SA (Pty) Ltd
720418
Hy-an
0,03mg
TAB
Trinity Pharma (Pty) Ltd
717443
Kanamycin biotech ampoule
1g/3mL
INJ
Biotech Laboratories (Pty) Ltd
20mg
Page 2 of 2
Non-Preferred Medicine List
6-digit
NAPPI code
Product name
Strength
Form
Manufacturer
718125
Kulair
10mg
TAB
Brimpharm
718123
Kulair
4mg
CHU
Brimpharm
718124
Kulair
5mg
CHU
Brimpharm
805521
Lamictin
100mg
TAB
Glaxo Smithkline (Pty) Ltd
819034
Lamictin
200mg
TAB
Glaxo Smithkline (Pty) Ltd
805513
Lamictin
50mg
TAB
Glaxo Smithkline (Pty) Ltd
709645
Lansoprazole-winthrop
15mg
CAP
Winthrop Pharmaceuticals (Pty) Ltd
709646
Lansoprazole-winthrop
30mg
CAP
Winthrop Pharmaceuticals (Pty) Ltd
710311
Levofloxacin-winthrop
250mg
TAB
Winthrop Pharmaceuticals (Pty) Ltd
710312
Levofloxacin-winthrop
500mg
TAB
Winthrop Pharmaceuticals (Pty) Ltd
715655
Levofloxacin-winthrop iv 100ml
500mg
INF
Winthrop Pharmaceuticals (Pty) Ltd
715654
Levofloxacin-winthrop iv 50ml
250mg
INF
Winthrop Pharmaceuticals (Pty) Ltd
820016
Lilly-fluoxetine
20mg
CAP
Eli Lilly (SA) (Pty) Ltd
705076
Lipidex
10mg
TAB
Sandoz SA (Pty) Ltd
705077
Lipidex
20mg
TAB
Sandoz SA (Pty) Ltd
714073
Lipogen
40mg
TAB
Ranbaxy SA (Pty) Ltd
716943
Lisinopril co unicorn 10mg/12.5mg
TAB
Pharma Dynamics (Pty) Ltd
716945
Lisinopril co unicorn 20mg/12.5mg
TAB
Pharma Dynamics (Pty) Ltd
711990
Lisinozide 10mg/12.5mg
TAB
Aurobindo Pharma (Pty) Ltd
711989
Lisinozide 20mg/12.5mg
TAB
Aurobindo Pharma (Pty) Ltd
701522
Loxiflam
15mg
TAB
Aspen Pharmacare (Pty) Ltd
701520
Loxiflam
7,5mg
TAB
Aspen Pharmacare (Pty) Ltd
705297
Melflam
15mg
TAB
Sandoz SA (Pty) Ltd
705296
Melflam
7,5mg
TAB
Sandoz SA (Pty) Ltd
716169
Meloxicam unicorn
15mg
TAB
Pharma Dynamics (Pty) Ltd
710870
Michol
40mg
TAB
Ingelheim Pharmaceuticals (Pty) Ltd
711422
Mistro
75mg
TAB
Dr Reddy's Laboratories (Pty)
842052
Mobic
15mg
TAB
Ingelheim Pharmaceuticals (Pty) Ltd
818615
Mobic
7,5mg
TAB
Ingelheim Pharmaceuticals (Pty) Ltd
717470
Monte-air
10mg
TAB
MSD (Pty) Ltd
717468
Monte-air
4mg
CHU
MSD (Pty) Ltd
717469
5mg
CHU
MSD (Pty) Ltd
744530
Monte-air
Morphine sulph fresenius ampoule
1ml
10mg/1mL
INJ
Fresenius Kabi (Pty) Ltd
705416
Mylan clarithromycin
500mg
TAB
Mylan (Pty) Ltd
716514
Mylan levofloxacin
250mg
TAB
Xixia Pharmaceuticals
716513
Mylan levofloxacin
500mg
TAB
Xixia Pharmaceuticals
705382
20mg
TAB
Mylan (Pty) Ltd
897984
Mylan simvastatin
Nurofen period pain (was Nurofen
extra strength)
400mg
TAB
Reckitt Benckiser Pharmaceuticals
715968
Oleanz rapitab
10mg
MLT
Pharmaplan (Pty) Ltd
Page 2 of 2
Non-Preferred Medicine List
6-digit
NAPPI code
Product name
Strength
Form
Manufacturer
715967
Oleanz rapitab
5mg
MLT
Pharmaplan (Pty) Ltd
720419
Oralcon
TAB
Trinity Pharma (Pty) Ltd
785296
Pax 2ml
5mg/1mL
INJ
Aspen Pharmacare (Pty) Ltd
704794
Paxil
20mg
TAB
Glaxo Smithkline (Pty) Ltd
717784
Perindopril unicorn
8mg
TAB
Biogaran SS (Pty) Ltd
895157
Pharma-q morphine ampoule 1ml
10mg/1mL
INJ
Pharma-Q
812250
Ponstel
250mg
CAP
Parke-med (div of Adcock Ingram)
703541
Prexum
4mg
TAB
Biogaran SS (Pty) Ltd
704929
Prexum plus 4mg/1.25mg
TAB
Biogaran SS (Pty) Ltd
758280
Purgoxin
0,25mg
TAB
Aspen Pharmacare (Pty) Ltd
714075
Ran-atorvastatin
10mg
TAB
Ranbaxy SA (Pty) Ltd
714076
Ran-atorvastatin
20mg
TAB
Ranbaxy SA (Pty) Ltd
714077
Ran-atorvastatin
40mg
TAB
Ranbaxy SA (Pty) Ltd
759635
2%
INJ
Adcock-Ingram Laboratories Limited (Pty)
711033
Remicaine 5ml
Sabax morphine sulphate ampoule
1ml
10mg/1mL
INJ
Adcock Ingram - Critical Care Ltd
704589
Sandoz meloxicam
15mg
TAB
Sandoz SA (Pty) Ltd
704588
Sandoz meloxicam
7,5mg
TAB
Sandoz SA (Pty) Ltd
710907
Sermax
100mg
TAB
Be-tabs Pharmaceutical (Pty) Ltd
711387
Sermax
50mg
TAB
Be-tabs Pharmaceutical (Pty) Ltd
703993
Sertzol
100mg
TAB
Ranbaxy SA (Pty) Ltd
703992
Sertzol
50mg
TAB
Ranbaxy SA (Pty) Ltd
707863
Simayla lansoprazole
15mg
CAP
Ranbaxy SA (Pty) Ltd
707864
Simayla lansoprazole
30mg
CAP
Ranbaxy SA (Pty) Ltd
703378
Sonke-lamivudine
150mg
TAB
Ranbaxy SA (Pty) Ltd
709846
Tavaloxx
500mg
TAB
Cipla-Medpro (Pty) Ltd
709847
Tavaloxx
750mg
TAB
Cipla-Medpro (Pty) Ltd
719385
Teicowin 200 iv 10ml vial
200mg
INJ
Winthrop Pharmaceuticals (Pty) Ltd
719387
Teicowin 400 iv 20ml vial
400mg
INJ
Winthrop Pharmaceuticals (Pty) Ltd
706757
Terbane
250mg
TAB
Sandoz SA (Pty) Ltd
705430
Terbicil
250mg
TAB
Aspen Pharmacare (Pty) Ltd
783005
Theoplus
200mg
SRT
Nycomed (Pty) Ltd
705368
Topzole
20mg
ECT
Nycomed (Pty) Ltd
705369
Topzole
40mg
ECT
Nycomed (Pty) Ltd
704048
Tramahexal 100mg/2ml
100mg
INJ
Sandoz SA (Pty) Ltd
720420
Trigestrel
TAB
Trinity Pharma (Pty) Ltd
707970
Triomune 30
TAB
Cipla-Medpro (Pty) Ltd
825832
Triphasil
TAB
Aspen Pharmacare (Pty) Ltd
720215
Trustan
20mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
720217
Trustan
40mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
719300
Ultracet
TAB
Janssen Cilag Pharmaceuticals (Pty) Ltd
Page 2 of 2
Non-Preferred Medicine List
6-digit
NAPPI code
Product name
Strength
Form
Manufacturer
706370
Ultreon
500mg
TAB
Pfizer Laboratories (Pty) Ltd
710297
Vectoryl
4mg
TAB
Biogaran SS (Pty) Ltd
711008
Wellbutrin xl
150mg
SRT
Glaxo Smithkline (Pty) Ltd
868302
Xenovate
CRE
Aspen Pharmacare (Pty) Ltd
708260
Zestozide 20
TAB
Mylan (Pty) Ltd
720032
Ziabeta 5/6.25mg
TAB
Merck Pharmaceuticals (Pty) Ltd
852929
Ziak 10mg/6.25mg
10mg;6,25mg
TAB
Merck Pharmaceuticals (Pty) Ltd
840300
Ziak 2.5mg/6.25mg
2,5mg/6,25mg
TAB
Merck Pharmaceuticals (Pty) Ltd
840319
Ziak 5mg/6.25mg
5mg;6,25mg
TAB
Merck Pharmaceuticals (Pty) Ltd
705975
Zithrogen
500mg
TAB
Mylan (Pty) Ltd
709850
Zosert
50mg
TAB
Sun Pharmaceuticals SA (pty) Ltd
720618
Zovilam 150mg/300mg
TAB
Mylan (Pty) Ltd
808547
Zoxil 500
500mg
CAP
Mylan (Pty) Ltd
717520
Zuvamor
10mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
717521
Zuvamor
20mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
717522
Zuvamor
40mg
TAB
Astra Zeneca Pharmaceuticals (Pty) Ltd
720231
Zypiron 5ml vial
20mg/1mL
INJ
Zydus Healthcare SA (Pty) Ltd
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