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Corticosteroids Oral, Nose Spray, Eye Drops, Topical -- Not for Asthma


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CORTICOSTEROID MEDICATIONS

for Allergic Conjunctivitis for Adrenal Cancer Treatment for Adrenal Fatigue/ Addison's
for Allergic Rhinitis for Anaphylaxic Treatment for Asthma
for Cluster Headaches for Eczema for Crohn's and Ulcerative Colitis
for Dupuytren Contraction for Gout for Vulvodynia and Lichen Sclerosis
for Hives for Ventricular Arrhythmia for Itching Skin
for Lupus Erythematosus for Reflux Sympathetic Dystrophy for Rheumatoid Arthritis
for Sjogren's Syndrome for Skin Allergies for Trigger Point Injections


FORMULARY TOPICAL CORTICOSTEROID CREAMS

Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand Price
Abroad
Generic Price
US
Brand
Price
US
Generic Price
Prior
Authorization
Price
per unit
 
_________________________________________________________________ ______________________________________________________________
Walgreens Cortef® hydrocortisone30gm 2.5% $  28.07$0.13/ gm
Walmart Kenalog® triamcinolone.01% ointment #15gm tube $   4.00$0.27/ gm
Walgreens Cortef® hydrocortisone28.5gm 1% ointment $   7.91$0.28/ gm
Kmart Cormax® clobetasol.05% #15gm tube $ 10.36$0.70/ gm
CVS Desowen® desonide.05% ointment #15gm tube $28.24$ 12.65$0.84/ gm
Kmart Temovate® clobetasol.05% #30gm tube $ 14.62$0.49/ gm
Kroger Clobex® clobetasol.05% #50ml solution $  21.10$0.42/
ml
Walgreens Cortef® hydrocortisone2.5% 59ml lotion $ 56.51 $  23.03$0.14/ gm
CVS Aprexicon® E XX diflorasone.05% #60gm tube $191.87General Prior
Authorization
$3.19/ gm


HEMORRHOIDS

Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand Price
Abroad
Generic Price
US
Brand
Price
US
Generic Price
Prior
Authorization
Price
per unit
 
____________________________________________________________ ______________________________________________________________
CVS Proctozone® HC hydrocortisone2.5% #30 gram Tube $ 14.74$0.49/ supp
CVS Anusol® HC hydrocortisone25mg #24 suppos-itories $ 80.50$ 18.70$0.78/ supp
CVS Analpram® hydrocortisone/ pramoxine2.5% 1% #30 gm Tube $138.45$ 29.51$0.98/ gm dose
CVS Proctofoam® HC hydrocortisone1%/ 1% #10gm Can $105.22 General Prior
Authorization
$10.50/ gm dose


FORMULARY NASAL CORTICOSTEROID NASAL SPRAYS

Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand
Price
Abroad
Generic
Price
US
Brand
Price
US
Generic Price
Replace with/ for Price
per unit
____________________________________________________________ ______________________________________________________________
Walmart Flonase® fluticasone propionate16gm 250mcg $ 99.45$ 13.63$0.13/ gm
CVS Nasalide® flunisolide25ml 0.025%g $ 30.88$0.33/ gm
Walgreens Nasacort® Aq triamcinolone acetonide16.5 gm 55mcg/ spray $ 56.21 General Prior
Authorization
$0.13/ dose

Walgreens Veramyst® fluticasone17 gm 27.5mcg/ spray$ 41.00$73.00
$ 131.82 $1.15/ dose

Walgreens Qnasl® beclomethasone8.7 gm 27.5mcg/ spray $ 136.79 General Prior
Authorization
$1.19/ dose

Walgreens Nasonex® mometasone17 gm 50mcg/ spray$ 84.00
for #3
$55.00
for #3
$ 172.23 General Prior
Authorization
$1.50/ dose

Kroger Beconase® XX beclomethasone25 gm 42mcg/ spray$ 52.00
for #2
$41.00
50g/ 100dose for #3
$ 213.57General Prior
Authorization
$1.50/ dose

Meijer Dymista® XX azelastine/ fluticasone136mcg/ 50mcg 23 gm/ spray$157.00
137mcg/ 50mcg #1
$42.00
#3 x 70dose
$ 172.51 General Prior
Authorization
$1.55/ dose

Kroger Sprix® XX ketorolac15.5mg/ spray #5 bottles5 $ 949.06Prior
Authorization
$188.21/ bottle

FORMULARY ORAL SUSPENSIONS CORTICOSTEROIDS

Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand Price
Abroad
Generic Price
US
Brand
Price
US
Generic Price
Prior
Authorization
Price
per unit
____________________________________________________________ ______________________________________________________________
Walgreens Decadron® dexamethasone4mg #30 $   8.92$0.30/ dose
Walmart Prelone® prednisolone15mg/ 5ml #60 ml $ 27.88$   8.84$0.15/ ml

Target Orapred® ODT prednisolone sodium phosphate15mg/ 5ml #100 ml $232.64$ 11.20$0.11/ ml

Walgreens Cortef® hydrocortisone20mg #50 $ 12.36$0.25/ dose

Walmart Deltasone® prednisone20mg #100 $ 14.78$0.15/ dose

Walgreens Cortef® hydrocortisone5mg #100 $ 53.51 $ 12.25$0.19/ dose

TargetSynalar®TS fluocinolone.01% #60ml lotion $65.00
.025% x100gm
$288.77$ 31.73 $0.53/ dose

FORMULARY- EYES DROPS

Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand Price
Abroad
Generic Price
US
Brand
Price
US
Generic Price
Prior
Authorization
Price
per unit
____________________________________________________________ ______________________________________________________________
WalmartCorticosporin®  neomycin/ polymyxin B sulfates and hydrocortisone #7.5ml Eye Dropper $39.00
#6ml
$ 43.38 $2.07/ 5-drops

CVSPred-forte®/ Omnipred®   prednisolone1% #5ml Eye Dropper $27.00
#10ml
$ 82.27$ 105.56 $1.09/ 5-drops

KrogerLotemax® loteprednol.05% #5ml Eye Dropper $73.00
#3
$39.00 $181.47General Prior
Authorization
$12.09/ 5-drops

CVSFML® flurometholone.01% #5ml Eye Dropper $27.00
#2
$11.00
1.4% 15ml OTC
$110.45General Prior
Authorization
$11.43/ 5-drops

KrogerDudrezol® difluprednate.05% #5ml Eye Dropper $59.00
1% 5ml OTC
$ 156.90 $11.43/ 5-drops

NON FORMULARY- MISCELLANEOUS

Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand Price
Abroad
Generic Price
US
Brand
Price
US
Generic Price
Prior
Authorization
Price
per unit
____________________________________________________________ ______________________________________________________________
Walgreens Cortone® hydrocortisone10mg #90 tablets $ 25.25hydro- cortisone$.58/ dose

Kmart Lokoid® desonide.1% #60ml bottle $ 412.27$ 15.97$0.27/ ml

Walgreens Diprosone® betamethasone dipropionate.05% #60ml lotion$35.00
#76ml
$ 23.03HC-0.1% cream O-T-C $11.55$0.38/ ml

Walgreens Diprosone® betamethasone dipropionate.05% #45gm ointment$28.00 $ 44.45HC-0.1% cream O-T-C $11.55$10.99/ gm

Walgreens Aclovate® alclometasone.05% #60gm tube $ 43.26 $0.72/ gm dose

Rite-Aid Medrol® methyl- prednisolone4mg #100 Tablets$22.00 $ 55.00 $  64.67$0.65/ dose

CVS Apexicon® diflorasone.05% #30gm tube $ 81.88$1.36/ gm

CVS Lokara® desonide.05% #59ml tube $ 72.53$1.23/ ml

Walmart Pandel® hydrocortisone.1% #15gm tube $ 93.85
HC-0.1% cream O-T-C $11.55
$6.27/ gm

Walmart Nucort® hydrocortisone2% #59ml lotion $ 72.26$1.23/ dose

Kroger Veripred® prednisolone20mg/ 5ml #100 ml $ 91.61$0.92/ dose

CVS Topicort® desoximetasone.05% #60gm tube gel$48.00 $102.77
HC-0.1% cream O-T-C $11.55
$1.71/ gm

CVS Cortone® cortisone25mg #100 tablets$58.00 $304.50$274.85General Prior
Authorization
$3.04/ dose

CVS Uceris®Budesonide5mg #30 Capsules$1999.00
9mg #30
$1490.07 General Prior
Authorization
$49.67/ dose



STRONGER and NON-FORMULARY TOPICAL STEROIDS
General Prior
Authorization
Coupon US Brand
Name

Drug Info
Generic/
ingredient
Dosage Quantity Abroad
Brand Price
Abroad
Generic Price
US
Brand
Price
US
Generic Price
Prior
Authorization
Price
per unit
____________________________________________________________ ______________________________________________________________
CVS Ultravate® halobetasol.05% #50gm Tube Ointment $ 745.36$ 46.84$0.94/ gm dose

Walmart Cutivate® fluticasone propionate.05%
ointment
#60 ml bottle$75.00
for 3x30gm tube
$106.40$140.08General Prior
Authorization
$2.33/ ml

CVS Clobex® clobetasol.05%
ointment
#118ml bottle$184.00
for #120ml
$653.99 $144.11General Prior
Authorization
$1.22/ ml

CVS Olux® clobetasol.05% foam #100gm can $169.69General Prior
Authorization
$1.35/ gm

CVS Aprexicon®E XX diflorasone.05% #60gm tube $191.87Aprexicon $3.19/ gm

Walmart Cyclocort® amcinonide.1% #60gm ointment$48.00$31.00
#60ml lotion
$ 243.70General Prior
Authorization
$4.39/ gm

CVS Vanos® fluocinonide.01%
ointment
#60gm tube $303.06General Prior
Authorization
$5.05/ gm

Target Cordran® SP flurandrenolide.05% #60ml bottle $345.42General Prior
Authorization
$5.76/ gm

Target Desonate® desonide.05% #60gm tube$55.00
$352.43General Prior
Authorization
$4.27/ dose
Kroger Cordran® Tape flurandrenolide4mcg
tape
#1 large roll $543.89General Prior
Authorization
$7.05/ gm


OBSERVATION:
*Conversion Table: Dosage Range of Therapeutic Medications. Within the oral group, 100mg of hydrocortisone equals 4mg of Decadron®/examethasone or 20mg of Medrol®/methylprednisolone.
*Within the topical corticosteroid group, there is little difference in effectiveness.

KEYWORDS:
Rx prednisone, Rx hdrocortisone, Rx kenalog, Rx triamcinolone,Rx Cultivate, Rx fluticasone propionate, Rx Clobex, Rx clobetasol, Rx Olux, Rx Temovate, Rx Cormax, Rx Medrol, Rx methylprednisolone, Rx Vanos, Rx fluocinonide, Rx Orapred, Rx prednisolone phosphate, Rx Pediapred, Rx Cortef, Rx hydrocortisone, Rx dexamethasone, Rx prelone, Rx Desowen, Rx desonide, Rx betamethasone dipropionate, Rx Elocon, Rx mometasone, Rx Westcort, Rx hydrocortisone valerate, Rx Topicort, Rx desoximetasone, Rx Derma Smoothe FS, Rx fluocinolone, Rx Synalar, Rx Diprolene, Rx Luviq, Rx Beta-Val, Rx Ultravate, Rx halobetasol, Rx Olux-E, Rx Temovate-E, Rx Locoid, Rx hydrocortisone butyrate, Rx Aclovate, Rx alclometasone, Rx Fluocinonide-e, Rx Cordran, Rx diflorasone, Rx Halog, Rx halcinonide, Rx Dexamethasone Intensol, Rx Cloderm, Rx Solu-Cortef, Rx Dermatop, Rx prednicarbate, Rx Pramasone, Rx Clocortolone pivalate, Rx Millipred, Rx amcinonide, Rx rianex, Rx depo-medrol, Rx methylprednisolone, Rx Solu-medrol, Rx cortisone, Rx Apexicon-E, Rx Veripred, Rx diflorasone, Rx Nucort, Rx Pandel, Rx Zema, Rx Desonate, Rx Apexicon, Rx Lokara, Rx Topicort, Rx desoximetasone, Rx Omnipred,Rx Uceris, Rx budesonide,Rx locoid, hydrocortisone butyrate, Rx diprosone, Rx betamethasone dipropionate, Rx cyclosort, rx difluprednate, rxdudrzol, Rx ultravate, Rx halobetasol,rx proctofoam hc, rx ansuol hc, rx analpram, Rx Aclovate, Rx alclometasone, buy, BUY

XX Excluded by Caremark or Express Scripts January 2014

Copyrighted® 2014: Revised June 13, 2015; Prices may vary