Exhibit 4.
Formulary Coverage of Selected Atypical Antipsychotics, Newer Antidepressants and Anticonvulsants for PDPs that Serve Dual Eligibles,2006–2008
| Drug Product | % Covered (Yes/No) | ||
|---|---|---|---|
| ′06 | ′07 | ′08 | |
| Antipsychotics | |||
| Abilify | 100% | 100% | 100% |
| Abilify Discmelt | N/A | 83% | 100% |
| Risperdal | 100% | 100% | 100% |
| Risperdal Consta (IM) | 93% | 100% | 100% |
| Risperdal M-TAB ODT | 93% | 100% | 100% |
| Zyprexa | 100% | 100% | 100% |
| Zyprexa IM | 74% | 90% | 100% |
| Zyprexa Zydis | 84% | 100% | 100% |
| Antidepressants | |||
| Celexa | 17% | 29% | 28% |
| Citalopram | 100% | 100% | 100% |
| Lexapro | 71% | 83% | 88% |
| Cymbalta | 100% | 100% | 100% |
| Paroxetine | 100% | 100% | 100% |
| Paxil | 17% | 29% | 28% |
| Paxil CR | 64% | 59% | 52% |
| Anticonvulsants | |||
| Carbamazepine | 98% | 100% | 94% |
| Carbamazepine chewable | 99% | 100% | 100% |
| Tegretol | 97% | 98% | 100% |
| Tegretol chewable | 64% | 58% | 63% |
| Lamictal | 100% | 100% | 100% |
| Lamictal chewable | 79% | 41% | 40% |
| Lamotragine chewable | 67% | 95% | 100% |
| Depakote | 92% | 100% | 100% |
| Depakote ER | 98% | 99% | 100% |
| Depakote sprinkles | 90% | 100% | 100% |
| Valproic acid | 100% | 100% | 100% |
| Valproate IV | 100% | 95% | 99% |
Note: The source of these data is the January 2006, 2007, and 2008 CMS Prescription Drug Formulary and Pharmacy Network Files. “N/A” refers to drug products not yet available as of January of the year in question. There were 409 PDPs serving dual eligibles in 2006,642 in 2007, and 495 in 2008.