Discovery Health Formularies And Benchmark Pricing
Discovery Health formularies and benchmark pricing Period: 2020 Q1 & Q2 Expected implementation date: 1 January 2020 Performance Based Remuneration (PBR) is a voluntarily programme designed to provide additional remuneration to pharmacists for adhering to the DHMS formulary. The PBR model aims to create additional funding through added prescription price efficiency and reduced remuneration for items that are not on the formulary. The inclusion of a broader set of products allows for a more affordable cross-funding mechanism. While prescriber preferences may from time to time compromise adherence to the formulary, this is adequately compensated for in the PBR model by lower compliance thresholds. Depending on the availability of preferentially priced generics, there may not always be a generic replacement item on the PBR formulary. PBR applies to Discovery Health Medical Scheme for claims paid from the Chronic Illness Benefit. We have enhanced what is flaged on pharmacy screens: Flaged items on pharmacy screens now include all formulary items, inclusive of non-PBR related items. Only PBR items attract additional dispensing fees subject to PBR rules. PBR items can be identified by CDL formulary flags and benchmark values. Although non-PBR items do not attract additional remuneration, it represents the Oncology and HIV formulary items as well as all DHMS plans. It may also represent other DH preferred items even non-formulary. PBR Exclusions: Claims for items listed below do not qualify for additional PBR dispensing fees and continue to be paid at the appropriate chosen standard network rates. These comprise claims: for KeyCare and Delta plans; for Non-SEP items such as unregistered medicine, schedule 0 medicines and surgical items; paid from HIV, oncology, acute and SMTB benefits. submitted by pharmacies without a signed non-exclusive designated service provider (DSP) contract submitted by courier pharmacies For out-of-stock products, pharmacists must please substitute with alternative formulary or benchmark items as most of these do not need to be re-authorised. Where necessary, however, please obtain authorisation for a replacement item by submitting the application form to CIBAPPFORMS@discovery.co.za or calling Add-A-Line on 0860 44 55 66 for emergencies. Application forms can be obtained from CIBAPPFORMS@discovery.co.za or by calling 0860 44 55 66 Product name Strength Dosage Active ingredient form Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Kavimun paed 60mg TAB ABACAVIR 5.06000 5.06000 Yes Yes Yes HIV Yes Adco abacavir 20mg/1mL SOL ABACAVIR 1.27000 1.27000 Yes Yes Yes HIV Yes Myoprin Aspirin teva Disprin Adco-acyclovir Acitop One alpha One alpha 100mg 80mg ACETYLSALICYLIC ACID ACETYLSALICYLIC ACID ACETYLSALICYLIC ACID ACICLOVIR ACICLOVIR ALFACALCIDOL ALFACALCIDOL 0.91000 0.87000 0.91000 0.87000 9.26000 27.51000 9.26000 27.51000 Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes CDL CDL KeyCare acute KeyCare acute KeyCare acute CDL CDL Yes 0.05 0,25mcg 1mcg TAB DSP EFT CRE CRE CAP CAP Symadin 100mg CAP AMANTADINE 3.68000 3.68000 Yes Yes Yes CDL Yes Hexarone 100mg TAB AMIODARONE 8.41000 8.41000 Yes Yes Yes CDL Yes Arycor 100mg TAB AMIODARONE 8.41000 8.41000 Yes Yes Yes CDL Yes Bio-amiodarone 200mg TAB AMIODARONE 14.68000 14.68000 Yes Yes Yes CDL Yes Hexarone 200mg TAB AMIODARONE 14.68000 14.68000 Yes Yes Yes CDL Yes Arycor 200mg TAB AMIODARONE 14.68000 14.68000 Yes Yes Yes CDL Yes Trepiline 10mg TAB AMITRIPTYLINE 1.13000 1.13000 Yes Yes Yes CDL-Oncology Yes Gulf amitriptyline 25mg TAB AMITRIPTYLINE 0.79000 0.79000 Yes Yes Yes CDL-Oncology Yes Discovery Health formularies and PBR benchmark pricing 1 Yes Yes Yes Yes Yes Yes 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Sandoz amitriptyline 25mg TAB AMITRIPTYLINE 0.79000 0.79000 Yes Yes Yes CDL-Oncology Yes Gulf amlodipine 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Pendine 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Amtas 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Aprate 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Austell-amlodipine 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Lomanor 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Pharma dynamics amlodipine besylate 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Gulf amlodipine 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Pendine 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Amtas 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Aprate 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Lomanor 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Austell-amlodipine 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Pharma dynamics amlodipine besylate 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Amlodipine unicorn 10mg TAB AMLODIPINE 3.15000 3.15000 Yes Yes Yes CDL Yes Amlodipine unicorn 5mg TAB AMLODIPINE 2.14000 2.14000 Yes Yes Yes CDL Yes Amoxicap 250mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Allmox 250mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Allmox 500mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Austell-amoxicillin 500mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Austell-amoxicillin 250mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Zaloxy 250mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Zaloxy 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Allmox s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Allmox sf 250mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Amyn s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Amyn sf 250mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Amyn 500mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Moxymax 250mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Moxymax 500mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Promoxil 250mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Promoxil 500mg CAP AMOXICILLIN - - Yes KeyCare acute Yes Betamox s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Moxymax s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Moxypen s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Promoxil s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Promoxil sf 250mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Zoxil s 125mg/5mL SUS AMOXICILLIN - - Yes KeyCare acute Yes Sandoz co-amoxiclav 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Sandoz co-amoxyclav bd sf 457mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Curam bd 457mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Amoclan 375mg AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Discovery Health formularies and PBR benchmark pricing TAB 2 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Amoclan S 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Amoclan SF 312,5mg/5mLSUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Austell-co-amoxiclav 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Austell-co-amoxiclav 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Apex-clavutin 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Apex-clavutin 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Auro-amoxiclav 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Auro-amoxiclav 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Auro-amoxiclav 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Bindoclav 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Bindoclav 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Sandoz co-amoxyclav 625mg DSP AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Austell co-amoxiclav bd sf 457mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Clamentin s 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Augmaxcil 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Augmaxcil 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Augmaxcil s 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Augmaxcil sf 312,5mg/5mLSUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Bio-amoksiklav 625mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Bio-amoksiklav 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Bio-amoksiklav s 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Sandoz co-amoxyclav 375mg TAB AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Sandoz co-amoxyclav s 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Sandoz co-amoclav sf 312,5mg/5mLSUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Ranclav 156,25mg/5mL SUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Ranclav forte 312,5mg/5mLSUS AMOXICILLIN AND BETA-LACTAMASE INHIBITOR - - Yes KeyCare acute Yes Agrylin 0,5mg CAP ANAGRELIDE Accord anastrozole 1mg TAB Stradexa 1mg Anastrozole sandoz Mylan anastrozole 51.78000 51.78000 Yes Yes Yes Oncology No ANASTROZOLE 7.24000 7.24000 Yes Yes Yes Oncology No TAB ANASTROZOLE 7.24000 7.24000 Yes Yes Yes Oncology No 1mg TAB ANASTROZOLE 7.24000 7.24000 Yes Yes Yes Oncology No 1mg TAB ANASTROZOLE 7.24000 7.24000 Yes Yes Yes Oncology No Dicyclomine co gel SUS ANTACIDS WITH ANTISPASMODICS - - Yes KeyCare acute Yes Alumag d SUS ANTACIDS WITH ANTISPASMODICS - - Yes KeyCare acute Yes Medigel SUS ANTACIDS WITH ANTISPASMODICS - - Yes KeyCare acute Yes Propan gel s SUS ANTACIDS WITH ANTISPASMODICS - - Yes KeyCare acute Yes Spasmogel SUS ANTACIDS WITH ANTISPASMODICS - - Yes KeyCare acute Yes Magasil SUS ANTACIDS, OTHER COMBINATIONS - - Yes KeyCare acute Yes Emend 80mg CAP APREPITANT Yes Yes Yes Oncology No Emend 125mg CAP APREPITANT Yes Yes Yes Oncology No APREPITANT Yes Yes Yes Oncology No Emend combi pack (1x125mg cap & 2x80mg cap) Arizofy 10mg TAB ARIPIPRAZOLE 16.49000 16.49000 Yes Yes Yes CDL Yes Arizofy 15mg TAB ARIPIPRAZOLE 24.53000 24.53000 Yes Yes Yes CDL Yes Arizofy 5mg TAB ARIPIPRAZOLE 9.78000 9.78000 Yes Yes Yes CDL Yes Discovery Health formularies and PBR benchmark pricing 3 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Tenopress 100mg TAB ATENOLOL 1.11000 1.11000 Yes Yes Yes CDL Yes B-block 100mg TAB ATENOLOL 1.11000 1.11000 Yes Yes Yes CDL Yes Adco-atenolol 100mg TAB ATENOLOL 1.11000 1.11000 Yes Yes Yes CDL Yes Tenopress 50mg TAB ATENOLOL 0.69000 0.69000 Yes Yes Yes CDL Yes Adco-atenolol 50mg TAB ATENOLOL 0.69000 0.69000 Yes Yes Yes CDL Yes Dynator 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Atorvastatin unicorn 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Adco atorvastatin 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Astor 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Aspavor 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Lipogen 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Vastor 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Lestavor 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Atolip 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Atorvastatin winthrop 10mg TAB ATORVASTATIN 1.14000 1.14000 Yes Yes Yes CDL Yes Dynator 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Atorvastatin unicorn 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Aspavor 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Lipogen 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Atolip 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Adco atorvastatin 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Astor 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Lestavor 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Atorvastatin winthrop 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Vastor 20mg TAB ATORVASTATIN 1.21000 1.21000 Yes Yes Yes CDL Yes Atolip 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Dynator 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Astor 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Adco atorvastatin 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Atorvastatin unicorn 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Lipogen 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Lestavor 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Aspavor 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Atorvastatin winthrop 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Vastor 40mg TAB ATORVASTATIN 2.12000 2.12000 Yes Yes Yes CDL Yes Lipogen 80mg TAB ATORVASTATIN 4.09000 4.09000 Yes Yes Yes CDL Yes Lestavor 80mg TAB ATORVASTATIN 4.09000 4.09000 Yes Yes Yes CDL Yes Dynator 80mg TAB ATORVASTATIN 4.09000 4.09000 Yes Yes Yes CDL Yes Astor 80mg TAB ATORVASTATIN 4.09000 4.09000 Yes Yes Yes CDL Yes Aspavor 80mg TAB ATORVASTATIN 4.09000 4.09000 Yes Yes Yes CDL Yes Azathioprine pch 50mg TAB AZATHIOPRINE 7.95000 7.95000 Yes Yes Yes CDL Yes Azamun 50mg TAB AZATHIOPRINE 7.95000 7.95000 Yes Yes Yes CDL Yes Zithrogen 500mg TAB AZITHROMYCIN - - Yes KeyCare acute Yes Discovery Health formularies and PBR benchmark pricing 4 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Azithromycin zydus 500mg TAB AZITHROMYCIN - - Yes KeyCare acute Yes Teva baclofen 10mg TAB BACLOFEN 5.72000 5.72000 Yes Yes Yes CDL Yes Bio-baclofen (was Norton-baclofen) 10mg TAB BACLOFEN 5.72000 5.72000 Yes Yes Yes CDL Yes Beceze 100 cfc free 200dose 100mcg INH BECLOMETASONE 168.06000 156.57000 Yes Yes No CDL No Beclate 200dose 100mcg INH BECLOMETASONE 168.06000 - Yes No No CDL No Beclate 200dose 200mcg INH BECLOMETASONE 268.34000 - Yes No No CDL No Beclate aquanase 150dose 50mcg AQS BECLOMETASONE 72.12000 72.12000 Yes Yes Yes CDL Enhanced-KeyCare acuteYes Clenil aqueous 200dose 50mcg AQS BECLOMETASONE 71.70000 71.70000 Yes Yes Yes CDL Enhanced-KeyCare acuteYes Alpha benzyl benzoate application 0.25 LOT BENZYL BENZOATE - - Yes KeyCare acute Yes LOT BENZYL BENZOATE - - Yes KeyCare acute Yes - - Yes KeyCare acute Yes App benzyl benz bpc App benzyl benz - Allied 0.25 SCL BENZYL BENZOATE Vari-betamethasone 0,1% CRE BETAMETHASONE 0.71000 0.71000 Yes Yes Yes CDL-KeyCare acute Yes Topivate 0,1% CRE BETAMETHASONE 0.71000 0.71000 Yes Yes Yes CDL-KeyCare acute Yes Repivate 0,1% CRE BETAMETHASONE 0.71000 0.71000 Yes Yes Yes CDL-KeyCare acute Yes Persivate 0,1% CRE BETAMETHASONE - - Yes KeyCare acute Yes Lenovate 0,1% CRE BETAMETHASONE - - Yes KeyCare acute Yes CRE BETAMETHASONE - - Yes KeyCare acute Yes Adco-betamethasone Sandoz bezafibrate 400mg SRT BEZAFIBRATE 7.82000 7.82000 Yes Yes Yes CDL Yes Bezalip retard 400mg SRT BEZAFIBRATE 7.82000 7.82000 Yes Yes Yes CDL Yes Accord bicalutamide 50mg TAB BICALUTAMIDE 19.25000 19.25000 Yes Yes Yes Oncology No Caloxa 50mg TAB BICALUTAMIDE 19.25000 19.25000 Yes Yes Yes Oncology No Teva bicalutamide 150mg TAB BICALUTAMIDE 101.85000 101.85000 Yes Yes Yes Oncology No Spec bicalutamide 50mg TAB BICALUTAMIDE 19.25000 19.25000 Yes Yes Yes Oncology No Tasdiam 150mg TAB BICALUTAMIDE 101.85000 101.85000 Yes Yes Yes Oncology No Spec bicalutamide 150mg TAB BICALUTAMIDE 101.85000 101.85000 Yes Yes Yes Oncology No Anandroca 50mg TAB BICALUTAMIDE 19.25000 19.25000 Yes Yes Yes Oncology No Lumigan 0,01% OPD BIMATOPROST 207.79000 - Yes No No CDL No Akineton 2mg TAB BIPERIDEN 3.78000 3.78000 Yes Yes Yes CDL Yes Bislo 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Bisozyd 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Bisoprolol unichem 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Bilocor 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Bisoprolol unicorn 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Bisbeta 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Betacor 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Adco-bisocor 10mg TAB BISOPROLOL 3.12000 3.12000 Yes Yes Yes CDL Yes Bilocor 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Bisoprolol unicorn 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Bislo 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Bisozyd 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Bisbeta 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Betacor 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Adco-bisocor 5mg TAB BISOPROLOL 1.81000 1.81000 Yes Yes Yes CDL Yes Discovery Health formularies and PBR benchmark pricing 5 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Brimoct 5ml 2mg/1mL OPD BRIMONIDINE 178.63000 178.63000 Yes Yes Yes CDL Yes Alphagan purite 5ml 1,5mg/1mL OPD BRIMONIDINE 178.63000 178.63000 Yes Yes Yes CDL Yes ENE BUDESONIDE 71.42000 - Yes No No CDL No Entocord Budeflam hfa 300dose 100mcg INH BUDESONIDE 244.06000 - Yes No No CDL No Pulmicort turbuhaler 200dose 100mcg TBH BUDESONIDE 121.39000 121.39000 Yes Yes Yes CDL Yes Pulmicort turbuhaler 200dose 200mcg TBH BUDESONIDE 121.39000 121.39000 Yes Yes Yes CDL Yes Temgesic sublingual 0,2mg TAB BUPRENORPHINE Yes Yes Yes Oncology No Scopex syrup 5mg/5mL SYR BUTYLSCOPOLAMINE - - Yes KeyCare acute Yes Hyospasmol 5mg/5mL SYR BUTYLSCOPOLAMINE - - Yes KeyCare acute Yes Hyospasmol 10mg TAB BUTYLSCOPOLAMINE - - Yes KeyCare acute Yes Scopex 10mg TAB BUTYLSCOPOLAMINE - - Yes KeyCare acute Yes Capexa 150mg TAB CAPECITABINE 7.48000 7.48000 Yes Yes Yes Oncology No Capexa 500mg TAB CAPECITABINE 25.63000 25.63000 Yes Yes Yes Oncology No Pecaset 150mg TAB CAPECITABINE 7.48000 7.48000 Yes Yes Yes Oncology No Pecaset 500mg TAB CAPECITABINE 25.63000 25.63000 Yes Yes Yes Oncology No Capecitabine specpharm 500mg TAB CAPECITABINE 25.63000 25.63000 Yes Yes Yes Oncology No Mylan captopril 25mg TAB CAPTOPRIL 0.39000 0.39000 Yes Yes Yes CDL Yes Bio-captopril 25mg TAB CAPTOPRIL 0.39000 0.39000 Yes Yes Yes CDL Yes Mylan captopril 50mg TAB CAPTOPRIL 0.45000 0.45000 Yes Yes Yes CDL Yes Tegretol cr 200mg SRT CARBAMAZEPINE 4.65000 4.65000 Yes Yes Yes CDL-Oncology Yes Zeptol 200mg TAB CARBAMAZEPINE 2.50000 2.50000 Yes Yes Yes CDL-Oncology Yes Degranol 200mg TAB CARBAMAZEPINE 2.50000 2.50000 Yes Yes Yes CDL-Oncology Yes Tegretol cr 400mg SRT CARBAMAZEPINE 8.60000 8.60000 Yes Yes Yes CDL-Oncology Yes Betaphlem 250mg/5mL SYR CARBOCISTEINE - - Yes KeyCare acute Yes Bronchette 250mg/5mL SYR CARBOCISTEINE - - Yes KeyCare acute Yes Lessmusec 250mg/5mL SYR CARBOCISTEINE - - Yes KeyCare acute Yes Co-flem 250mg/5mL SYR CARBOCISTEINE - - Yes KeyCare acute Yes Flemgo 250mg/5mL SYR CARBOCISTEINE - - Yes KeyCare acute Yes Carvedilol unicorn 12,5mg TAB CARVEDILOL 2.53000 2.53000 Yes Yes Yes CDL Yes Vediblok 12,5mg TAB CARVEDILOL 2.53000 2.53000 Yes Yes Yes CDL Yes Carvetrend 12,5mg TAB CARVEDILOL 2.53000 2.53000 Yes Yes Yes CDL Yes Carvedilol unicorn 25mg TAB CARVEDILOL 3.23000 3.23000 Yes Yes Yes CDL Yes Vediblok 25mg TAB CARVEDILOL 3.23000 3.23000 Yes Yes Yes CDL Yes Carvetrend 25mg TAB CARVEDILOL 3.23000 3.23000 Yes Yes Yes CDL Yes Vediblok 6,25mg TAB CARVEDILOL 2.41000 2.41000 Yes Yes Yes CDL Yes Carvedilol unicorn 6,25mg TAB CARVEDILOL 2.41000 2.41000 Yes Yes Yes CDL Yes Carvetrend 6,25mg TAB CARVEDILOL 2.41000 2.41000 Yes Yes Yes CDL Yes Ranceph 250mg CAP CEFALEXIN - - Yes KeyCare acute Yes Ranceph 500mg CAP CEFALEXIN - - Yes KeyCare acute Yes Ranceph 125mg/5mL SUS CEFALEXIN - - Yes KeyCare acute Yes Ranceph 250mg/5mL SUS CEFALEXIN - - Yes KeyCare acute Yes Celecoxib unicorn 100mg CAP CELECOXIB 3.78000 - Yes No No CDL Enhanced No Coxleon 100mg CAP CELECOXIB 3.78000 - Yes No No CDL Enhanced No Discovery Health formularies and PBR benchmark pricing 6 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Celecoxib unicorn 200mg CAP CELECOXIB 7.57000 - Yes No No CDL Enhanced Coxleon 200mg CAP CELECOXIB 7.57000 - Yes No No CDL Enhanced No Chlorcol 3.5g 0.01 EYO CHLORAMPHENICOL - - Yes KeyCare acute Yes Chlornicol 3.5g 0.01 EYO CHLORAMPHENICOL - - Yes KeyCare acute Yes Chlorphen 3.5g 0.01 EYO CHLORAMPHENICOL - - Yes KeyCare acute Yes Plasmoquine 200mg CAP CHLOROQUINE Yes Yes Yes CDL Yes Allergex 2mg/5mL SYR CHLORPHENAMINE - - Yes KeyCare acute Yes Rhineton 4mg TAB CHLORPHENAMINE - - Yes KeyCare acute Yes TAB CHLORPHENAMINE, COMBINATIONS - - Yes KeyCare acute Yes Sinuend 2.66000 2.66000 No Largactil 100mg TAB CHLORPROMAZINE 6.64000 6.64000 Yes Yes Yes CDL Yes Largactil 25mg TAB CHLORPROMAZINE 2.24000 2.24000 Yes Yes Yes CDL Yes Largactil 50mg TAB CHLORPROMAZINE 3.91000 3.91000 Yes Yes Yes CDL Yes Ciclovent 60 dose 160mcg INH CICLESONIDE 215.23000 215.23000 Yes Yes No CDL No Ciclovent 60 dose 80mcg INH CICLESONIDE 130.34000 130.34000 Yes Yes No CDL No Pharma-q cimetidine ampoule 2ml 200mg/2mL INJ CIMETIDINE Yes Yes Yes Oncology No Lenamet 400mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Secadine 200mg TAB CIMETIDINE Yes Yes Yes Oncology No Adco-cimetidine 400mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Adco-cimetidine 200mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Cimetidine 100mg/ml 2ml sz111 INJ CIMETIDINE Yes Yes Yes Oncology No Cimlok 200mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Cimlok 400mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Bio-cimetidine 200mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Bio-cimetidine 400mg TAB CIMETIDINE Yes Yes Yes Oncology-KeyCare acute Yes Cpl alliance ciprofloxacin 250mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Cpl alliance ciprofloxacin 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Orpic 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Ciprogen 250mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Ciprogen 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Austell ciprofloxacin 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Austell ciprofloxacin 250mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Ciprol 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Ciprol 250mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Loxip 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Biotech ciprofloxacin 250mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Biotech ciprofloxacin 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Flopro 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Cifran 500 500mg TAB CIPROFLOXACIN - - Yes KeyCare acute Yes Cilate 20mg TAB CITALOPRAM 2.63000 2.63000 Yes Yes Yes CDL Yes Recita 20mg TAB CITALOPRAM 2.63000 2.63000 Yes Yes Yes CDL Yes Adco-talomil 20mg TAB CITALOPRAM 2.63000 2.63000 Yes Yes Yes CDL Yes Citalopram-winthrop 20mg TAB CITALOPRAM 2.63000 2.63000 Yes Yes Yes CDL Yes Arrow citalopram 40mg TAB CITALOPRAM 4.16000 4.16000 Yes Yes Yes CDL Yes Discovery Health formularies and PBR benchmark pricing 7 04/12/2019
Product name Strength Dosage form Active ingredient Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Klarithran 500mg TAB CLARITHROMYCIN - - Yes KeyCare acute Yes Claren granules 125mg/5mL SUS CLARITHROMYCIN - - Yes KeyCare acute Yes Claren granules 250mg/5mL SUS CLARITHROMYCIN - - Yes KeyCare acute Yes Klaryvid 250mg TAB CLARITHROMYCIN - - Yes KeyCare acute Yes Klaryvid 500mg TAB CLARITHROMYCIN - - Yes KeyCare acute Yes Klaribin 250mg TAB CLARITHROMYCIN - - Yes KeyCare acute Yes Klaribin 500mg TAB CLARITHROMYCIN - - Yes KeyCare acute Yes Clindahexal 150mg CAP CLINDAMYCIN - - Yes KeyCare acute Yes Rivotril 0,5mg TAB CLONAZEPAM 1.92000 1.92000 Yes Yes Yes CDL-Oncology Yes Rivotril 2mg TAB CLONAZEPAM 4.41000 4.41000 Yes Yes Yes CDL-Oncology Yes Clopidogrel 75 biotech 75mg TAB CLOPIDOGREL 5.88000 5.88000 Yes Yes No CDL Enhanced No Zyklot 75mg TAB CLOPIDOGREL 5.88000 5.88000 Yes Yes No CDL Enhanced No Pharma dynamics clopidogrel 75mg TAB CLOPIDOGREL 5.88000 5.88000 Yes Yes No CDL Enhanced No Clopidogrel unicorn 75mg TAB CLOPIDOGREL 5.88000 5.88000 Yes Yes No CDL Enhanced No Plagrol 75mg TAB CLOPIDOGREL 5.88000 5.88000 Yes Yes Yes CDL Enhanced No Canex topical 0.01 CRE CLOTRIMAZOLE - - Yes KeyCare acute Yes Canex vag 0.01 VCR CLOTRIMAZOLE - - Yes KeyCare acute Yes VCR CLOTRIMAZOLE - - Yes KeyCare acute Yes CRE CLOTRIMAZOLE - - Yes KeyCare acute Yes CRE CLOTRIMAZOLE - - Yes KeyCare acute Yes Fungispor (1 applicator) Fungispor 0.01 Clomaderm Cloxin 250mg CAP CLOXACILLIN - - Yes KeyCare acute Yes Cloxin 500mg CAP CLOXACILLIN - - Yes KeyCare acute Yes Aspen clozapine 100mg TAB CLOZAPINE 11.13000 11.13000 Yes Yes Yes CDL Yes Cloment 100mg TAB CLOZAPINE 11.13000 11.13000 Yes Yes Yes CDL Yes Aspen clozapine 25mg TAB CLOZAPINE 3.67000 3.67000 Yes Yes Yes CDL Yes Cloment 25mg TAB CLOZAPINE 3.67000 3.67000 Yes Yes Yes CDL Yes Octanine f vial 30ml 1000iu INJ COAGULATION FACTOR IX 3519.09000 3519.09000 Yes Yes Yes CDL Yes Octanine f 30ml vial 250iu INJ COAGULATION FACTOR IX 879.77000 879.77000 Yes Yes Yes CDL Yes Octanine f 30ml vial 500iu INJ COAGULATION FACTOR IX 1759.54000 1759.54000 Yes Yes Yes CDL Yes Haemosolvex ix 500u INJ COAGULATION FACTOR IX 2096.99000 2096.99000 Yes Yes Yes CDL Yes Haemosolvate viii 300u INJ COAGULATION FACTOR VIII 1135.22000 1135.22000 Yes Yes Yes CDL Yes Haemosolvate viii 10ml 500u INJ COAGULATION FACTOR VIII 1785.80000 1785.80000 Yes Yes Yes CDL Yes Octanate vial 10ml 1000iu INJ COAGULATION FACTOR VIII 3033.99000 3033.99000 Yes Yes Yes CDL Yes Octanate vial 5ml 250iu INJ COAGULATION FACTOR VIII 758.49000 758.49000 Yes Yes Yes CDL Yes Octanate vial 10ml 500iu INJ COAGULATION FACTOR VIII 1517.00000 1517.00000 Yes Yes Yes CDL Yes Haemosolvate viii 2x10ml 1000u INJ COAGULATION FACTOR VIII 3571.60000 3571.60000 Yes Yes Yes CDL Yes Painamol plus TAB CODEINE AND PARACETAMOL - - Yes KeyCare acute Yes Varipan co 8mg/500mg TAB CODEINE AND PARACETAMOL - - Yes KeyCare acute Yes Cogesic TAB CODEINE AND PARACETAMOL - - Yes KeyCare acute Yes Adco-napacod 500mg/10mg TAB CODEINE AND PARACETAMOL - - Yes KeyCare acute Yes Codorol TAB CODEINE AND PARACETAMOL - - Yes KeyCare acute Yes Colchicine 0,5mg TAB COLCHICINE - - Yes KeyCare acute Yes Apen 500mg CAP COMBINATIONS OF PENICILLINS - - Yes KeyCare acute Yes Discovery Health formularies and PBR benchmark pricing 8 04/12/2019
Product name Strength Dosage Active ingredient form Comp & Exec Core Benchmark (Unit Benchmark (Unit SEP incl. VAT) SEP incl. VAT) Comp & Exec Core highlight highlight indicator indicator KeyCare Highlight indicator (Chronic and acute) Item indicator - Primary Care EDL Formulary flag flag Macropen 500mg CAP COMBINATIONS OF PENICILLINS - - Yes KeyCare acute Yes Apen s 250mg SUS COMBINATIONS OF PENICILLINS - - Yes KeyCare acute Yes Macropen s 250mg/5mL SUS COMBINATIONS OF PENICILLINS - - Yes KeyCare acute Yes Theophen SYR COMBINATIONS OF XANTHINES - - Yes KeyCare acute Yes Stop allerg 13,5ml OPD CROMOGLICIC ACID - - Yes KeyCare acute Yes Medazine-s 12,5mg/5mL SYR CYCLIZINE - - Yes KeyCare acute Yes Nauzine 50mg TAB CYCLIZINE Yes Yes Yes Oncology-KeyCare acute Yes TAB CYCLIZINE Yes Yes Yes Oncology-KeyCare acute Yes Nauzine s 12,5mg/5mL SYR CYCLIZINE - - Yes KeyCare acute Yes Aranesp prefilled syringe 0.4ml 10mcg/0,4mLINJ DARBEPOETIN ALFA 195.57000 195.57000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.5ml 20mcg/0,5mLINJ DARBEPOETIN ALFA 391.14000 391.14000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.3ml 30mcg/0,3mLINJ DARBEPOETIN ALFA 586.71000 586.71000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.3ml 60mcg/0,3mLINJ DARBEPOETIN ALFA 1173.44000 1173.44000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.4ml 40mcg/0,4mLINJ DARBEPOETIN ALFA 782.28000 782.28000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.5ml 50mcg/0,5mLINJ DARBEPOETIN ALFA 977.87000 977.87000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.4ml 80mcg/0,4mLINJ DARBEPOETIN ALFA 1564.55000 1564.55000 Yes Yes Yes CDL Yes Aranesp prefilled syringe 0.5ml 100mcg/0,5mL INJ DARBEPOETIN ALFA 1955.69000 1955.69000 Yes Yes Yes CDL Yes Ddavp nasal spray 5ml 0,1mg/1mL NSS DESMOPRESSIN 973.86000 973.86000 Yes Ye
Discovery Health formularies and benchmark pricing Period: 2020 Q1 & Q2 Expected implementation date: 1 January 2020 Product name Strength Dosage form Active ingredient Comp & Exec Benchmark (Unit SEP incl. VAT) Core Benchmark (Unit SEP incl. VAT) Comp & Exec highlight indicator Core highlight indicator KeyCare Highlight
PRICE LIST 09_2011 rev3. English. 2 Price list 09_2011. 3. MMA. Discovery 150TP - Multipower 184. 4 Discovery 200S - Discovery 250: 5 Discovery 400 - Discovery 500: 6: TIG DC: Discovery 161T - Discovery 171T MAX 7: Multipower 204T - Discovery 220T 8: Discovery 203T MAX - Discovery 300T 9: Pioneer 321 T 10:
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