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2Oct
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

New Rapid-Acting Insulin Approved

The U.S. Food and Drug Administration (FDA) approved Novo Nordisk’s rapid-acting insulin, Fiasp® (insulin aspart injection) 100Units/mL, on Sept. 29, 2017. It is indicated to manage blood sugar levels for adults with either type 1 or type 2 diabetes. Because it has been modified to increase absorption, the neopredisan dosierung ciprofloxacin effects of Fiasp may begin as soon as 20 minutes after injection. Novo Nordisk plans to price Fiasp evenly with its NovoLog® (insulin aspart), but it has not yet announced a date for Fiasp’s release. Recommendations are to inject Fiasp before a meal or within 20 minutes of beginning to eat. It will be dispensed in 10mL multi-dose vials and pre-filled FlexTouch® pen devices. Full prescribing information is available here. 

Tenth Indication Approved for Keytruda

Under its accelerated approval program, the U.S. Food and Drug Administration (FDA) granted a new indication for Keytruda® (pembrolizumab - Merck) on Sept. 22, 2017. The human programmed death receptor-1 (PD-1)-blocking antibody now is approved to treat recurrent locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma that expresses PD-L1. Eligible patients must have disease progression during or after finishing treatment with at least two other therapies -- including chemotherapy (chemo) containing fluoropyrimidine and platinum-based drugs. Additionally, their tumors will have to test positive for PD-1 with the Dako PD-L1 IHC 22C3 pharmDx companion diagnostic test. Either in combination with other drugs or alone, Keytruda has indications to treat multiple other types of cancer. In May 2017, it became the first drug to be FDA approved for treating colorectal cancer and any solid tumors that are microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) regardless of the tumors’ primary site of origin. Full prescribing information is available here.  

Opdivo Receives New Indication

Opdivo® (nivolumab) injection for intravenous (IV) use, Bristol-Myers Squibb’s PD-1 inhibitor, was U.S. Food and Drug Administration (FDA) approved on Sept. 22, 2017, to treat some patients who have hepatocellular carcinoma (HCC). The most common type of liver cancer, HCC is expected to cause about 29,000 U.S. deaths in 2017. It is associated with chronic liver diseases such as hepatitis and non-alcoholic steatohepatitis (NASH). Previously approved to treat a number of other cancer types, Opdivo now is indicated as second-line for HCC patients who previously were treated with Nexavar® (sorafenib). Recommended dosing for the new HCC indication is one 240mg infusion every two weeks. Complete prescribing information for Opdivo is available here. 

Verzenio Approved to Treat Breast Cancer

On Sept. 28, 2017, the U.S. Food and Drug Administration (FDA) approved Eli Lilly’s Verzenio™ (abemaciclib) for use in combination with fulvestrant for the treatment of women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with disease progression following endocrine therapy. It also is approved as monotherapy for the treatment of adult patients with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy and prior chemotherapy in the metastatic setting. Verzenio selectively inhibits cyclin-dependent kinases (CDK) 4 and 6 (CDK4/6), enzymes that promote the growth and spread of cancer cells. The recommended starting dose in combination with fulvestrant is 150mg twice daily; as monotherapy, the recommended starting dose is 200mg twice daily. Lilly plans on launching Verzenio within the next two weeks. It will be available through a limited network of specialty pharmacies that includes Accredo. Full prescribing information is available here. 

Updated Hepatitis C Issues Document Available

The standard of care for treating chronic hepatitis C (CHC) has been evolving. This Issues Document describes current and pipeline medications for treating hepatitis C and how Express Scripts and Accredo can effectively manage this market. This latest update includes the new pan-genotypic hepatitis C medications Vosevi™ and Mavyret™. The pipeline table also has been updated. The Hepatitis C Issues Document is available here. 

 

 

26Sep
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Solosec Approved to Treat Bacterial Vaginosis

A new single-dose, oral antimicrobial, Solosec™ (secnidazole – Symbiomix Therapeutics) was U.S. Food and Drug Administration (FDA) approved on Sept. 15, 2017. It is indicated to treat women who are at least 18 years old and who have vaginal infections caused by specific kinds of bacteria. Solosec is dispensed in packets of granules. Recommended dosing is one packet, containing 2Gm of Solosec, sprinkled onto a soft food, such as yogurt, and consumed within one-half hour. It may be taken alone or during a meal. The launch is expected early in 2018. In clinical studies, about 10% of women taking Solosec developed fungal vaginal infections, compared to about 3% of women who took an inactive placebo. Most of the infections were not serious, though, and all the affected women were treated successfully with an antifungal agent. Complete prescribing information is available here.  

FDA Approval for Adzenys ER

On Sept. 15, the U.S. Food and Drug Administration (FDA) approved Neos Therapeutics’ third drug for attention deficit hyperactivity disorder (ADHD). Adzenys ER™, an oral liquid form of extended-release amphetamine, is indicated to treat ADHD for children as young as six years old. It is taken once every morning, with doses based on the patient’s age. Supplied in 450mL (about 15-ounce) bottles, Adzenys ER contains 1.25mg of amphetamine in each milliliter. A boxed warning on its labeling cautions that, as a C-II controlled substance, it is subject to misuse and it also may cause dependence. Patients will receive a medication guide with every prescription. Adzenys ER is bioequivalent (interchangeable) with Adderall XR® (mixed salts of a single-entity amphetamine) capsules. The launch is expected early next year. Prescribing information is available here. 

Trelegy Ellipta Approved

The first inhaler that contains three medications for maintenance treatment of chronic obstructive pulmonary disease (COPD) was approved by the U.S. Food and Drug Administration (FDA) on Sept. 18, 2017. Trelegy™ Ellipta®, jointly developed by GlaxoSmithKline and Innoviva, contains a corticosteroid (fluticasone furoate, 100mcg), a long-acting muscarinic antagonist (umeclidinium, 62.5mcg) and a long-acting beta2-adrenergic agonist (vilanterol, 25mcg) in a dry-powder inhaler. It is indicated for patients who already are using some of the included drugs, but who need additional control of airway obstruction or worsening COPD. Dosing is once daily. Like other products that contain a beta2-agonist such as vilanterol, the labeling includes a boxed warning that Trelegy Ellipta may increase the chances of death if it is used by an asthma patient. GlaxoSmithKline plans to release it in the U.S. soon. Its complete prescribing information is available here.

Xhance Approved to Treat Nasal Polyps

A new formulation of the inhaled corticosteroid fluticasone propionate was approved by the U.S. Food and Drug Administration (FDA) on Sept. 18, 2017, to relieve congestion and inflammation caused by polyps in the nose. Xhance™ uses the proprietary Exhalation Delivery System developed by its manufacturer, Optinose®. To use the nasal spray device, the patient inserts part of the device into one nostril and then blows on another part to deliver 93mcg of fluticasone per spray. It is approved for use in adults age 18 years and older at a recommended dose of one spray into each nostril twice a day. Some patients may need to use two sprays per nostril twice a day and the full effects may not be felt for up to 16 weeks of regular use. Using Xhance may cause bleeding, fungal infections or sores inside the nose. Beginning in the first quarter of 2018, it will be dispensed in full units each including the spray device and a 16mL bottle containing 120 sprays. Full prescribing information is available here.

Generic Approved for Tamiflu Oral Suspension

The U.S. Food and Drug Administration (FDA) has approved the first generic for Genentech’s Tamiflu® (oseltamivir) oral suspension. Nesher Pharmaceuticals, a U.S. subsidiary of Zydus Cadila, announced it had received approval on Sept. 14, 2017. Oseltamivir oral suspension is indicated for acute treatment of influenza (flu) when started no more than 48 hours after flu symptoms are first observed. Patients two weeks of age and older may use it. Generic oseltamivir capsules have been available in the U.S. since December 2016. Plans for pricing and a launch date for the oral suspension have not yet been released. 

New Indication for Somatuline Depot

Somatuline® Depot (lanreotide – Ipsen Biopharmaceuticals) was granted a new indication on Sept. 18, 2017. The long-acting somatostatin analog, first approved in 2007 to treat acromegaly, is now indicated for treating adult carcinoid syndrome. Acromegaly includes uncontrolled growth of the face, feet and hands caused by excess growth hormone secretion; carcinoid syndrome is due to over production of serotonin and other substances that results in breathing problems, diarrhea, fast heartbeats and skin reactions such as flushing. Somatuline Depot also is approved for treating neuroendocrine tumors of the gastro-entero-pancreatic system (GEP-NETs). Administered by a healthcare professional as deep subcutaneous (SC) injections once every four weeks, doses vary depending on the condition being treated. Updated prescribing information is available here.

FDA Expands Rapivab Indication

BioCryst Pharmaceuticals’ Rapivab® (peramivir injection) was given approval by the U.S. Food and Drug Administration (FDA) for pediatric use on Sept. 21, 2017. Rapivab, a neuraminidase inhibitor, is now indicated to treat influenza (flu) for patients who are at least two years old and who have had flu symptoms for no more than 48 hours. As an intravenous (IV) injection, it provides an alternative for patients who cannot use an oral flu treatment. Rapivab is given as one 600mg dose over 15 minutes or longer. Prescribing information is available here. 

 

 

 

 

 

 

19Sep

State of Emergency due to an Earthquake in Mexico City, Mexico

  • Staff
  • FSBP   Overseas-Information   Prescription  

News reports are circulating of a 7.1 magnitude earthquake in Mexico City, Mexico with major impact. FSBP is therefore activating its state of emergency response. Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override for home delivery of medications if needed. You may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717). Alternately, you may obtain a prescription from your local health care provider, fill it on the economy and send us a claim.

 

18Sep
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Privigen Approved for Chronic Inflammatory Demyelinating Polyneuropathy

On September 14, 2017, the U.S. Food and Drug Administration (FDA) approved CSL Behring’s Privigen® [Immune Globulin Intravenous (Human), 10% Liquid] for the treatment of adults with chronic inflammatory demyelinating polyneuropathy (CIDP) to improve neuromuscular disability. CIDP is a progressive autoimmune disorder that causes weakness, numbness and tingling of the arms and legs due to damaged myelin sheath (protective covering) of the peripheral nerves. Approximately 40,000 patients in the U.S. have CIDP. Privigen was originally approved in 2007; it is also indicated to treat primary humoral immunodeficiency (PI) and chronic immune thrombocytopenic purpura (ITP) in patients 15 years of age and older. Privigen is administered by intravenous (IV) infusion. Full prescribing information is available here.

 

15Sep
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

 

FDA Approves Mvasi, a biosimilar to Avastin

On September 14, 2017, the U.S. Food and Drug Administration (FDA) approved Allergan and Amgen’s Mvasi™ (bevacizumab-awwb), a biosimilar to Genentech’s Avastin®. Mvasi is approved for treating metastatic colorectal cancer, non-squamous non-small cell lung cancer, glioblastoma, metastatic renal cell carcinoma, and cervical cancer. It was not approved for three Avastin indications (ovarian, fallopian tube, and primary peritoneal cancer) because they are still protected by Orphan Drug Exclusivity (ODE). The dose of Mvasi varies depending on the indication. While launch plans for Mvasi are unknown, it will likely be delayed until July 2019. Full prescribing information is available here.

  • Brand (Generic) Name: Mvasi™ (bevacizumab-awwb)
  • Manufacturer: Allergan and Amgen
  • Date Approved: September 14, 2017
  • Indication: Mvasi is approved for treating metastatic colorectal cancer, non-squamous non-small cell lung cancer, glioblastoma, metastatic renal cell carcinoma, and cervical cancer.
  • Dosage Forms Available: 100mg/4mL and 400mg/16mL solution in single dose vials for IV infusion.
  • Launch Date: Launch plans for Mvasi are not known at this time. However, it will likely be delayed until at least July 2019.
  • Estimated Annual Cost: Pricing information is not available at this time.
  • Specialty Status: Mvasi will be added to Express Scripts’ specialty drug list.
  • According to IMS Health, U.S. annual sales for Avastin were approximately billion.
  • While approved, the launch of Mvasi will likely be delayed until an Avastin patent expires in July 2019
  • Mvasi is the seventh biosimilar approved by FDA. In addition to Avastin, the agency has also approved biosimilars to Enbrel® (etanercept – Amgen), Neupogen® (filgrastim – Amgen), Humira® (adalimumab – AbbVie) and Remicade® (infliximab – Janssen).
  • Biosimilars to Neulasta® (pegfilgrastim – Amgen), Herceptin® (trastuzumab – Genentech) and Rituxan® (rituximab – Genentech) are also under FDA review.

Aliqopa Approved for Follicular Lymphoma

On September 14, 2017, Bayer received U.S. Food and Drug Administration (FDA) approval of Aliqopa™ (copanlisib) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior systemic therapies. The recommended dose of Aliqopa is 60mg administered as a one-hour intravenous (IV) infusion on Days 1, 8 and 15 of a 28-day treatment cycle. Bayer is expected to launch Aliqopa immediately. It will only be available through hospitals and clinics; Accredo will not be dispensing Aliqopa. Full prescribing information is available here. 

  • Brand (Generic) Name: Aliqopa™ (copanlisib)
  • Manufacturer: Bayer
  • Date Approved: September 14, 2017
  • Indication: Treatment of adults with relapsed follicular lymphoma who have received at least two prior systemic therapies.
  • Dosage Forms Available: 60mg lyophilized powder in single-dose vials for reconstitution and further dilution for IV infusion
  • Launch Date:  September 15, 2017
  • Estimated Annual Cost: Pricing information is not yet available.
  • Specialty Status: Aliqopa will be added to Express Scripts’ specialty drug list.
  • Each year in the U.S., more than 72,000 patients are diagnosed with some form of non-Hodgkin lymphoma (NHL). Follicular lymphoma is the most common subtype, accounting for approximately 22% of these cases. Limited treatment options are available for patients who relapse after prior therapies.
  • Aliqopa is a phosphatidylinositol-3-kinase (PI3K) inhibitor with inhibitory activity predominantly against the PI3K-alpha and PI3K-delta isoforms expressed in malignant B cells.
  • Aliqopa was approved two months ahead of schedule under FDA’s accelerated approval, orphan drug and priority review programs. 
  • FDA’s accelerated approval of Aliqopa was based on a single-arm Phase II trial of 104 patients with follicular B-cell NHL who had relapsed following at least two prior treatments. Aliqopa demonstrated an overall response rate of 59% for a median of 12.2 months. Continued approval is dependent upon a confirmatory trial that demonstrates a clinical benefit.

 

13Sep
FSBP Expands Direct Billing Partnerships in Seoul Korea

FSBP Expands Direct Billing Partnerships in Seoul Korea

  • Staff
  • All   FSBP  

The Foreign Service Benefit Plan proudly welcomes Catholic University of Korea- Seoul St. Mary’s Hospital and Soon Chun Hyang University Hospital in Seoul Korea as direct billing partners.

Soon Chun Hyang University Hospital is conveniently located near the ITAEWON and provides care to approximately 6,000 international patients a year.  Our direct billing arrangement with Soon Chun Hyang University Hospital covers inpatient and complete maternity care.

The Catholic University of Korea Seoul St. Mary’s Hospital is the largest among Korean hospitals consisting of a single building with1,320 sick beds.  Our direct billing arrangement with the Catholic University of Korea Seoul St. Mary’s Hospital covers inpatient, accidental injury, complete maternity care, and all covered outpatient care.
We strive to simplify your care overseas and are delighted to have these billing arrangements. If you have overseas direct billing questions, please visit our FSBP Overseas Partners page on our website, email us, or call us at +1 202-833-4910 for assistance.
Thank you for being a valued FSBP member.
Accidental injury, inpatient, and complete maternity care: Member pays no deductible. FSBP pays 100% of covered services.
All covered outpatient care: Member pays applicable calendar year deductible and 10% coinsurance.

 

11Sep

States of Emergency due to Hurricane Irma in Georgia and Alabama

  • Staff
  • Prescription   FSBP  

The Governors of Georgia and Alabama have declared a State of Emergency due to Hurricane Irma. All counties are impacted in Alabama. The following counties in Georgia are impacted: Appling, Atkinson, Bacon, Baker, Baldwin, Ben Hill, Berrien, Bibb, Bleckley, Brantley, Brooks, Bulloch, Calhoun, Candler, Charlton, Chattahoochee, Clay, Clinch, Coffee, Colquitt, Cook, Crawford, Crisp, Decatur, Dodge, Dooly, Dougherty, Early, Echols,, Effingham, Emanuel, Evans, Grady, Harris, Houston, Irwin, Jeff Davis, Jefferson, Jenkins, Johnson, Jones, Lamar, Lanier, Laurens, Lee, Long, Lowndes, Macon, Marion, Meriwether, Miller, Mitchell, Monroe, Montgomery, Muscogee, Peach, Pierce, Pike, Pulaski, Quitman, Randolph, Schley, Screven, Seminole, Stewart, Sumter, Talbot, Tattnall, Taylor, Telfair, Terrell, Thomas, Tift, Toombs, Treutlen, Troup, Turner, Twiggs, Upson, Ware, Washington, Wayne, Webster, Wheeler, Wilcox, Wilkinson and Worth.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

11Sep
Keeping our Members Informed

Keeping our Members Informed

  • Staff
  • All  

As you may have heard by now, Equifax, one of the largest credit reporting firms in the country recently suffered a data breach.  Equifax estimates that data on around 143 million US customers was obtained in the breach.  This data includes: names, birth dates, social security numbers, credit card numbers, as well as other information.  Many cybersecurity ciprofloxacin experts are already saying that this breach could be even worse than the Office of Personnel Management data breach back in 2015 where personal information on many government employees was compromised.

In this high tech world that we live in today, we need to make sure that we are extra vigilant in monitoring and protecting our personal information as best we can. 

Even though AFSPA is not directly involved,  we realize the Equifax breach might affect our members – anyone who has or has applied for a mortgage, an auto loan, a credit card, etc.  We have  attached a link to the Equifax website where you can see if your personal information may have been compromised.  Equifax announced that they would offer free credit monitoring services to US consumers for one year.  As with any agreement of this nature, we advise our members to read all the terms and conditions before signing up or agreeing to anything.

Take a look at the URL below to learn more about the breach and also to check to see if your information was compromised.

https://www.equifaxsecurity2017.com/

 

11Sep
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

New Injection Approved for Knee Osteoarthritis

Durolane® (hyaluronic acid, intra-articular) was approved by the U.S. Food and Drug Administration (FDA) on August 29, 2017, to treat pain caused by osteoarthritis of the knees. Like similar, previously approved products, Durolane will be injected by a healthcare professional directly into affected joints to help replace the natural fluids that provide lubrication, protection and pain relief. Each injection provides up to six months of pain relief. First approved in Europe sixteen years ago, Durolane also is available in numerous other countries, including Canada and Mexico. The manufacturer, Bioventus, plans a U.S. launch early next year.

Durolane will be added to Express Scripts’ specialty drug list.

Austedo Approved for Tardive Dyskinesia

The U.S. Food and Drug Administration (FDA) approved Teva’s Austedo® (deutetrabenazine) to treat tardive dyskinesia on August 30, 2017. Tardive dyskinesia is a side effect from long-term use of some drugs — primarily antipsychotics. It typically involves uncontrollable movements of the face, including the eyes, jaw, lips and tongue; but it also can affect other parts of the body. Austedo originally was approved in April for adult patients who have a similar condition, chorea, which is caused by Huntington’s disease. It is believed to modulate signals between nerves by temporarily decreasing the amounts of monoamines, such as dopamine and serotonin, within the brain. To treat tardive dyskinesia, the recommended starting dose is 12mg each day, which may be increased at weekly intervals to a maximum of 48mg daily. A boxed warning on Austedo’s label cautions that depression and suicidality may be increased among patients taking it. Prescribing information for it is available here.

New Dosing for Orfadin

On September 1, 2017, the U.S. Food and Drug Administration (FDA) approved a new dosing schedule for the Swedish Orphan Biovitrum (Sobi) drug, Orfadin® (nitisinone). Used with dietary restrictions, Orfadin prevents the accumulation of tyrosine metabolites for individuals who have hereditary tyrosinemia type 1 (HT-1). Tyrosine is an amino acid that patients with HT-1 cannot break down adequately because they lack the necessary enzyme. Results from a clinical study showed that taking one dose per day was as effective as the previously recommended twice-daily dose schedule for patients who are at least five years old and who have been on a stable dose of Orfadin for at least four weeks. Updated prescribing information is available here. 

Tracleer Gets a Pediatric Indication

Tracleer® (bosentan), an oral endothelin receptor antagonist that treats pulmonary arterial hypertension (PAH), is now U.S. Food and Drug Administration (FDA) approved for patients as young as three years old. The FDA granted the pediatric indication and approved a new 32mg dispersible tablet on Sept. 6, 2017. PAH is progressively worsening high blood pressure in the arteries between the heart and the lungs, which forces the heart to beat harder and damages the arteries. Tracleer is taken twice a day with doses dependent on body weight for children under the age of 12 years. Its manufacturer, Actelion, plans to market the 32mg tablets in the next few weeks. The new tablets can be divided easily to customize doses and they can be dissolved in a teaspoon of water for patients who cannot swallow the larger 62.5mg and 125mg film-coated tablets. Labeling carries a boxed warning that Tracleer may cause liver damage and severe birth defects. It is dispensed under a risk evaluation and mitigation strategy (REMS) that requires all patients, pharmacies and prescribers involved in its use to be registered with the program. Full prescribing information is available here.

 

 

6Sep
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and Welcome to September 2017! This means that summer is ending. Many have started a new school year or maybe even moved to a new post. These changes can cause us to vary our routine and even vary our meals.

Along those lines, September is Fruits & Veggies—More Matters ® Month. Eating more fruits and vegetables helps you and your family be at their best and it may reduce the risk of many diseases. I found a great website that provides tons of information on topics from the Top 10 Reasons to Eat More Fruits and Veggies (which we all should) to Fruit and Vegetable Storage 101. Check out the website for yourself.

Also, it is not too late to receive 0 in incentive rewards by completing your Health Risk Assessment (HRA) and Biometric Screening. You can quickly take your HRA online at My Online Services or on the phone with a health coach by calling 866-237-1442. You can obtain a Biometric Screening at a Quest Diagnostic Patient Service Center (PSC) at your convenience. Visit my.questforhealth.com and enter the registration key “aetnafsbp2017” to register and locate a PSC location near you or on your way home. For members who are overseas or who prefer to have their Biometric Screening through their physician, you can print your own Physician Result form. Your provider can complete it and send to Quest Diagnostics. Then, you might as well complete a Healthy Action for another wellness incentive reward. The HRA, Biometric Screening, and Healthy Action must be completed by December 1, 2017 to earn the reward(s). You only have a few months left.  

Lastly, September is Life Insurance Awareness Month. This makes it the perfect time to look at ways to better protect your family’s future. Funeral expenses and outstanding bills can create an added burden for your loved ones. To assist, AFSPA offers a comprehensive package of life insurances policies for our members’ unique needs. Learn more about your options and how to estimate coverage of your needs by browsing the “Life Insurances” section of the AFSPA website. You can apply or enroll in any of our plans at any time.

This time of year is busy for AFSPA as we continue to go through the Migration process, prepare the 2018 FSBP brochure, and get ready for Open Season travel. We will keep you informed through our website, on Facebook, in the Fall newsletter, and our Open Season mailing. Again this year, look for new benefits and programs at a great premium for 2018!
 

As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

9Sep

States of Emergency due to Hurricane Irma in the US Virgin Islands, Georgia, North and South Carolina and Wildfires in California (Los Angeles County)

  • Staff
  • Prescription   FSBP  

The Governors of the US Virgin Islands, Georgia, North and South Carolina have declared a State of Emergency due to Hurricane Irma. All counties are impacted in the US Virgin Islands, North and South Carolina. The following counties in Georgia are impacted: Appling, Atkinson,  Bacon, Brantley, Bryan, Bulloch, Burke, Camden, Candler, Charlton, Clinch, Coffee, Echols, Effingham, Emanuel, Evans, Glynn, Jenkins, Jeff Davis, Liberty, Long, McIntosh, Pierce, Screven, Tattnall, Toombs, Treutlen, Wayne and Ware.

The Governor of California has declared a State of Emergency due to Wildfires, impacting Los Angeles County.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

6Sep

States of emergency from Irma and Washington wild fires

  • Staff
  • FSBP   Prescription  

The Governors of Florida and Puerto Rico have issued States of Emergency for all counties due to Hurricane Irma.

The Governor of Washington has issued a State of Emergency for all counties due to fires.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

5Sep
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

New Rabies Immune Globulin Approved

On August 25, 2017, the U.S. Food and Drug Administration (FDA) granted approval for Kedrab™ [rabies immune globulin (human)]. It provides temporary, passive protection against rabies infection, when given immediately after contact with a rabid or possibly rabid animal. A full course of rabies vaccine, which gives active protection, must follow treatment with it. Kedrab will be dispensed in 2mL or 10mL vials each containing 150 IU/mL. Dosing is by body weight – a one-time dose of 20 IU/Kg is injected into the animal bite, if possible, and into muscles as far from the bite as practical. Because it is made from human blood plasma, Kedrab has a slight risk of containing infective viruses. Individuals given it also may have allergic reactions or blood problems, such as clots or ruptured red blood cells. Live vaccines for other diseases, such as measles or polio, should not be given until at least three months after treatment with Kedrab. Made by Kamada, Kedrab will be distributed in the U.S. by Kedrion Biopharma, Inc., beginning in early 2018.  Prescribing information is available here. 

First Drug Approved for Chagas Disease

Accelerated approval was granted by the U.S. Food and Drug Administration (FDA) on August 29, 2017, for benznidazole. The first drug fully approved in the United States to treat Chagas disease, benznidazole is an antiparasitic agent used to treat acute Chagas infection for children between 2 and 12 years of age. Doses based on body weight are given orally twice a day for 60 days. Also called American trypanosomiasis, Chagas disease is caused by the parasite Trypanosoma cruzi and is transmitted primarily through contact with triatomine bugs. The Centers for Disease Control and Prevention (CDC) estimates that approximately 300,000 Americans have Chagas disease, which progresses in two phases. The acute phase has only general symptoms that are similar to the flu and that last for a few weeks after exposure. Infection is confirmed with a blood test for antibodies to the T. cruzi parasite. If untreated, the infection may become chronic. Usually asymptomatic, chronic Chagas disease lasts for decades and eventually results in serious heart and digestive system problems for 30% or more of individuals who have it. Reinfection is possible after treatment. Launch and pricing plans for benznidazole have not yet been released, but the manufacturer, Chemo Group, has partnered with non-profit groups to price it reasonably, prioritize its distribution in areas needing it and use part of the profits for developing other drugs for neglected conditions.

New Antibacterial Drug Approved

The U.S. Food and Drug Administration (FDA) approved Vabomere™ (meropenem/vaborbactam) injection on August 29, 2017. It combines a previously approved antibiotic with a new beta-lactamase inhibitor. An intravenous (IV) formulation, it is indicated to treat adults who have complicated urinary tract infections (cUTI) caused by specific types of bacteria. Designated by FDA as a qualified infectious disease product (QIDP), Vabomere was given both fast-track and priority approval. QIPDs treat serious bacterial or fungal infections, including those resistant to other anti-infective therapies. Recommended dosing is 4Gm (two vials) given as a three-hour infusion once every eight hours for up to two weeks. Rempex, a subsidiary of The Medicines Company, plans to release Vabomere before the end of 2017. Its complete prescribing information is available here. 

New Indication for Faslodex

Faslodex® (fulvestrant - AstraZeneca) injection, an estrogen-receptor blocker, received an additional U.S. Food and Drug Administration (FDA) indication on August 25, 2017. It now is approved as a single agent to treat post-menopausal patients who have hormone-receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer, but who have not yet received endocrine therapy. In the FALCON clinical trial for fulvestrant and anastrozole compared in hormonal therapy-naïve advanced breast cancer, average progression-free survival rates were about three months longer for patients given Faslodex as they were for patients taking AstraZeneca’s oral aromatase inhibitor, Arimidex® (anastrozole). Recommended dosing for Faslodex is one 500mg dose divided into two intramuscular (IM) injections once a month after three loading doses during the first month of treatment. Full prescribing information for Faslodex is available here.

Expanded Indication for Victoza

Novo Nordisk announced on August 25, 2017, that the U.S. Food and Drug Administration (FDA) had approved Victoza® (liraglutide) to decrease risk of major adverse cardiovascular (CV) events for adults who have both type 2 diabetes and documented CV disease. A glucagon-like peptide-1 (GLP-1) receptor agonist, it first was FDA approved in 2010, along with diet changes and exercise, to improve blood sugar control for adults with type 2 diabetes. Recommended dosing is 0.6mg, 1.2mg or 1.8mg once a day delivered subcutaneously (SC) through a pre-filled, multi-dose pen-like device. Victoza is known to cause some types of thyroid tumors, so it carries a boxed warning against its use by patients or close relatives of patients who have medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2). Prescribing information is available here.

Actemra Indicated for CAR-T Side Effects

In tandem with its approval of the first CAR-T therapy, Kymriah™ (tisagenlecleucel – Novartis) on August 30, 2017, the U.S. Food and Drug Administration (FDA) also approved Genentech’s Actemra® (tocilizumab) to treat cytokine release syndrome (CRS), a possible major side effect of treatment with CAR-T products. An immune reaction, CRS usually is a mild flu-like condition that causes fever, headache, nausea and rash. Sometimes called a cytokine storm, severe CRS can become life-threatening, however, potentially causing acute respiratory syndrome, heart failure, multi-organ collapse or death. In one clinical trial, nearly 50% of the 68 patients treated with Kymriah developed severe cases of CRS. Actemra is a monoclonal antibody that interferes with interleukin-6 (IL-6) to reduce inflammation. Indicated for patients two years old and older, Actemra is given intravenously (IV) at a dose of 8mg/Kg or 12mg/Kg depending on body weight to control CRS. Up to four doses of Actemra, separated by eight hours or more, may be needed, as may concurrent high doses of steroids. A boxed warning in Actemra’s label cautions that patients are at increased risk of having serious infections, including tuberculosis, while undergoing treatment with it. Revised prescribing information is available here. 

 

1Sep
Express Scripts News Flash

Express Scripts News Flash

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FDA Approves Mylotarg for CD33 Positive Acute Myeloid Leukemia

On September 1, 2017, the U.S. Food and Drug Administration (FDA) approved MylotargTM (gemtuzumab ozogamicin - Pfizer) injection for intravenous use after it had been off the market since October 2010. The antibody-drug conjugate now is indicated to treat adults newly diagnosed with acute myeloid leukemia (AML) that expresses the CD33 antigen. It also gained an indication for CD33 positive AML patients as young as 2 years old who have relapsed after or who no longer respond to standard treatment. As initial therapy, it will be given either as monotherapy or along with chemotherapy. It will be used alone for second-line treatment. Dosing is by body weight. Launch is expected next week through the same distribution channel as Pfizer’s Besponsa® (inotuzumab ozogamicin), which includes one specialty pharmacy, Biologics. Accredo will not have access to Mylotarg. Full prescribing information is available here.

  • Brand (Generic) Name: MylotargTM (gemtuzumab ozogamicin)
  • Manufacturer: Pfizer
  • Date Approved: September 1, 2017
  • Indication: Mylotarg is approved for treatment of newly diagnosed CD33-positive acute myeloid leukemia (AML) in adults and treatment of relapsed or refractory CD33-positive AML in adults and in pediatric patients 2 years and older.
  • Dosage Forms Available: Single-dose vials containing 4.5mg of Mylotarg for reconstitution and intravenous infusion
  • Launch Date: Mylotarg is expected to be launched within one week.
  • Estimated Annual Cost:  Pricing information is not available at this time.
  • Specialty Status: Mylotarg will be added to Express Scripts’ specialty drug list.
  • AML is a rare and aggressive cancer of the blood and bone marrow. Approximately 21,000 patients are diagnosed with AML each year in the United States. An estimated 90% of AML produces large amounts of an antigen, CD33.
  • Mylotarg combines an antibody specific for CD33 and ozogamicin, which attacks and destroys AML.
  • It originally was given accelerated approval in 2000 as monotherapy for patients 60 years and older whose CD33 positive AML had relapsed after chemotherapy. Additional clinical trials uncovered significant safety concerns for the targeted patient group at the approved doses. Voluntary market withdrawal followed in October 2010.
  • The new indications are for different patient populations and recommended doses have been reduced.
  • A boxed warning on Mylotarg labeling cautions that it could cause potentially severe or fatal liver damage.

 

1Sep

State of Emergency due to Tropical Storm Harvey in Oklahoma

  • Staff
  • FSBP   Prescription  

The Governor of Oklahoma has declared a State of Emergency due to Tropical Storm Harvey to allow displaced members from Texas and Louisiana to refill prescriptions in Oklahoma. All counties are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

1Sep

State of Emergency due to Tropical Storm Harvey in Texas

  • Staff
  • FSBP   Prescription  

The Governor of Texas has declared a State of Emergency due to Tropical Storm Harvey. The following counties are impacted: Bastrop, Burleson, Polk and San Jacinto.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

1Sep
Express Scripts News Flash

Express Scripts News Flash

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  • FSBP   Prescription  

On August 30, 2017, the U.S. Food and Drug Administration (FDA) approved KymriahTM (tisagenlecleucel – Novartis), a personalized cellular therapy to treat patients under the age of 25 years who have B-cell acute lymphoblastic leukemia (ALL) that have relapsed at least twice or no longer respond to standard treatments. It is the first gene therapy approved for use in the U.S. Kymriah attaches a gene containing a chimeric antigen receptor (CAR) to T-cells harvested from each individual patient. When the modified cells are infused back into the patient, they seek out CD19, a protein overexpressed by ALL cells. The drug will be administered as a one-time intravenous (IV) infusion only at a certified treatment center that will have staff members trained to recognize signs of adverse reactions. Novartis announced that it will price Kymriah at 5,000 and will adjust cost according to outcomes for patients who respond to treatment after the first month. Frozen in liquid nitrogen, Kymriah will be delivered directly to the facilities that give it, not through pharmacies. Full prescribing information is available here.

  • Brand (Generic) Name: KymriahTM (tisagenlecleucel)
  • Manufacturer: Novartis
  • Date Approved: August 30, 2017
  • Indication: Kymriah is appproved for the treatment of patients up to 25 years of age with B-cell precursor ALL that is refractory or in second or later relapse
  • Dosage Forms Available: Genetically modified, patient-specific T-cells frozen in single IV bags containing between 10mL and 50mL of suspension for IV infusion
  • Launch Date: Launch plans for Kymriah are not known at this time.
  • Estimated Annual Cost: 5,000
  • Specialty Status: Kymriah will be added to Express Scripts’ specialty drug list.
  • ALL is the most common cancer among children, teens and young adults -- with about 3,100 new cases diagnosed annually according to the National Cancer Institute. After successful treatment, ALL reoccurs in approximately 20% of patients.
  • Kymriah uses the patient’s immune system. T-cells are collected from the blood, linked with a gene that contains a CAR sensitized to CD19 antigens and reintroduced to the patient. These cells replicate and target CD19, which is present more abundantly on ALL cells than on normal cells.
  • Patients need pretreatment with chemotherapy and they will be monitored for possible adverse effects that may need drug therapy as well.
  • In a clinical trial of 63 patients, the overall remission rate was 83% three months after treatment with Kymriah.
  • Adverse neurological events, such as delirium and encephalopathy; and/or cytokine release syndrome (CRS), an overreaction to T-cell activation, may be associated with Kymriah infusions. Because either may be fatal, labeling carries a boxed warning and Kymriah also has a risk evaluation and mitigation strategy (REMS).
  • Kymriah potentially may cause other severe side effects that include acute kidney injury, hypotension and susceptibility to infections.
  • Kymriah was approved one month ahead of schedule under the FDA’s breakthrough therapy and priority review programs.
  • Another CAR-T therapy, Kite’s axicabtagene ciloleucel, is under FDA review for treating patients who have relapsed and/or refractory aggressive B-cell non-Hodgkin lymphoma (NHL) and who are not candidates for a stem-cell transplant. It is expected to be approved by November 29, 2017. Kite recently was purchased by Gilead.

 

29Aug
Express Scripts News Flash

Express Scripts News Flash

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FDA Approves Cyltezo, a Second Biosimilar to Humira

On August 25, 2017, the U.S. Food and Drug Administration (FDA) approved Boehringer Ingelheim’s Cyltezo™ (adalimumab – adbm), a biosimilar to AbbVie’s Humira®. Cyltezo is approved for treating adults with rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis. It is also approved for treating children four years of age and older with polyarticular juvenile idiopathic arthritis. The dose of Cyltezo varies depending on the indication. While Boehringer Ingelheim’s launch plans for Cyltezo are unknown, it is possible that launch could be delayed for two or more years due to patent litigation. Full prescribing information is available here.

  • Brand (Generic) Name: Cyltezo™ (adalimumab – adbm)
  • Manufacturer: Boehringer Ingelheim
  • Date Approved: August 25, 2017
  • Indication:Cyltezo is approved for treating adults with rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis. It is also approved for treating children four years of age and older with polyarticular juvenile idiopathic arthritis.
  • Dosage Forms Available:40mg/0.8mL solution in single-dose prefilled glass syringes for subcutaneous injection
  • Launch Date: Launch plans for Cyltezo are not known at this time.
  • Estimated Annual Cost:  Pricing information is not available at this time.
  • Specialty Status: Cyltezo will be added to Express Scripts’ specialty drug list.
  • Cyltezo represents the second FDA-approved biosimilar to AbbVie’s Humira. Amgen’s Amjevita™ (adalimumab – atto) was approved September 23, 2016. Similar to Cyltezo, launch of Amjevita is not expected for at least a couple years.
  • Cyltezo is not considered a generic medication nor is it considered automatically interchangeable with its innovator brand, Humira.

 

28Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

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Gocovri Approved for Parkinson’s Disease

On August 24, 2017, the U.S. Food and Drug Administration (FDA) approved Adamas Pharmaceuticals’ Gocovri™ (amantadine) extended-release capsules for treating involuntary muscle movement, or dyskinesia, in patients with Parkinson’s disease receiving levodopa-based therapy. Levodopa is a standard treatment of Parkinson’s disease, but can cause levodopa-induced dyskinesia (LID). The company estimates that about 200,000 people, or 20% of the estimated 1 million Parkinson’s disease patients in the U.S., suffer from LID. Administered once-daily at bedtime, dosing is 137mg per day for one week, and then increased to the recommended daily dose of 274mg. This product is an extended-release formulation of generically-available amantadine, which has been used off-label for this indication. According to Adamas, the extended-release properties allow for consistently high levels of amantadine throughout the day. Adamas plans on making Gocovri 68.5mg and 137mg capsules available in the fourth quarter of 2017 with a formal product launch in January 2018. Prescribing information is available here.

New Combination Approved to Treat Gout

Ironwood Pharmaceuticals’ Duzallo® was approved by the U.S. Food and Drug Administration (FDA) on August 18, 2017. A fixed-dose combination, it includes 200mg of lesinurad, a uric acid transporter (URAT1) inhibitor that increases elimination of uric acid, and either 200mg or 300mg of allopurinol, a xanthine oxidase inhibitor that  decreases uric acid production. It is approved to treat hyperuricemia (high blood levels of uric acid) associated with gout in patients who have not achieved target serum uric acid (sUA) levels with a medically appropriate daily dose of allopurinol alone. Recommended dosing for Duzallo is one tablet each morning along with food and water. Patients should drink at least two liters (about one-half gallon) of fluid per day. A boxed warning advises that taking lesinurad (also sold separately as Zurampic®) has been associated with sudden kidney failure. Kidney function testing is recommended before beginning and then periodically during treatment with any lesinurad-containing product. Ironwood plans to launch Duzallo in the fourth quarter of 2017. Although exact pricing has not been released, a cost similar to Zurampic’s is expected. Prescribing information is available here.

 

 

28Aug

State of Emergency due to Tropical Storm Harvey in Texas

  • Staff
  • FSBP   Prescription  

The Governor of Texas has declared a State of Emergency due to Tropical Storm Harvey. The following counties are impacted: Atascosa, Bexar, Brazos, Caldwell, Cameron, Comal, Grimes, Guadalupe, Hardin, Jasper, Kerr, Lee, Leon, Madison, Montgomery, Newton, Tyler, Walker, Washington and Wiilacy.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

25Aug

State of Emergency due to Tropical Storm Harvey in Louisiana

  • Staff
  • FSBP   Prescription  

The Governor of Louisiana has declared a State of Emergency due to Tropical Storm Harvey. All counties are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

24Aug

State of Emergency due to Tropical Storm Harvey in Texas

  • Staff
  • FSBP   Prescription  

The Governor of Texas has declared a State of Emergency due to Tropical Storm Harvey. The following counties are impacted: Aransas, Austin, Bee, Calhoun, Chambers, Colorado, Brazoria, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Harris, Jackson, Jefferson, Jim Wells, Karnes, Kleberg, Lavaca, Liberty, Live Oak, Matagorda, Nueces, Refugio, San Patricio, Victoria, Waller, Wharton, and Wilson.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

 

 

21Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

New Approvals for Lynparza

On August 17, 2017, the U.S. Food and Drug Administration (FDA) granted full approval to Lynparza® (olaparib – AstraZeneca and Merck) for treating patients with BRCA mutated (gBRCAm) advanced ovarian cancer who have been treated with chemotherapy (chemo) at least three times. Lynparza is a poly ADP-ribose polymerase (PARP) inhibitor, which prevents cancer cells from repairing chemo-caused damage to their DNA. The original indication has now been finalized following similarly successful results from further studies. In addition, FDA approved a new indication – for maintenance treatment of patients who have recurrent epithelial ovarian, fallopian tube or primary peritoneal cancers. Treatment is not dependent on BRCA status, but patients must have a complete or partial response after platinum-based chemo. FDA also approved a new oral tablet dosage form (in 100mg and 150mg strengths), which was launched immediately after its approval. Although the capsule form will be discontinued gradually, it is not directly interchangeable with the tablets. Recommended dosing of the tablets for both indications is 300mg taken twice a day. Full prescribing information for Lynparza tablets is available here.


Generic Approved for Fosrenol

Natco Pharma announced on August 16, 2017, that the U.S. Food and Drug Administration (FDA) has approved its generics for Shire’s Fosrenol® (lanthanum carbonate). The drug reduces hyperphosphatemia (high blood phosphate levels) for patients with end-stage renal disease (ESRD). Recommended dosing is 1,500mg to 3,000mg per day divided into three doses and taken with food. Although Natco’s generic is the first to be FDA approved, its exclusivity status currently is unclear. According to QuintilesIMS, sales for Fosrenol amounted to approximately 2 million for the year ending on June 30, 2017. Natco plans to launch lanthanum carbonate 500mg, 750mg and 1,000mg tablets shortly and market it in a partnership with Lupin Pharmaceuticals.

Besponsa Approved for Acute Lymphoblastic Leukemia

On August 17, 2017, Pfizer received U.S. Food and Drug Administration (FDA) approval of Besponsa® (inotuzumab ozogamicin) for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). Besponsa is administered as a one-hour intravenous (IV) infusion. Recommended dosing for the first cycle is 0.8mg/m2 on Day 1, 0.5mg/m2 on Day 8 and 0.5mg/m2 on Day 15. Dosing for subsequent cycles varies based on response to therapy. Pfizer is expected to launch Besponsa on August 21, 2017. It will be available through open distribution. Full prescribing information is available here.

 

 

 

15Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

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  • FSBP   Prescription  

New Delivery System Approved for QVAR

The U.S. Food and Drug Administration (FDA) approved QVAR® RediHaler™ (beclomethasone dipropionate HFA), a corticosteroid in a breath-actuated inhalation device, on August 3, 2017. Indicated as long-term preventive maintenance treatment for asthma, it can be used by patients as young as four years old. To use it, the patient just needs to breathe in from the inhaler. No hand-eye coordination to squeeze the device while breathing in is necessary. Additionally, the device does not need to be shaken, primed or used with a spacer. Teva plans to release QVAR RediHalers containing either 40mcg or 80mcg per inhalation in the first quarter of 2018. Recommended dosing ranges from 40mcg to 320mcg twice a day depending on the patient’s age and the asthma’s severity. Prescribing information for QVAR RediHaler is available here.

New Form of Pitavastatin Approved

Lupin’s Nikita™ (pitavastatin sodium) tablets were approved by the U.S. Food and Drug Administration (FDA) on August 4, 2017. It will be used, in combination with diet changes and exercise, to regulate cholesterol, lipoprotein and triglyceride levels for patients who have primary hyperlipidemia or mixed dyslipidemia. Nikita was approved through FDA’s 505(b)(2) pathway, allowing the submitting company to use documentation from a similar product that already is FDA approved rather than requiring a repeat of the clinical trials. In this case, the reference product is Livalo® (pitavastatin calcium – Kowa Company). The two drugs, however, are not A-rated or automatically interchangeable. Livalo currently has patents protecting it from direct generic competition until at least Dec. 25, 2020. Recommended dosing for Nikita is once daily. It will be manufactured in 1mg, 2mg and 4mg tablets. Lupin has not announced pricing or launch plans. Complete prescribing information is available here.

Nikita will be evaluated for the exclude at launch program on the NPF.

CaroSpir Liquid Approved

The U.S. Food and Drug Administration (FDA) approved CMP Pharma’s CaroSpir® (spironolactone oral suspension, 25mg/5mL), a new liquid formulation of the potassium-sparing diuretic for treating patients with high blood pressure, heart failure or edema. According to the manufacturer, the new formulation will provide another treatment option for patients who have difficulty swallowing or cannot swallow tablets. The recommended starting dose is dependent upon the indication. The company expects to launch CaroSpir 118mL and 473mL bottles during the fourth quarter of the year. Complete prescribing information is available here.  CaroSpir will be evaluated for the exclude at launch program on the NPF.

MedWatch Update

Opana ER

Endo Pharmaceuticals has announced that it will stop shipping Opana® ER (oxymorphone extended release) tablets to its customers on September 1, 2017. Opana ER is being discontinued after the FDA determined that its risks outweigh its value for treating patients with long-term moderate-to-severe pain. Although it was re-formulated in 2012, Opana ER was not FDA designated as abuse-deterrent. It still can be abused by injection or snorting. In June, FDA requested Opana ER be removed from the U.S. market.

 

7Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
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Abilify Maintena Receives New Indication

Otsuka’s Abilify Maintena®, an extended-release formulation of aripiprazole, was granted a new indication on July 28, 2017. The U.S. Food and Drug Administration (FDA) approved it to be used as a single agent for the maintenance treatment of adults who have bipolar I disorder. It is an atypical antipsychotic drug that previously was approved to treat schizophrenia. The recommended dose is 400mg injected intramuscularly (IM) by a healthcare professional once a month  A boxed warning cautions against using Abilify Maintena to treat dementia-related psychoses for elderly patients because it may increase their risk of death. Complete prescribing information is available here. 

Expanded Indication for Kalydeco

On July 31, the U.S. Food and Drug Administration (FDA) approved Kalydeco® (ivacaftor - Vertex) to treat cystic-fibrosis patients who are age 2 years and older and who have any of five additional mutations that cause splicing defects in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The original FDA approval, in 2012, was for patients with one of 23 other specific mutations. For patients 6 years old and older, dosing is one 159mg tablet per day. Younger patients take smaller doses of powdered Kalydeco that is mixed into soft foods. Approximately 600 additional patients will be eligible for treatment with the new indications. Prescribing information for Kalydeco is available here. 

New Indication for Opdivo

Bristol-Myers Squibb received a new indication on July 31, 2017, for its programmed death receptor-1 (PD-1) checkpoint inhibitor, Opdivo® (nivolumab) injection for intravenous (IV) use. It now is indicated to treat patients at least 12 years old who have microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer (mCRC) that has progressed despite treatment with  fluoropyrimidine, oxaliplatin, and irinotecan. A 240mg dose of Opdivo is infused   once every two weeks until the cancer worsens or the patient can no longer tolerate using the drug. The FDA initially approved Opdivo in December 2014 as a breakthrough therapy for advanced melanoma. It also has several additional indications, both alone and in combination with other drugs, to treat various types of cancer. Using it may be associated with several possible immune-related adverse effects, including infections in the intestines, kidneys, liver or lungs, which can be severe or even fatal. Opdivo’s full prescribing information is available here. 

Generic Launched for Transderm Scop

On July 31, 2017, Perrigo launched an AB-rated generic for Transderm Scop® (scopolamine) 1.5mg patches. Transdermal scopolamine is used to prevent nausea and vomiting induced by motion or by surgery. To prevent motion sickness, one patch is adhered to clean, dry, hairless skin behind one ear and worn for three days. For patients undergoing surgical procedures, one patch should be placed behind the ear the evening before the scheduled procedure and it should remain in place for 24 hours after the surgery. Pricing for the generic has not yet been announced. For the 12 months ended on May 31, 2017, sales for Transderm Scop amounted to about 8 million.

Imbruvica Indicated for Chronic Graft-versus-Host-Disease

The U.S. Food and Drug Administration (FDA) announced on August 2, 2017, that it has approved Pharmacyclics’ Imbruvica® (ibrutinib) to treat adults who have chronic graft-versus-host disease (cGvHD). Between 30% and 70% of patients who receive a stem cell transplant from a donor develop the potentially life-threatening condition in which the immune cells in the donated tissue (the graft) attack the transplant recipient (the host) as foreign. Usually, treatment with corticosteroids controls GvHD, but some patients have a chronic form of the condition that does not resolve. A Bruton’s tyrosine kinase inhibitor with prior indications for several cancers, Imbruvica is the first drug to be FDA approved to treat such resistant cGvHD. In a clinical trial, nearly 50% of cGvHD patients taking Imbruvica responded to therapy for at least five months. Dosing is 420mg (three 140mg capsules) once a day until the cancer returns, the cGvHD gets worse or the patient cannot take Imbruvica any longer. Updated prescribing information is available here.

Mavyret Approved for Hepatitis C

On August 3, 2017, the U.S. Food and Drug Administration (FDA) approved AbbVie’s Mavyret™ (glecaprevir 300mg/pibrentasvir 120mg) for the treatment of patients with chronic hepatitis C virus (HCV) genotype (GT) 1, 2, 3, 4, 5 or 6 infection without cirrhosis or with compensated cirrhosis. It is also indicated for the treatment of adult patients with HCV GT 1 infection, who previously have been treated with a regimen containing an HCV NS5A inhibitor or an NS3/4A protease inhibitor, but not both. The recommended dose of Mavyret is three tablets once daily with food for 8, 12 or 16 weeks, depending on which (if any) medications the patient has previously tried and whether or not the patient has compensated cirrhosis. Please refer to the prescribing information for details regarding dosing. AbbVie plans on launching Mavyret on August 8, 2017. It will be available through open distribution. Full prescribing information is available here. 

 

7Aug
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Vyxeos Approved for Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) approved Vyxeos™ (daunorubicin/cytarabine - Jazz Pharmaceuticals) on Aug. 3, 2017, to treat some patients with acute myeloid leukemia (AML). Specifically, it is indicated for adults who have either newly diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC). It will be dispensed as 44mg daunorubicin and 100mg cytarabine powder for reconstitution and intravenous (IV) administration. Due to its liposomal formulation, Vyxeos cannot be interchanged with any other drugs. Recommended dose is determined by both body surface area (BSA) and stage of treatment (induction or consolidation). Jazz plans to launch Vyxeos within one week. Full prescribing information is available here.

  • Brand (Generic) Name: Vyxeos™ (daunorubicin/cytarabine) liposome for injection
  • Manufacturer:  Jazz Pharmaceuticals
  • Date Approved: August 3, 2017
  • Indication:  For treating adults who have newly diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC).
  • Dosage Forms Available: Single-use vials containing 44mg daunorubicin/100mg cytarabine encapsulated in liposomes as a lyophilized powder cake for reconstitution and administration via intravenous infusion
  • Launch Date: Within one week
  • Estimated Annual Cost:  Pricing information is not yet available
  • Specialty Status: Vyxeos will be added to Express Scripts’ specialty drug list.
  • According to the American Cancer Society (ACS), approximately 21,000 patients – mostly adults over 45 years of age – are diagnosed with AML in the U.S. each year. AML begins in immature bone-marrow cells, which are more subject to mutations among older patients. AML may be more aggressive for older individuals and standard treatments may be too strong for them to tolerate.
  • Although multiple drug options are available to treat AML, none has the same indications as Vyxeos does.
  • Vyxeos encapsulates daunorubicin and cytarabine in liposomes that penetrate into the bone marrow, infiltrating AML cells more than normal cells. Once inside, the liposomal shells break apart, releasing the drugs.
  • Its pivotal clinical study included 309 patients between the ages of 60 and 75. Average overall survival for patients receiving Vyxeos was longer (9.6 months) than for patients treated with daunorubicin and cytarabine as separate agents. (5.9 months). Although at least 6% of patients in each group died during the study, patients treated with Vyxeos generally had better response rates and more of them improved enough to undergo stem cell transplants.
  • Recommended dosing for induction therapy is 44mg daunorubicin/100mg cytarabine per square meter (m2) of body surface area (BSA). Induction treatments are given on the first, third and fifth days of initial Vyxeos treatment. For patients who do not respond, a second induction with the same dose, but on days one and three only, may be given after two weeks to five weeks. Once response is shown, consolidation cycles are administered on the first and third days once every two weeks to five weeks at 29mg daunorubicin/65mg cytarabine per m2.

 

4Aug

State of Emergency in Florida Due to Tropical Storms

  • Staff
  • fsbp411   All   FSBP  

The Governor of Florida has declared a State of Emergency due to Tropical Storms. The counties of Brevard, Broward, Charlotte, Citrus, Collier, DoSoto, Glades, Hardee, Hendry, Hernando, Highlands, Hillsborough, Indian River, Lake, Lee, Manatee, Martin, Miami-Dade, Monroe, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole, St. Lucie, Sumter and Volusia are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

4Aug
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and Welcome to August 2017! This means summer is winding down and a new school year is coming quickly, which is a good time for those of you with children to visit the pediatrician and the dentist to ensure a successful and healthy school year.

August is National Immunization Awareness Month
Immunizations aren’t just for babies and children at their well-child visits. They are necessary for preteen/teens, adults as well as pregnant women. FSBP provides comprehensive benefits for child and adult immunizations – payable at 100% for providers in-network and outside the U.S. Adult immunizations include those endorsed by the Centers for Disease Control and Prevention (CDC). For children, we cover routine childhood and adolescent immunizations. Having your child vaccinated can be important to their long-term health.

Need a Second Opinion on a Diagnosis when Overseas?

Did you know FSBP has a special arrangement with Cleveland Clinic? Patients who receive treatment in foreign countries can receive a second opinion for certain diagnoses, through the e-Cleveland Clinic. Refer to page 96 of the 2017 FSBP Brochure for more information on this important benefit. Cleveland Clinic also provides educational materials and other resources free to our members. Please see their information on heartburn and acid reflux as well as a schedule for their August online health chats.

Update your Information in our Member Portal

Lastly, have you moved? If so, please let us know. As you prepare to leave one post for another, please send us your new address. Your employing agency/retirement office does not notify FSBP when you change your contact information with them. Please send a note with your updated mailing address, telephone number(s), and email address. You also can change your contact information via the Member Portal.

Look for the 2017 Summer Newsletter in your mailbox. It highlights AFSPA’s activities, services, and new programs, such as IT Security, our new Advanced Illness support program, and important information on the upcoming migration to the Aetna computer platform.
As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

2Aug
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Idhifa Approved to Treat Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) announced on Aug. 1, 2017, that it had approved Idhifa® (enasidenib) oral tablets. The first in its therapy class, Idhifa is indicated for treating adults who have relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation that has been detected by an FDA approved test, RealTime™ IDH2 Assay (Abbott Laboratories). Idhifa was developed jointly by Celgene and Agios Pharmaceuticals. Its recommended dosing is 100mg daily until the patient can no longer tolerate the drug or the cancer spreads. A boxed warning cautions that differentiation syndrome, which can be life-threatening, may be associated with taking Idhifa. Celgene and Agios plan on launching Idhifa immediately; it will be available through a limited network of specialty pharmacies that includes Accredo. Prescribing information is available here.

  • Brand (Generic) Name: Idhifa® (enasidenib)
  • Manufacturer:  Celgene and Agios
  • Date Approved: August 1, 2017
  • Indication:  Treatment of adults with relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation as detected by an FDA approved test.
  • Dosage Forms Available:  50mg and 100mg oral tablets
  • Launch Date: Idhifa will be launched immediately.
  • Estimated Annual Cost:  0,000
  • Specialty Status: Idhifa will be added to Express Scripts’ specialty drug list.
  • According to the American Cancer Society (ACS), approximately 21,000 patients – mostly adults over 45 years of age – are diagnosed with AML in the United States each year. Between 8% and 19% of patients with AML have IDH2 mutations.
  • AML usually begins in immature bone-marrow cells, which normally develop into a type of white blood cells known as myeloid cells. Because young myeloids divide very quickly, myeloid cancer can spread rapidly, as well; even when it is treated early and aggressively. Relapses or resistance to treatment are fairly common.
  • Idhifa is the first in a new class called IDH2 inhibitors. It blocks the activity of IDH2, an enzyme located in mitochondria, which are cell structures responsible for changing nutrients into energy. Normal IDH2 assists in the energy transition process, but mutated forms produce high levels of a chemical (2-hydroxyglutarate or 2-HG) that may contribute to cancer formation and growth.
  • Approval of Idhifa was based on a single-arm trial in which 19% patients experienced complete remission, or no evidence of disease and full recovery of blood counts, for a median of 8.2 months.
  • Almost 15% of clinical trial participants receiving Idhifa developed differentiation syndrome, a potentially fatal condition caused by very fast production of immature myeloid cells. Its symptoms include fever, difficult breathing, low blood pressure, swelling and rapid weight gain.

 

31Jul
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Second Biosimilar for Remicade Launched

Merck and Samsung Bioepis released Renflexis™ (infliximab-abda) in the United States on July 24, 2017. It is the second U.S. Food and Drug Administration (FDA)-approved biosimilar to be launched for Janssen Biotech’s tumor necrosis factor (TNF) inhibitor, Remicade® (infliximab). Pfizer/Celltrion’s biosimilar, Inflectra® (infliximab-dyyb), entered the U.S. market in November 2016. Like Remicade and Inflectra, Renflexis is FDA approved for treating ankylosing spondylitis, Crohn’s disease (for both adults and children), plaque psoriasis, psoriatic arthritis, rheumatoid arthritis (RA) and ulcerative colitis. Dosing varies by indication. A boxed warning and medication guide for all infliximab drugs notifies patients and prescribers about their potential to cause lymphomas or other cancers among children and teens, as well as serious infections for patients of any age who use them. The expected wholesale acquisition cost (WAC or list price) for a 100mg vial of Renflexis is  0, which is about 0 less per vial than the brand and about 0 less than Inflectra. In 2016, U.S. sales for Remicade were approximately billion, according to Johnson & Johnson, Janssen’s parent company. Full prescribing information is available here. 

Expanded Age Indication for Yervoy

Following a review of clinical studies with teens and children, the U.S. Food and Drug Administration (FDA) approved a pediatric indication for Yervoy® (ipilimumab – Bristol-Myers Squibb) injection for intravenous (IV) use. It now can be used to treat patients 12 years of age and older who have advanced stages of metastatic melanoma. At 3mg/Kg, dosing is based on the patient’s weight, not age. A total of four Yervoy doses are infused. Each is given over a 90-minute period with one every three weeks. Product labeling carries a boxed warning that it can cause immune-mediated adverse reactions potentially involving any organ system and possibly life-threatening. Patients should be tested for adrenal, hormone, liver, thyroid and other functions before Yervoy is initiated and before each dose. Complete, revised prescribing information is available here.

New Indication for Fycompa

On July 26, 2017, Eisai, Inc. announced that the U.S. Food and Drug Administration (FDA) had approved Fycompa® (perampanel) for use as a single agent to treat patients 12 years of age and older with epilepsy who have partial-onset seizures with or without secondarily generalized seizures. Fycompa is a selective, non-competitive ionotropic alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionic acid (AMPA) receptor antagonist – the only drug in its class. It originally was approved in October 2012 for the same types of seizures, but only in combination with other anti-epileptic drugs. It has an additional indication as part of a combination regimen to treat patients at least 12 years old who have primary generalized tonic-clonic seizures. Available in oral tablets and an oral suspension, its recommended dosing is 8mg to 12mg once a day at bedtime. A Medication Guide and a boxed warning on Fycompa’s labeling caution that taking it has been associated with behavioral, mood or personality changes and/or psychiatric effects, such as aggression, anger, anxiety, irritability or hallucinations. Some Fycompa patients think about or attempt to hurt themselves or other people. A C-III controlled substance, it also has the potential to cause dependence and/or abuse. Updated prescribing information is available here. 

Teva Launches Generic for Epiduo

Teva’s adapalene 0.1%/benzoyl peroxide 2.5%, topical gel, an AB-rated generic for Epiduo®, (Galderma Laboratories) was introduced in both 45mg tubes and 45mg pumps on July 28, 2017. It contains antibacterial and anti-inflammatory components that treat acne for patients who are nine years old and older. A pea-sized amount of the gel is applied once a day to each clean, dry affected area. Individuals using it are cautioned to avoid too much exposure to natural and artificial sunlight or use a strong sunscreen because the retinoid (adapalene) increases the risk of sunburn. Teva expects to have 180 days of exclusivity. As estimated by IMS, annual U.S. sales of Epiduo through the end of March 2017 were 1 million. Epiduo® Forte (adapalene 0.3%/benzoyl peroxide 2.5%) gel remains brand-only.

 

25thJul
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Vosevi Approved for Hepatitis C

On July 18, 2017, Gilead announced that the U.S. Food and Drug Administration (FDA) approved Vosevi™ (sofosbuvir 400mg/velpatasvir 100mg/voxilaprevir 100mg) for the re-treatment of chronic hepatitis C virus (HCV) infection in adults with genotypes 1, 2, 3, 4, 5 or 6 previously treated with an NS5A inhibitor-containing regimen, or with genotype 1a or 3 previously treated with a sofosbuvir-containing regimen without an NS5A inhibitor. The recommended dose of Vosevi is one tablet once daily for 12 weeks. Gilead plans on launching Vosevi on Monday, July 24. It will be available through open distribution. Full prescribing information is available here. 

  • Brand (Generic) Name: Vosevi™ (sofosbuvir/velpatasvir/voxilaprevir)
  • Manufacturer:  Gilead
  • Date Approved: July 18, 2017
  • Indication:  Vosevi is indicated for the re-treatment of chronic hepatitis C virus (HCV) infection in adults with genotypes 1, 2, 3, 4, 5 or 6 previously treated with an NS5A inhibitor-containing regimen, or with genotype 1a or 3 previously treated with a sofosbuvir without an NS5A inhibitor.
  • Dosage Forms Available:  Tablets containing 400mg sofosbuvir, 100mg velpatasvir, and 100mg voxilaprevir
  • Launch Date: July 24, 2017
  • Estimated Annual Cost:  The wholesale acquisition cost (WAC) of the 12-week regimen is set at,760, which is at parity to Gilead’s Epclusa® (sofosbuvir 400mg/velpatasvir 100mg).
  • Specialty Status: Vosevi will be added to Express Scripts’ specialty drug list.
  • Vosevi contains sofosbuvir, a nucleotide analog polymerase inhibitor, velpatasvir, an NS5A inhibitor, and voxilaprevir, a protease inhibitor.
  • Vosevi was approved under FDA’s priority review and breakthrough therapy programs.

AbbVie’s glecaprevir/pibrentasvir is another pan-genotypic regimen that is expected to be approved by Aug. 19, 2017, as an 8-week regimen in treatment-naïve patients and as a 12-week regimen in direct-acting antiviral-experienced chronic HCV-infected patients.

 

25Jul
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Benlysta Subcutaneous Injection Approved

On July 21, 2017, GlaxoSmithKline (GSK) announced the U.S. Food and Drug Administration (FDA) approval of a new subcutaneous (SC) formulation of Benlysta® (belimumab) for the treatment of adult patients with active, autoantibody-positive systemic lupus erythematosus (SLE). Benlysta is a biologic drug that inhibits the protein B-lymphocyte stimulator (BLyS). It has been on the market since 2011 as a one-hour intravenous (IV) infusion. The recommended dose of Benlysta IV is 10mg/kg every four weeks following induction dosing, while the recommended dose for Benlysta SC is 200mg once weekly. Patients are able to self-administer the SC formulation after receiving proper training by a healthcare provider. GSK plans on launching Benlysta SC in late August. Similar to Benlysta IV, it will be available through a large network of specialty pharmacies that includes Accredo. Click here for full prescribing information.

First Generic Approved for Renvela Tablets

The U.S. Food and Drug Administration (FDA) approved Aurobindo Pharma Limited’s generic to Genzyme’s Renvela® (sevelamer carbonate) tablets on July 17, 2017. Sevelamer carbonate is indicated to control phosphorous levels in the blood of patients as young as six years old who need dialysis to manage chronic kidney disease. The drug attaches to phosphorous, which then is eliminated from the body because sevelamer carbonate is not absorbed. The recommended adult dose is one or two tablets three times a day. Estimated sales of Renvela tablets amounted to about.9 billion for the 12 months that ended on May 31, 2017. The generic already has been launched. In mid-June, Aurobindo launched an A-rated generic to the oral suspension dosage form of Renvela.


Generic to Androgel 1.62% Packets Approved

Perrigo recently announced the approval of its A-rated generic to AbbVie’s Androgel® (testosterone gel) 1.62% packets, CIII, a product approved for treating men who have deficiencies or absences of natural (endogenous) testosterone. Although FDA approved, launch plans have not been released for the generic. According to Perrigo’s press release, U.S. sales of Androgel 1.62% packets were approximately million for the 12 months ending May 2017. Generics to Androgel 1% have been available since January 2015.

 

19Jul
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Nerlynx Approved as Adjuvant for HER2+ Breast Cancer

Puma Biotechnology, Inc. announced on July 17, 2017, that the U.S. Food and Drug Administration (FDA) approved Nerlynx™ (neratinib). A tyrosine kinase inhibitor, Nerlynx is an oral, once-a-day, extended adjuvant treatment for adults who have early stage HER2-overexpressed/amplified breast cancer. Intended to prevent cancer recurrence, it will be used following adjuvant treatment with Herceptin® (trastuzumab). Recommended dosing is six tablets (totaling 240mg) taken once daily for one year. To manage diarrhea associated with its use, patients are advised to take Imodium® (loperamide) for at least the first eight weeks of Nerlynx treatment. Puma plans on launching Nerlynx in September. It will be available through a limited network of specialty pharmacies that includes Accredo. Complete prescribing information is available here. 

  • Brand (Generic) Name: Nerlynx™ (neratinib)
  • Manufacturer: Puma Biotechnology
  • Date Approved: July 17, 2017
  • Indication: Extended adjuvant treatment for adults with early-stage HER2-overexpressed / amplified breast cancer, following adjuvant treatment with Herceptin
  • Dosage Forms Available:  40mg tablets
  • Launch Date: September 2017
  • Estimated Annual Cost:  Pricing information is not yet available.
  • Specialty Status: Nerlynx will be added to Express Scripts’ specialty drug list.
  • According to the National Cancer Institute, about 250,000 American women will be diagnosed with breast cancer in 2017. Approximately 15% of breast cancers are HER2 positive, an aggressive form of the disease that recurs for up to one-quarter of patients even after treatment with surgery and Herceptin.
  • Nerlynx is the first  drug to be FDA-approved for long-term adjuvant treatment. However, Perjeta® (pertuzumab - Genentech) has been on the U.S. market since 2012 to treat HER2+ breast cancer in combination with Herceptin. Even though it must be infused once every three weeks after initial dosing, Perjeta could compete with Nerlynx to prevent recurrences.
  • In clinical studies, approximately one-half of participants receiving Nerlynx developed serious diarrhea. To control it, Puma recommends that patients take Imodium for the first 56 days of Nerlynx therapy.

 

 

18Jul
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Blincyto Receives Full Approval

Amgen’s Blincyto® (blinatumomab) initially was approved in December 2014 under the U.S. Food and Drug Administration’s (FDA) breakthrough therapy, priority review and accelerated approval provisions. Based on phase 2 study results and dependent on further confirmation of clinical benefits, it was indicated for treating patients who have Philadelphia chromosome-negative (Ph-) relapsed or refractory B-cell-precursor acute lymphoblastic leukemia (ALL). On July 11, 2017, FDA gave it full approval and also expanded its indications to include Philadelphia chromosome-positive (Ph+) patients. The only monotherapy drug approved for treating these forms of ALL, Blincyto also is the only FDA approved immuno-oncology drug that uses bispecific CD19-directed CD3 T cell engager (BiTE®) technology. It is administered in up to five 42-day cycles that include continuous intravenous (IV) infusions on the first 28 days, followed by 14 days without treatment. Dosing is weight based. Hospitalization is recommended for the first nine days of the first treatment cycle and the first two days of the second cycle. A risk evaluation and mitigation strategy (REMS), Medication Guide for patients and a boxed warning on the labeling for Blincyto all caution about its potential to cause life-threatening adverse effects. Among patients in clinical trials, cytokine release syndrome (CRS) and neurologic toxicities, such as confusion and seizures, occurred. CRS is a flu-like condition that produces fever, headache, low blood pressure, nausea and rash. Caused by inflammatory response to the activation of T cells, it can be severe or even fatal. Revised prescribing information is available here.   

Tremfya Approved for Psoriasis

On July 13, 2017, Janssen received U.S. Food and Drug Administration (FDA) approval of Tremfya™ (guselkumab) for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic or phototherapy. Tremfya is a biologic in a new class of medications that inhibit interleukin (IL)-23. After the initial doses at weeks 0 and 4, it is administered every 8 weeks by subcutaneous injection. Janssen plans on launching Tremfya this week. It will be available through open distribution; therefore, Accredo will have access to this medication. Full prescribing information is available here.  

 

12Jul
FSBP Partners with The London Clinic

FSBP Partners with The London Clinic

  • Staff
  • FSBP   All  

Featured Partner: The London Clinic

The Foreign Service Benefit Plan is excited to announce our newest direct billing arrangement partner – The London Clinic. The London Clinic is one of the UK’s largest private hospitals dedicated to providing personalized healthcare with a breadth of surgical and medical expertise.  With over 1,000 staff in specialist teams at The London Clinic across all clinical and non-clinical areas, combined with over 300 consultant surgeons and physicians they are prepared to assist you with your care.

Our direct billing arrangement with The London Clinic covers inpatient and day patient care at four locations:

  • The London Clinic Main Hospital
  • The Duchess of Devonshire Wing
  • The London Clinic Outpatient Department
  • The London Clinic Eye Centre

For covered inpatient care, the London Clinic will bill us directly.  For all covered day patient care, you pay your deductible and 10% coinsurance.  Please note The London Clinic may bill you if a balance remains for any services not covered.

As a new patient with The London Clinic, please contact their International Office via email [email protected] or by calling +44 (0) 203 219 3266 for assistance with finding a consultant, making appointments, and assisting you with coordinating your admissions.

We strive to simplify your care overseas and are delighted to have this billing arrangement with The London Clinic.  However, if you have overseas direct billing questions, please visit our FSBP Overseas Partners page on our website, email us, or call us at +1 202-833-4910 for assistance.  Thank you for being a valued FSBP member.

Cheers to your health!

 

11Jul
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Endari Approved for Sickle Cell Disease

The U.S. Food and Drug Administration (FDA) approved Endari™ (L-glutamine) oral powder on July 7, 2017. A replacement for an amino acid deficiency resulting from sickle cell disease, Endari is indicated to decrease complications, such as acute attacks (sickle cell crises), for patients as young as five years old. In clinical trials that lasted 48 weeks, patients taking it had fewer crises, emergency room visits and hospitalizations than patients receiving placebo. They reported less pain, as well. Sickle cell disease is a genetic condition that deforms red blood cells into a characteristic crescent or sickle shape and makes them less flexible. The damaged blood cells get trapped in blood vessels, blocking normal blood flow and limiting the amounts of oxygen reaching body tissues. Anemia, fatigue, jaundice and swollen hands and feet occur frequently. Dehydration, extreme heat or cold, illness and stress can bring about crises, which also may happen spontaneously and unpredictably. Eventually, internal organs sustain significant damage. About 100,000 Americans have sickle cell disease, which is more common among individuals of African, southwest Asian, Middle Eastern, Hispanic or southern European heritage. For use, Endari powder is combined with eight ounces of a cold or lukewarm drink or about four ounces to six ounces of soft food, like pudding or applesauce, and then consumed right away. Recommended dosing is a total of 10Gm to 30Gm per day, based on body weight and taken in two doses. The manufacturer, Emmaus Life Sciences, Inc., has not yet announced launch or pricing plans for Endari. Complete prescribing information is available here.   

Generic Launched for Vigamox

Lupin launched moxifloxacin ophthalmic solution, 0.5%, the generic for Novartis’ Vigamox®, on July 5, 2017. Moxifloxacin is a fluoroquinolone antibiotic used in the eyes to treat conjunctivitis (eye infections) caused by bacteria that are susceptible to it. IMS reports that Vigamox had sales of 8 million in the U.S. for the 12-months ending on March 31, 2107.

New Indication for Orencia

On June 30, 2017, Bristol-Myers Squibb’s Orencia® (abatacept) gained the U.S. Food and Drug Administration (FDA) approval to treat adults with psoriatic arthritis (PsA). First FDA approved in 2005 for treating adults who have rheumatoid arthritis (RA), Orencia also has an indication to treat juvenile idiopathic arthritis (JIA) for patients at least two years old. It can be used alone or combined with other drugs, but it should not be given along with tumor necrosis factor (TNF) inhibitors, such as Enbrel® (etanercept) or other biologicals, such as Kineret® (anakinra). Available in both intravenous (IV) injection and subcutaneous (SC) forms, Orencia is administered once a month (IV) or once a week (SC) depending on the condition and the patient’s weight. Revised prescribing information is available here. 

 

5Jul
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and Welcome to July 2017! That means summer is in full swing. While enjoying the seasonal activities, I encourage you to maintain a healthy diet. Attending summer barbeques and family reunions can invite temptations to eat unhealthy foods. Please eat fruits and vegetables with every meal and snack. They can help your body fight off sickness. Plus, nutritious eating can give you energy and help you stay at a healthy weight. Our Mediterranean Wellness Program offers a Summer Seminar Series – a practical 9-week guide to staying healthy all summer. Enroll anytime. Learn more about the Mediterranean Wellness Program here.

July is Herbal/Prescription Interaction Month 

Medication interactions can have harmful, even deadly effects. Many commonly prescribed medications have potentially fatal side effects from interactions with other medications, over-the-counter drugs, supplements, herbal preparations, and even food. Know that over-the-counter drugs are medications too

Patients who are on these medications often don’t have access to a pharmacist with the clinical expertise to help them understand the risks and get the most benefit from their medication. Express Scripts continually works behind the scenes to assure your safety.

Update all prescriptions taken including over-the-counter drugs, herbal preparations and vitamins on your Express-Scripts Patient Medical Profile. Here’s how:

  • Register at www.express-scripts.com- Select Forms & Cards from menu under Benefit
  • Scroll to Health Questionnaire.  
  • Download Express-Scripts Mobile App- Select Medicine Cabinet from menu, follow steps.

July is National Minority Mental Health Awareness Month

Lastly, it is a time to focus on the importance of mental wellness and effective mental health care. We also can make others aware of available resources. The Foreign Service Benefit Plan offers many benefits to address your mental health needs including Digital Coaching, Health Coaching, and myStrength™ - the online mental health support program, and even video visits through our Telehealth Services with American Well. Learn about these programs and other Special features in Section 5(a) and 5(h) of your Plan Brochure.

I hope you enjoyed a happy and healthy Independence Day. Every year, this holiday commemorates the adoption of the Declaration of Independence on July 4, 1776. Many Americans celebrated with fireworks, parades, and picnics; however, we always want to remember the true meaning of the day. The Fourth of July represents our nation’s history and heritage. Wherever you are in the world, I hope you took a moment to appreciate the freedoms we have in the United States. Thank you for the work you do to protect those freedoms. 

Please enjoy your friends and family this summer. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU

CEO, AFSPA

Executive Director, Senior Living Foundation

 

5Jul

State of Emergency in Utah Due to Wildfires

  • Staff
  • All   FSBP   fsbp411  

The Governor of Utah has declared a State of Emergency due to Wildfires. All counties are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

3Jul
Closing early on July 3- In observance of Independence Day

Closing early on July 3- In observance of Independence Day

  • Kyle Longton, COO
  • FSBP   All  

AFSPA will close at 3 pm EDT on Monday, July 3. We will remain closed through the Independence Day holiday on Tuesday, July 4th. We will resume our normal business hours at 8:30 am EDT on Wednesday, July 5th.

We wish all of our members and their families a safe and fun Independence Day!

 

3Jul
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Triptodur Approved to Treat Central Precocious Puberty

The U.S. Food and Drug Administration (FDA) approved Triptodur™ (triptorelin) extended-release injectable suspension on June 30, 2017. It is a gonadotropin releasing hormone (GnRH) agonist approved to treat children at least two years old for central precocious puberty. Triptodur is to be given as one 22.5mg intramuscular (IM) injection every 24 weeks. It is packaged as a powder that will be reconstituted and administered by a healthcare professional. Children using it should be monitored every few months for bone age, height and blood sex-steroid levels. The U.S. distributor for Triptodur, Arbor Pharmaceuticals, plans a launch in the fourth quarter of 2017. Full prescribing information is available here.

New Indication for Vectibix

Amgen announced on June 29, 2017, that Vectibix® (panitumumab) has been approved by the U.S. Food and Drug Administration (FDA) to treat patients with metastatic wild-type RAS colorectal cancer. It can be used as initial therapy in combination with FOLFOX (folinic acid, fluorouracil and oxaliplatin) or by itself for patients with cancer that has progressed despite prior chemotherapy with fluoropyrimidine, oxaliplatin, and irinotecan. Along with the new indication, FDA also approved a companion diagnostic test to validate RAS status. On the U.S. market since late 2006, Vectibix has several other colorectal cancer indications. Recommended dosing is once every two weeks at 6mg/Kg infused intravenously (IV) over 30 minutes to 90 minutes, depending on the size of the dose. It carries a boxed warning that 90% of patients using it as monotherapy in clinical trials developed skin reactions ranging from dryness and itching to skin cracks and shedding. Reactions were severe for about 15% of patients. Complete prescribing information for Vectibix is available here.

 

27Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

BevyxXa Approved for Clot Prevention

On June 23, 2017, the U.S. Food and Drug Administration (FDA) approved Portola Pharmaceuticals’ BevyxXa™ (betrixaban). It is an oral, once-daily factor Xa inhibitor indicated to prevent venous thromboembolism (VTE) in hospitalized adults with acute illnesses who are at high risk for thromboembolic complications due to moderate or severe restricted mobility and other risk factors for VTE. The recommended dose is an initial dose of 160mg on day 1, followed by 80mg once daily at the same time each day, with food. Treatment should continue for 35 to 42 days. According to Portola, BevyxXa will be available as 40mg and 80mg capsules sometime between August and November 2017. Full prescribing information is available here.  

New Fluoroquinolone Antibiotic Approved

Baxdela™ (delafloxacin) was approved by the U.S. Food and Drug Administration (FDA) on June 19, 2017. It treats adults who have acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible gram-positive and gram-negative bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Baxdela is the first FDA-approved drug for Melinta Therapeutics, which has not released launch or pricing plans. Available as both oral tablets and intravenous (IV) infusions, Baxdela is dosed at 12 hour intervals for five days to 14 days. One 450mg tablet is equivalent to and interchangeable with one 300mg infusion. All fluoroquinolone antibiotics have the potential to cause tendonitis or tendon ruptures, peripheral neuropathy and central nervous system (CNS).reactions ranging from dizziness to toxic psychosis. A boxed warning on their labeling alerts patients to the risks and also cautions against their use for patients who have myasthenia gravis. Full prescribing information is available here.  

FDA Approved Cotempla XR-ODT

On June 19, 2017, Neos Therapeutics received U.S. Food and Drug Administration (FDA) approval for its once-daily Cotempla XR-ODT™ (methylphenidate) extended-release orally disintegrating tablets. It is indicated to treat attention deficit hyperactive disorder (ADHD) for children and teens between the ages of six and 17 years. Launch is planned for the autumn of 2017 in blister-packages containing 8.6mg, 17.3mg or 25.9mg tablets. Because it is a C-II controlled substance Cotempla XR-ODT has a medication guide for patients and a boxed warning about its possible abuse, misuse and/or dependence. Cotempla XR-ODT’s prescribing information is available here.  

Mydayis Approved for Treating ADHD

On June 20, 2017, U.S Food and Drug Administration (FDA) also approved Shire’s ADHD medication, Mydayis™ (mixed salts of single-entity amphetamine product, CII) capsules. It is approved for treating ADHD in patients 13 years of age and older. The recommended starting dose is 12.5mg once daily. If needed, this dose can be titrated by 12.5mg per week to a maximum daily dose of 25mg in children (13 to 17 years) and 50mg per day for adults. Mydayis has a duration of action up to 16 hours, and is a follow-on to the company’s Adderall XR® (mixed salts of single-entity amphetamine product, CII), which lasts for up to 12 hours. Shire is planning on launching Mydayis 12.5mg, 25mg, 37.5mg and 50mg extended-releases capsules during the third quarter of 2017. Pricing information is not yet available. Full prescribing information is available here.  

Mekinist and Tafinlar Combination Approved for Lung Cancer

On June 23, 2017, the U.S. Food and Drug Administration (FDA) granted approval for GlaxoSmithKline’s Mekinist® (trametinib) and Tafinlar® (dabrafenib) as a combination therapy to treat patients with metastatic non-small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test. The combination was previously approved for treating advanced melanoma that has metastasized or that cannot be surgically removed, and that has been tested as positive for specific genetic mutations – BRAF V600E or BRAF V600K. Mekinist and Tafinlar are oral kinase inhibitors; Mekinist inhibits MEK and Tafinlar inhibits BRAF. Full prescribing information is available here.  

Rituxan Hycela Approved

On June 22, 2017, the U.S. Food and Drug Administration (FDA) approved Genentech’s Rituxan Hycela™ (rituximab and hyaluronidase human) for subcutaneous injection. It is indicated to treat previously untreated and relapsed or refractory follicular lymphoma, previously untreated diffuse large B-cell lymphoma, and previously untreated and previously treated chronic lymphocytic leukemia. Patients can use Rituxan Hycela only after they have received at least one full dose of a rituximab product by intravenous infusion. While both are administered by a healthcare professional, treatment with Rituxan Hycela can be administered in five to seven minutes, compared to 1.5 hours or more for intravenous Rituxan. According to Genentech, the new formulation will be available within the next one to two weeks. Full prescribing information is available here.  

Haegarda Approved for Hereditary Angioedema

On June 22, 2017, the U.S. Food and Drug Administration (FDA) approved CSL Behring’s Haegarda® (C1 esterase inhibitor subcutaneous [human]). It is indicated for routine prophylaxis to prevent hereditary angioedema (HAE) attacks in adolescent and adult patients. The recommended dose is 60 international units (IU) of Haegarda per kilogram (kg) of body weight, injected subcutaneously twice weekly (every 3 or 4 days). CSL Behring plans to launch Haegarda during the third quarter of 2017. It will be available through a limited network of specialty pharmacies that will include Accredo. Complete prescribing information is available here.  

 

 

23Jun

State of Emergency Due to Tropical Storm Cindy in Louisiana

  • Staff
  • All   FSBP   fsbp411  

The Governor of Louisiana has declared a State of Emergency due to Tropical Storm Cindy. All counties are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

21Jun

State of Emergency Due to Tropical Storm Cindy in Alabama

  • Staff
  • fsbp411   All   FSBP  

The Governor of Alabama has declared a State of Emergency due to Tropical Storm Cindy. All counties are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

19Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

New Indication for Darzalex

On June 16, 2017, Janssen Biotech announced that a new indication has been approved by the U.S. Food and Drug Administration (FDA) for its Darzalex® (daratumumab) injection. It is now approved for use in combination with pomalidomide and dexamethasone for treating patients with multiple myeloma who have received at least two prior therapies including Revlimid® (lenalidomide – Celgene) and a proteasome inhibitor (PI). Darzalex, a CD38-directed antibody, was originally approved in November 2015 for use as a monotherapy in patients with multiple myeloma who have received at least three prior lines of therapy, including a PI and an immunomodulatory agent, or who are double-refractory to a PI and an immunomodulatory agent. In November 2016, it received additional approvals for use in combination with lenalidomide and dexamethasone, or Velcade® (bortezomib – Takeda) and dexamethasone, for treating patients with multiple myeloma who have received at least one prior therapy. Updated prescribing information for Darzalex will soon be available here. 

First Generic Launched for Pataday

Teva Pharmaceutical Industries launched olopatadine ophthalmic solution 0.2%, the first A-rated generic to Alcon Laboratories’ Pataday®, on June 9, 2017. Olopatadine is a mast cell stabilizer that helps to relieve itchy eyes caused by allergic conjunctivitis. Recommended dosing is one drop in the affected eye(s) each day. It is dispensed in 5mL plastic dropper bottles that contain 2.5mL of solution. QuintilesIMS estimates that U.S. sales for Pataday accounted for 3 million in the 12 months that ended on March 31, 2017. Teva will have 180 days of generic exclusivity.

Generic for Renvela Oral Suspension

On June 13, 2017, the U.S. Food and Drug Administration (FDA) approved Aurobindo Pharma Limited’s A-rated generic to Genzyme’s Renvela® (sevelamer carbonate) oral suspension. It is indicated to control phosphorous levels in the blood of patients as young as six years old who need dialysis to manage chronic kidney disease. The drug attaches to phosphorous, which then is eliminated from the body because sevelamer carbonate is not absorbed. Aurobindo has already begun shipments of the generic, which is available in individual foil packets that each contains either 0.8Gm or 2.4Gm of the drug. According to IMS Health, 2016 annual sales for Renvela oral suspension were approximately 7 million.

Acticlate Generic Approved

On June 14, 2017, Mayne Pharma Group received approval from the U.S. Food and Drug Administration (FDA) for its doxycycline hyclate tablets, 75mg and 150mg. Although a number of generic doxycycline products already are on the U.S. market, Mayne’s are the first for Acticlate® (Aqua Pharmaceuticals). Mayne will also have 180-day exclusivity. Doxycycline is an antibiotic indicated to treat numerous bacterial infections, including anthrax, cholera and some eye, respiratory, sexually-transmitted and urinary infections. The 75mg and 150mg tablets primarily are marketed, in combination with other therapy, to treat severe acne. Annual U.S. sales for Acticlate through the end of April 2017 were approximately 0 million, according to QuintilesIMS.

Symjepi Approved

On Jun. 15, 2017, the U.S. Food and Drug Administration (FDA) approved Adamis Pharmaceuticals’ Symjepi™ (epinephrine) injection for the emergency treatment of allergic reactions (Type I) including anaphylaxis. It is a single-dose, pre-filled syringe for manual injection that contains 0.3mg/0.3mL of epinephrine. The recommended dose for patients who weigh at least 30kg (66 pounds) is one injection, administered intramuscularly (IM) or subcutaneously (SC) into the thigh. Adamis plans to launch Symjepi by mid-summer in a package that contains two syringes. Pricing information is not yet available. However, according to the manufacturer, Symjepi will be discounted to its main competitor, EpiPen® (epinephrine auto-injector – Mylan). Full prescribing information is available here. 

Updated "Near Term Pipeline: Highly Impacted Therapy Classes” Issues Document Available

The Office of Clinical Evaluation and Policy (OCEP) has updated the “Near Term Pipeline: Highly Impacted Therapy Classes” Issues document. Several pipeline products will significantly influence drug spend by the end of 2017. Awareness of products that will have high cost or that may impact large patient populations encourages payers not only to build proactive management strategies for utilization management, but also to anticipate future plan costs. This document includes an “ESI Perspective” section, describing potential strategies that may be used to help ensure appropriate utilization of these therapies. The document is available here.  

Updated Biosimilar Issues Document Available

The Emerging Therapeutics department has updated the Biosimilars Issues Document to include the U.S. Supreme Court’s ruling that 180-day notice of biosimilar launch can be given before the U.S. Food and Drug Administration (FDA) approval and that the patent dance is optional under federal law. Based on the 180-day notice ruling, going forward, biosimilar manufacturers will be able to launch their biosimilars upon FDA approval rather than having to wait six months to launch. The Biosimilars Issues Document is available here.  

 

12Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

New Dosage Approved for Aristada

A fourth strength (1,064mg) of Aristada® (aripiprazole lauroxil – Alkermes) extended-release was approved by the U.S. Food and Drug Administration on June 5, 2017. An injectable suspension used for treating schizophrenia, Aristada now is available in single-use, prefilled syringes containing 441mg, 662mg, 882mg or 1,064mg. Lower doses are given once every four weeks or once every six weeks by a healthcare professional. The highest dose is administered once every eight weeks. Aristada is injected into the muscle of the upper arm (the lowest dose, only) or buttock. A boxed warning on its label cautions that antipsychotic drugs, including Aristada, increase the risk of death when used for elderly patients whose psychosis is caused by dementia. Full prescribing information is available here. 

First Generic for Truvada

On June 8, 2017, the FDA approved Teva Pharmaceutical’s generic for the 200mg/300mg strength of Truvada® (emtricitabine/tenofovir disoproxil fumarate – Gilead Sciences) tablets. Other strengths of Truvada remain brand only. The drug is indicated for use in combination with other antiretroviral drugs to treat HIV-1 infections for adults and children who weigh 17Kg (about 40 pounds) or more. Along with safe-sex practices and regular HIV testing, emtricitabine/tenofovir disoproxil fumarate also is FDA approved as pre-exposure prophylaxis (PrEP) for HIV-negative individuals who are at high risk of being infected. As the first generic to be FDA approved, Teva’s product has 180 days of exclusivity However, no launch or pricing plans have been announced. According to Gilead’s 2016 annual report, all strengths of Truvada accounted for U.S. sales of nearly.1 billion, last year.


Generic Approved for Lialda

The first generic for Shire’s Lialda® (mesalamine) 1.2Gm delayed-release tablets was FDA approved on June 5, 2017. Zydus Cadila was first to file, so it has 180 days of exclusivity for the drug, which is taken orally to treat mild-to-moderate ulcerative colitis. Launch is projected for July or August, but pricing currently is unknown. IMS estimates that global sales for Lialda were.2 billion for the 12-month period ending on April 30, 2017.

 

5Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Zerviate Approved to Treat Allergic Conjunctivitis

On May 30, 2017, the U.S. Food and Drug Administration (FDA) approved Nicox’s Zerviate™ (cetirizine ophthalmic solution) 0.24% to reduce itching, redness, swelling and watering of the eyes caused by allergic conjunctivitis (eye inflammation from pollen or other irritants). Although cetirizine, a second-generation antihistamine, has been available in oral forms for more than 20 years, Zerviate is the first eye drop formulation. Nicox has not announced launch or pricing plans for Zerviate. Recommended dosing is one drop into the affected eye(s) once a day. Click here for Zerviate’s complete prescribing information. Express Scripts is currently investigating the data around Zerviate for a possible utilization management strategy.

New Dose for Isentress

A new formulation of Merck’s Isentress® (raltegravir), a human immunodeficiency virus (HIV) integrase strand transfer inhibitor, was approved by FDA on May 26, 2017. Isentress® HD (raltegravir) is dosed at 1,200mg orally once-daily, administered as two 600mg tablets, taken along with other antiretroviral drugs to treat adults and children who weigh 40 Kg (88 pounds) or more and who have HIV-1. Patients who are new to HIV therapy and patients whose HIV load is suppressed while they are taking 1,600mg of Isentress (two 400mg tablets twice a day) are candidates for Isentress HD. However, it is not interchangeable with chewable or liquid forms of Isentress. Merck expects to launch Isentress HD in about one month. Click here for full prescribing information is available.

 

5Jun

Direct Billing Arrangements Update

  • Staff
  • FSBP   Overseas-Information  

As a follow up to our January 26, 2017 communication where we notified you of our efforts to update our direct billing arrangements, we are pleased to announce we have reinstated several direct billing arrangements with the following China and German facilities. Below is a list of the reinstated facilities as of June 5, 2017.

We understand the importance of these direct billing arrangements: To simplify receiving care while overseas and avoid prepaying the bill.

If you have any questions related to the process of receiving care at over 100 of our overseas partners direct billing facilities around the world, please call us at 202-833-4910. 

Thank you for being a valued FSBP member!

 

Country

City

Facility

Billing Arrangement

Reinstated

China

Beijing

Beijing United Family Hospital Co. Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Hospital Management Co., Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Jian Guo Men Clinic Co., Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Chao Wai Clinic Co. Ltd (CBD Clinic)

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family LiangMa Clinic Co., Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Health Center Co. Ltd (New Hope)

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Rehabilitation Hospital Co. Ltd.

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Fu Xing Men Clinic Co. Ltd (Financial Street)

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Wudaokou Clinic Co. Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Guangqumen Clinic Co. Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Guangzhou

 

Guangzhou United Family Yue Xiu Clinic

Inpatient/ Accidental Injury/ Complete maternity care/ All covered outpatient services

March 15, 2017

Guangzhou United Family Hospital Co. Ltd

Inpatient/ Accidental Injury/ Complete maternity care/ All covered outpatient services

March 15, 2017

Shanghai

Shanghai He Man Jia Clinic Co 

Inpatient/  Routine annual physical exam / Accidental Injury/  Complete maternity care/ All covered outpatient services

March 20, 2017

Shanghai United Family Hospital Inc.

Inpatient/  Routine annual physical exam / Accidental Injury/  Complete maternity care/ All covered outpatient services

March 20, 2017

Shanghai United Family Clinic- Minhang, Inc.

Inpatient/  Routine annual physical exam / Accidental Injury/  Complete maternity care/ All covered outpatient services

March 20, 2017

Germany

Berlin

Krankenhaus Waldfriede

Inpatient

April 7, 2017

Heidelberg

Universitätsklinikum Heidelberg

Inpatient

May 8, 2017

Mainz

Universitätsklinik Mainz

Inpatient

May 8, 2017

Mannheim

Theresienkrankenhaus und St. Hedwig-Klinik

Inpatient

June 3, 2017

 

 

 

 

5Jun
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Welcome to Summer 2017! By now, you should have seen the Spring AFSPA in Action Newsletter in your mailbox. It highlights our Annual Meeting that occurred in March 2017. The Newsletter discusses managing your blood pressure, telehealth, and frequently asked questions from members. As always, COO Kyle Longton explains our handling of some of your most difficult situations and responds to member concerns in his ongoing AFSPA Listens column. See an electronic copy of the Spring 2017 AFSPA in Action Newsletter here.   

June is Migraine and Headache Awareness month.  For anyone who has suffered from even one migraine, you know how painful and even debilitating it can be.  Please refer to page 8 of our Spring Newsletter for helpful tips.  FSBP members have access to pharmacists who specialize in the treatment of migraine headaches in the Express Scripts Neuroscience Therapeutic Resource Center through our cobranded website.

June is also Men’s Health MonthTo the 48% of our FSBP members who are men, please take the time to pay attention to your health.  If it has been more than a year since your last full physical exam, then pick up the phone today and call your primary care physicians office and book yourself an appointment.  The Plan covers your annual physical exam at 100% if you use an in-network provider in the U.S.  or any covered provider outside the U.S.  In addition, we cover:

  • Preventive services, counseling, and screenings that have a recommendation of “A” or “B” from the Unites States Preventive Task Force (USPSTF) and also are covered under the Affordable Care Act (ACA)
  • Adult routine immunizations endorsed by the Centers for Disease Control (CDC)

Summertime also means traveling to visit family or looking forward to a much-needed vacation. If you plan to travel this summer or if you have family coming to visit you, whether internationally or domestically, please consider applying for AFSPA’s travel insurance. AFSPA’s travel insurance provides referrals to physicians and hospitals, payment for medical claims, emergency evacuation, and emergency accidents and illnesses.  This plan is especially important for family members visiting you overseas if their health insurance, like Medicare, does not cover services outside the U.S.  See the full description of AFSPA’s travel insurance services here.

I hope you and your family continue to make healthy choices throughout the summer. We will do our part in delivering the level of service you have come to expect. As always, thank you for your trust in us and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

1Jun
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Rebinyn Approved for Hemophilia B

On May 31, 2017, the U.S. Food and Drug Administration (FDA) approved Rebinyn® [Coagulation Factor IX (Recombinant), GlycoPEGylated) – Novo Nordisk]. Also known as nonacog beta pegol or N9-GP, Rebinyn is an extended-release form of blood clotting Factor IX, indicated to control bleeding episodes, including before and after surgery, for patients with hemophilia B. Dosing is as needed and infused intravenously (IV) at 40 international units (IU) per Kg of the patient’s body weight for minor-to-moderate bleeds or invasive procedures; and 80IU/Kg for more serious bleeds or major surgery. Rebinyn is not approved for regular use to prevent bleeding episodes. Launch is anticipated during the first six months of 2018 through a limited network of specialty pharmacies that will include Accredo. Click here for complete prescribing information.

  • Brand (Generic) Name: Rebinyn® [Coagulation Factor IX (Recombinant), GlycoPEGylated]
  • Manufacturer: Novo Nordisk
  • Date Approved: May 31, 2017
  • Indication: Rebinyn is indicated for use in adults and children with hemophilia B for on-demand treatment and control of bleeding episodes and for perioperative management of bleeding.
  • Dosage Forms Available: Single-use vials containing 500 IU, 1,000 IU or 2,000 IU of Rebinyn, packaged with a syringe containing sterile solution for reconstitution for IV infusion
  • Launch Date: First half of 2018
  • Estimated Annual Sales:  Pricing information is not yet available.
  • Specialty Status: Rebinyn will be added to Express Scripts’ specialty drug list.
  • Hemophilia B is a hereditary bleeding disorder affecting approximately 4,000 patients in the United States. Patients produce insufficient amounts of clotting Factor IX, which leads to bleeding episodes that cause pain, irreversible joint damage and possibly life-threatening hemorrhages.
  • Several other recombinant Factor IX products are FDA approved for treating hemophilia B episodes and perioperative bleeding. Alprolix® (Biogen) and Idelvion® (CSL Behring) are long-acting forms. BeneFIX® (Pfizer), Ixinity® (Emergent Biosolutions) and Rixubis® (Baxter) are shorter acting.
  • Rebinyn is not indicated to prevent bleeding episodes. However, the other Factor IX products can be used on a regular schedule for prevention.

 

1Jun
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Generic Strattera Launched

The U.S. Food and Drug Administration (FDA) has approved the first AB-rated generics to Lilly’s Strattera® (atomoxetine), a drug approved for the treatment of attention-deficit/hyperactivity disorder (ADHD) in pediatric and adult patients. Generic exclusivity was not granted. Therefore, FDA approved generics from several manufacturers. Shipments of the generics have already begun.

  • Brand (Generic) Name: Strattera® (atomoxetine - Lilly)
  • Manufacturer: Apotex, Aurobindo, Glenmark and Teva
  • Indication: Treatment of attention-deficit/hyperactivity disorder (ADHD).
  • Dosage Forms Available:  10mg, 18mg, 25mg, 40mg, 60mg, 80mg and 100mg capsules
  • Launch Date: May 30, 2017
  • Annual U.S. Sales:.1 billion for the most recent twelve months ending in April 2017 according to IMS Health.
  • Strattera is a non-stimulant drug originally approved by FDA in 2002.
  • The last patent for Strattera expired on May 26, 2017. As a result, FDA was able to approve all eligible atomoxetine abbreviated new drug applications (ANDAs).

 

30May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Actemra Approved to Treat Giant Cell Arteritis

An additional indication was granted on May 22, 2017, by the U.S. Food and Drug Administration (FDA), for Genentech’s Actemra® (tocilizumab). It is an interleukin-6 (IL-6), first approved in 2010, to treat rheumatoid arthritis. Actemra also has additional indications for types of juvenile arthritis, as well. Now, it has become the first drug approved for patients with giant cell arteritis. Sometimes called temporal arteritis because it mainly affects arteries in the head and neck, giant cell arteritis involves inflammation of the inside linings of the arteries. The disease usually occurs after the age of 50 years, and is about three times more common among women than men. In the United States, only around 700 individuals in every 100,000 of population have it. To treat giant cell arteritis, 162mg of Actemra will be injected subcutaneously (SC) once a week. Initially, it will be given along with a corticosteroid, but the steroid dose will be decreased gradually until it is stopped. The label for Actemra cautions that its use may predispose patients to having opportunistic bacterial, fungal, viral or other infections. Before Actemra is started, prospective patients should be tested for latent tuberculosis. Click here for full prescribing information.

Zykadia Gains a New Indication

On May 26, 2017, the U.S. Food and Drug Administration (FDA) approved the expanded use of Novartis’ Zykadia® (ceritinib) to include the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive, as detected by an FDA-approved test. In the clinical trial, ASCEND-4, the average progression-free survival (PFS) was about 16.6 months for Zykadia-treated patients compared to about 8.1 months for patients treated with other standard drugs. Zykadia is an oral tyrosine kinase inhibitor (TKI) originally approved in 2014 for use in patients with ALK-positive metastatic NSCLC who progressed on or are intolerant to Pfizer’s Xalkori® (crizotinib). It is supplied as 150mg oral capsules with a recommended dose is five capsules (750mg) taken once a day. Click here for full prescribing information.

New Indication for Keytruda

For the first time, the U.S. Food and Drug Administration (FDA) has approved a drug to treat multiple types of cancer that have specific genetic characteristics (biomarkers), rather than cancers that develop from a particular body tissue. Under accelerated FDA approval, Merck’s Keytruda® (pembrolizumab) was given an indication on May 23, 2017, for treating colorectal cancer and any solid tumors that are microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). It can be used by both adults and children who have exhausted available treatments for appropriate inoperable or metastatic cancers that have worsened despite previous drug therapy. Keytruda is a human programmed death receptor-1 (PD-1)-blocking antibody initially FDA approved in September 2014. It is an immuno-oncology (I/O) drug that increases the ability of the body’s immune system to destroy cancer cells. MSH-I and dMMR tumors, estimated to affect between 15,000 and 20,000 Americans each year, are associated most often with cancers of the colon/rectum, endometrium and gastrointestinal tract. Keytruda is administered by intravenous (IV) infusion once every three weeks for up to two years, until the cancer begins to progress or until the patient can no longer take the drug. The recommended dose of Keytruda for children is 2mg/Kg of body weight (up to 200mg); for adults, the dose is 200mg. Click here for updated prescribing information.

 

23May
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Kevzara Approved to Treat Rheumatoid Arthritis

Sanofi and Regeneron Pharmaceuticals received approval for Kevzara® (sarilumab) from the U.S. Food and Drug Administration (FDA) on May 22, 2017. It is indicated to treat adults who have moderate-to-severe rheumatoid arthritis (RA) that has not been controlled adequately by previous treatment with other disease-modifying antirheumatic drugs (DMARDs). Kevzara is a monoclonal antibody that works by blocking interleukin-6, which is associated with inflammation. Recommended dosing is one 200mg subcutaneous (SC) injection once every two weeks either alone or in combination with methotrexate or other non-biological RA drugs. Labeling for Kevzara carries a boxed warning that patients using it are at an increased risk of developing infections, including some that may be life threatening. Sanofi and Regeneron launched Kevzara upon approval. It is available through open distribution. Click here for full prescribing information.

  • Brand (Generic) Name: Kevzara® (sarilumab)
  • Manufacturer: Sanofi/Regeneron Pharmaceuticals
  • Date Approved: May 22, 2017
  • Indication: Treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to one or more disease-modifying antirheumatic drugs
  • Dosage Forms Available:  Single-dose, pre-filled syringes in packages of two syringes, each containing 150mg or 200mg of Kevzara for subcutaneous injection
  • Launch Date: May 22, 2017
  • Estimated Annual Cost: Annual wholesale acquisition cost in the U.S. is,000 for either strength.
  • Specialty Status: Kevzara will be added to Express Scripts’ specialty drug list.
  • Rheumatoid arthritis is an inflammatory, autoimmune disease that attacks joints. Over 1.3 million American adults have rheumatoid arthritis, which causes pain, stiffness, swelling and deformity of the affected joints.
  • The only other IL-6 inhibitor presently FDA approved is Actemra® (tocilizumab - Genentech), which is available in both SC and intravenous (IV) forms.
  • Several other classes of DMARDs are available to treat rheumatoid arthritis. Currently, the most used are biological agents known as tumor necrosis factor alpha (TNFα) inhibitors, such as Enbrel® (etanercept - Amgen) and Humira® (adalimumab - AbbVie). Other biologics for RA include Orencia® (abatacept - Bristol-Myers Squibb) and Rituxan® (rituximab - Genentech/Biogen). Non-biologic agents include hydroxychloroquine, methotrexate and sulfasalazine -- mostly available as generics.
  • A boxed warning for Kevzara cautions that its use may predispose patients to opportunistic bacterial, fungal, viral or other infections. Before it is used, prospective patients should be tested for latent tuberculosis.
  • Kevzara will compete with Actemra; as well as with TNFα inhibitors and other biologicals.
  • A third IL-6 inhibitor, sirukumab (Janssen/GlaxoSmithKline), is under FDA review for treating rheumatoid arthritis. Its action date is September 23, 2017.

Implications: Express Scripts is currently investigating the data around Kevzara for a possible utilization management strategy.

 

22May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

FDA Expands Approved Use of Kalydeco

On May 17, 2017, the U.S. Food and Drug Administration (FDA) expanded the approved use of Kalydeco® (ivacaftor - Vertex), a product for treating cystic fibrosis (CF) in patients at least 2 years of age. Previously, it was indicated for use in patients who had one of 10 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The new indication expanded use to include patients who have one mutation in the CFTR gene that is responsive to Kalydeco based on clinical and/or in vitro assay data. This expanded indication increases treatment to include 33 mutations, impacting an additional estimated 900 patients. Click here for full prescribing information.

New Indications for Keytruda

On May 18, 2017, Merck’s Keytruda® (pembrolizumab) was granted two new indications. It received accelerated approval to treat locally advanced or metastatic urothelial carcinoma (bladder, ureter and/or urethra cancer) in patients who are not eligible for cisplatin-containing chemotherapy. Accelerated approval is given for drugs with clinical study information showing promise for treating serious or life-threatening diseases, even though studies are not completed. Keytruda also received standard approval to treat patients with locally advanced or metastatic urothelial carcinoma who have progressed on or after platinum-containing chemotherapy, or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. Keytruda, a human programmed death receptor-1 (PD-1)-blocking antibody, boosts the immune system’s ability to attack cancer cells. Keytruda's label now includes indications in melanoma, non-small cell lung cancer (NSCLC), squamous cell cancer of the head and neck (SCCHN), classical Hodgkin's lymphoma and urothelial carcinoma. Click here for revised prescribing information.


MedWatch Update

Safety Warning for Canagliflozin Drugs

Acting on new information from ongoing clinical trials, the U.S. Food and Drug Administration revised a Safety Communication that it had issued last year. Invokana®, Invokamet® and Invokamet® XR, the three FDA-approved drugs containing canagliflozin, now must have a boxed warning about their higher risk of foot and leg amputations for patients who take them. Although the risk is still very small at less than one affected patient per 1,000, participants taking canagliflozin in the CANVAS and CANVAS-R studies had about twice the risk of needing an amputation as patients taking an inactive placebo. A sodium-glucose cotransporter-2 (SGLT2) inhibitor, canagliflozin is used to treat type 2 diabetes. Whether other SGLT2 inhibitors have similar risks is not yet known. The FDA is cautioning physicians to review patient histories for peripheral vascular disease or any other conditions that might predispose individuals to amputations before prescribing canagliflozin. Doctors also should monitor all patients taking it and consider a different drug if patients have diabetic nephropathy, foot ulcers or any other complication that might result in amputation. Current canagliflozin patients are advised to continue taking the drug as prescribed, but to report immediately any pain, sores or infections on their feet or legs. More information about canagliflozin’s safety is available here.

 

19May

Direct Billing Arrangements Update

  • Staff
  • FSBP   Overseas-Information  

As a follow up to our January 26, 2017 communication where we notified you of our efforts to update our direct billing arrangements, we are pleased to announce we have reinstated several direct billing arrangements with the following China and German facilities.

We understand the importance of these direct billing arrangements: To simplify receiving care while overseas and avoid prepaying the bill. If you have any questions related to the process of receiving care at over 100 of our overseas partners direct billing facilities around the world, please call us at 202-833-4910. 

Thank you for being a valued FSBP member!

 

Country

City

Facility

Billing Arrangement

Reinstated

China

Beijing

Beijing United Family Hospital Co. Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Hospital Management Co., Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Jian Guo Men Clinic Co., Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Chao Wai Clinic Co. Ltd (CBD Clinic)

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family LiangMa Clinic Co., Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Health Center Co. Ltd (New Hope)

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Rehabilitation Hospital Co. Ltd.

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Fu Xing Men Clinic Co. Ltd (Financial Street)

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Wudaokou Clinic Co. Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Beijing United Family Guangqumen Clinic Co. Ltd

Inpatient/  Routine annual physical exam/ Accidental Injury/  Complete maternity care/ All covered outpatient services

March 16, 2017

Guangzhou

 

Guangzhou United Family Yue Xiu Clinic

Inpatient/ Accidental Injury/ Complete maternity care/ All covered outpatient services

March 15, 2017

Guangzhou United Family Hospital Co. Ltd

Inpatient/ Accidental Injury/ Complete maternity care/ All covered outpatient services

March 15, 2017

Shanghai

Shanghai He Man Jia Clinic Co 

Inpatient/  Routine annual physical exam / Accidental Injury/  Complete maternity care/ All covered outpatient services

March 20, 2017

Shanghai United Family Hospital Inc.

Inpatient/  Routine annual physical exam / Accidental Injury/  Complete maternity care/ All covered outpatient services

March 20, 2017

Shanghai United Family Clinic- Minhang, Inc.

Inpatient/  Routine annual physical exam / Accidental Injury/  Complete maternity care/ All covered outpatient services

March 20, 2017

Germany

Berlin

Krankenhaus Waldfriede

Inpatient

April 7, 2017

Heidelberg

Universitätsklinikum Heidelberg

Inpatient

May 8, 2017

Mainz

Universitätsklinik Mainz

Inpatient

May 8, 2017

 

 

 

 

15May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Kisqali/Femara Combination Package Approved

The U.S. Food and Drug Administration (FDA) approved a combination package that contains two Novartis drugs, Kisqali® (ribociclib) and Femara® (letrozole) on May 4, 2017. Kisqali initially was FDA approved in March 2017 as first-line treatment for postmenopausal women who have metastatic or advanced hormone receptor positive (HR2+), human epidermal growth factor receptor-2 negative (HER2-) breast cancer. It is indicated for use along with any aromatase inhibitor, such as anastrozole, exemestane or letrozole. The co-packs, which each contain a one-month supply of both drugs, will be launched later in May at a cost equal to Kisqali’s alone. Available in three strengths, they will be sold through an open network of specialty and traditional pharmacies. Kisqali is on Express Scripts’ specialty drug list; therefore, this combination package will be included as well. Click here for full prescribing information.

Second Indication for Bavencio

Under the U.S. Food and Drug Administration's  (FDA) accelerated approval program, Bavencio® (avelumab - EMD Serono/Pfizer) was approved on May 9, 2017, to treat patients with locally advanced or metastatic urothelial carcinoma that has progressed during or after platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy. Urothelial carcinoma accounts for around 90% of bladder cancer cases, affecting nearly 80,000 Americans each year. Once urothelial carcinoma metastasizes, the five-year survival rate is only about 5%. Bavencio is a programmed death receptor-ligand 1 (PD-L1)-blocking antibody given by intravenous (IV) infusion once every two weeks. It originally was FDA approved on March 23, 2017, to treat Merkel cell carcinoma, which is an aggressive type of skin cancer. Click here for complete prescribing information.

New Indication for Keytruda

On May 9, 2017, Merck’s Keytruda® (pembrolizumab) was granted a new indication to be used first-line to treat metastatic nonsquamous non-small cell lung cancer (NSCLC), whether or not the cancer expresses PD-L1. Keytruda will be used in combination therapy with Alimta® (pemetrexed – Eli Lilly) and carboplatin. Positive results from additional trials will be needed for full approval. Keytruda, a human programmed death receptor-1 (PD-1)-blocking antibody, boosts the immune system’s ability to attack cancer cells. Previously, the Keytruda/Alimta/carboplatin combination was limited to treating patients with NSCLC that expresses PD-1 as confirmed by a companion diagnostic test. Keytruda has additional indications for treating melanoma, classic Hodgkin lymphoma and head and neck cancers. Click here for revised prescribing information.

 

12May

State of Emergency Due to Severe Weather in Texas

  • Staff
  • FSBP   fsbp411   All  

The Governor of Texas has declared a State of Emergency due to severe weather. The Texan counties of Henderson, Rains and Van Zandt are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

9May
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Radicava Approved to Treat Amyotrophic Lateral Sclerosis

On May 5, 2017, the U.S. Food and Drug Administration (FDA) approved Radicava™ (edaravone injection) for intravenous use. It treats patients with amyotrophic lateral sclerosis (ALS). Also known as Lou Gehrig’s disease, ALS gradually destroys the nerves involved in voluntary movement. Radicava’s manufacturer, MT Pharma America, a subsidiary of the Japanese company Mitsubishi Tanabe Pharma Corp., plans a U.S. launch in August. Each 60mg (two IV bag) Radicava dose will be given by a health provider as a 60-minute intravenous (IV) infusion. During the first 28-day dosing cycle, it will be administered once a day on the first 14 days, then not at all for the next 14 days. Subsequent cycles will include infusions of Radicava on 10 of the first 14 days, then 14 days without treatment. Complete prescribing information is available here.   

  • Brand (Generic) Name: Radicava™ (edaravone)
  • Manufacturer: MT Pharma America
  • Date Approved: May 5, 2017
  • Indication:Amyotrophic lateral sclerosis (ALS)
  • Dosage Forms Available:  30mg/100mL of solution in a single-use IV bag
  • Launch Date: August 2017
  • Estimated Annual Cost: 5,500
  • Specialty Status:  Radicava will be added to Express Scripts specialty drug list.
  • In the United States, about 20,000 individuals have ALS, a progressive disease that destroys nerve cells in the brain and spinal cord (central nervous system or CNS). Patients who have it gradually lose the abilities to move, speak, swallow and even breathe. With most patients diagnosed between the ages of 40 years and 70 years, life expectancy is only three years to five years after ALS diagnosis. 
  • Around 5% to 10% of ALS patients inherit the defective gene, but the majority of cases are “sporadic” – they have no obvious cause.
  • Previously, the only FDA-approved drug for ALS was Rilutek® (riluzole – sanofi-aventis U.S.) tablets, which is believed to reduce potentially damaging excess levels of a neurotransmitter, glutamate, in the CNS.
  • In the small, six-month-long clinical trial of Radicava that was conducted in Japan, disease progression was slower for participants who were treated with it compared with those who received placebo. Many of the participants in each group also were taking Rilutek. Although the way it works is not known, Radicava may shield CNS nerves from damage.

 

9May

STATE OF EMERGENCY IN FLORIDA DUE TO WILDFIRES

  • Staff
  • All   FSBP   fsbp411  

The Governor of Florida has declared a State of Emergency due to wildfires. All counties in Florida are impacted.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

8May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

New Indication Approved for Bunavail

Bunavail® (buprenorphine/naloxone – BioDelivery Sciences International) buccal film was given a second indication by the U.S. Food and Drug Administration (FDA) on April 27, 2017. Bunavail is a C-III controlled substance that was originally approved in 2014 for the maintenance phase of opioid addiction treatment. Now, it also is indicated for initial (induction) treatment for patients beginning therapy. Using BioDelivery’s proprietary BioErodible MucoAdhesive (BEMA®) technology, Bunavail sticks to the inside of the cheek and dissolves to release the drugs. It is used once a day in comprehensive treatment plans that include counseling and psychosocial support. Under the Drug Addiction Treatment Act (DATA), prescribing of Bunavail is restricted to physicians who are specially trained and registered with the U.S. Department of Health and Human Services. Patients are given a medication guide that details correct use of Bunavail, as well as warnings about its many possible side effects. With a recommended daily maintenance dose of 8.4mg buprenorphine/1.4mg naloxone, Bunavail is available in three strengths. Its full prescribing information is available here.  


Expanded Indication for Ravicti

On April 28, 2017, the FDA approved Ravicti® (glycerol phenylbutyrate – Horizon Pharma) oral liquid for treating patients who are as young as two months of age and who have a urea cycle disorder. Rare hereditary conditions estimated to affect fewer than 150 new patients per year in the U.S., urea cycle disorders are caused by shortages of one or more enzymes that eliminate nitrogen (converted into ammonia) from the blood. For patients with a urea cycle disorder, excess ammonia accumulates — eventually causing brain damage, which could result in death. Ravicti initially was FDA approved to treat urea cycle disorder patients two years of age and older. It must be used along with a protein-restricted diet and, possibly, dietary supplements. The recommended dose of Ravicti is 4.5mL/m2/day to 11.2mL/m2/day in three equally divided doses that are given, along with food or infant formula, by mouth, nasogastric tube or gastrostomy tube. Complete prescribing information is available here.   

 

4May
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and welcome to May 2017! At the American Foreign Service Protective Association (AFSPA), we aim to provide you with a valuable combination of services that you can use to manage your health and well-being. Just to name a few, AFSPA offers comprehensive health coverage through the Foreign Service Benefit Plan (FSBP), dental coverage, long-term care planning services, travel benefits, life insurance, and disability income insurance.

May is National Disability Insurance Awareness Month

Disability income insurance is often overlooked because many people think a disabling illness or injury will never happen to them. But it happens more than they think.  Most Federal employees earn very generous sick leave benefits, but it may take a while, several years, to build up adequate time.  While many in the Federal workforce have enough sick leave to get them through months of a long-term illness or injury,  many more are faced with severe financial challenges should they not be able to work for an extended period of time. If you are a newly hired employee, do not have a substantial amount of sick leave, or you just want added protection, you should consider applying for AFSPA’s Disability Plan which covers 60% of your annual salary –that’s up to,000 a month. We offer two (2) disability plans you can choose from to meet your needs. Click here to learn more.

FSBP Member Benefit: Quest Diagnostics – Outpatient Lab Card

Did you know that FSBP members can receive covered outpatient lab tests performed in the U.S. at no cost - no deductible, no copays, and no coinsurance, as long as you use the Quest Diagnostics Outpatient Lab Card Program? If you are an FSBP member, a Lab Card packet recently was mailed to you that includes two (2) Lab Cards and four (4) stickers to affix to your FSBP ID card(s). To use this benefit, simply present your Quest Diagnostics Lab Card and/or FSBP ID card with the Lab Card sticker affixed to it to your physician and mention you would like to use the Quest Outpatient Lab Card benefit! Click here to learn more.

Senior Living Foundation supports Foreign Affairs Day

Lastly, the Senior Living Foundation (SLF) is once again a proud sponsor of Foreign Affairs Day, happening on Friday, May 5, 2017. This event serves as a homecoming for retirees from the State Department and provides them with an opportunity to engage with active officers and learn about current developments at State. Visit the SLF website at www.slfoundation.org to view past event photos or to make a worthwhile contribution to the Foundation. Your tax deductible donation will assist the many elderly Foreign Service colleagues who turn to the Foundation when they have nowhere else to go for assistance.

I truly hope you enjoy your Memorial Day holiday with your family, as we remember the sacrifices of the men and women who gave their lives in service to our country. As always, thank you for being a valued member and for your continued confidence in our ability to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

2May
Clinical Matters News Flash

Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

Imfinzi Approved for Bladder Cancer

On May 1, 2017, the U.S. Food and Drug Administration (FDA) gave accelerated approval to AstraZeneca’s Imfinzi™ (durvalumab). It is a programmed death ligand 1 (PD-L1) inhibitor approved for use in patients whose locally advanced or metastatic urothelial carcinoma (bladder, ureter and/or urethra cancer) progresses during or following platinum-containing chemotherapy. Imfinzi also is indicated for patients who have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. Recommended dosing is 10mg/Kg of body weight once every two weeks as a one-hour intravenous (IV) infusion. Complete prescribing information is available here. 

  • Brand (Generic) Name: Imfinzi™ (durvalumab )
  • Manufacturer: AstraZeneca
  • Date Approved: May 1, 2017
  • Indication: To treat patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or who have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy
  • Dosage Forms Available:  single-use vials each containing either 500mg of Imfinzi in 10mL of solution or 120mg in 2.4mL
  • Launch Date: Launch plans are unknown at this time
  • Estimated Annual Cost: Pricing information not yet available. However, it will likely be in line with similar products with a cost of at least 0,000 per year.
  • Specialty Status:  Infinzi will be added to Express Scripts specialty drug list.
  • Urothelial carcinoma also is called transitional cell carcinoma because it usually begins in the transitional cells that line the urinary tract. It is the most common form of bladder cancer, affecting nearly 80,000 Americans each year. About three times as many men as women have it and most newly diagnosed patients are 55 years old or older.
  • Ventana Medical System’s VENTANA PD-L1 (SP263) Assay also was FDA approved on May 1, 2017 as a companion diagnostic
  • Imfinzi is a programmed death ligand 1 (PD-L1) inhibitor -- immunotherapy that helps the body’s immune system attack cancer cells
  • Interim results from participants in the main clinical trial showed an objective response rate of 26.3% among patients who scored high on the diagnostic test for PD-L1.
  • Other PD-1/PD-L1 blockers are available in the U.S. In May 2016, Genentech’s Tecentriq™ (atezolizumab) became the first PD-L1 blocker to gain an FDA indication for bladder cancer, with approval for first-line bladder cancer treatment granted in February 2017. Bristol-Myers Squibb’s Opdivo® (nivolumab) was approved for urothelial carcinoma in February 2017 and Merck’s Keytruda® (pembrolizumab) is expected to be approved by June 14, 2017, for the same indication, as well.

 

2May

States of Emergency Due to Flooding in Arkansas and Kansas

  • Staff
  • fsbp411   All   FSBP  

The Governors of Arkansas and Kansas have declared States of Emergency due to flooding. All counties in Arkansas are impacted. The following counties in Kansas are impacted: Bourbon, Cherokee, Cheyenne, Crawford, Decatur, Gove, Graham, Greeley, Logan, Neosho, Norton, Rawlins, Sheridan, Sherman, Thomas, Wallace and Wichita.  

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

1May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Liquid Dose Form of Methotrexate Approved

Xatmep™ (methotrexate) Oral Solution was approved by the U.S. Food and Drug Administration (FDA) on April 25, 2017. It is indicated to treat pediatric patients who have acute lymphoblastic leukemia (ALL) or polyarticular juvenile idiopathic arthritis (pJIA). For ALL, it will be used along with other oncology drugs and taken once a week at a dose of 20mg/m2. Recommended dosing for pJIA is 10mg/m2 per week. A boxed warning on all methotrexate products cautions that it can cause severe side effects in the bone marrow, gastrointestinal (GI) system, kidneys, liver and lungs. Additionally it can trigger hypersensitivity reactions, infections or skin reactions. If methotrexate is taken during pregnancy, the fetus may be harmed severely. Xatmep’s manufacturer, Silvergate Pharmaceuticals, has not yet disclosed launch or pricing plans. It will be dispensed in 120mL bottles containing 2.5mg/mL of methotrexate. Complete prescribing information is available here. 


RoxyBond Approved for Pain

Inspirion Delivery Sciences announced the U.S. Food and Drug Administration (FDA) approval for RoxyBond™ (oxycodone) tablets on April 26, 2017. A C-II controlled substance, RoxyBond is an immediate-release opioid intended to treat severe pain that needs continual management and that does not respond to other treatments. It has been formulated; both chemically and physically, to be difficult to break, crush or dissolve; making it challenging to abuse by injection. It still may be misused through ingestion, inhalation or intravenous (IV) administration, however. Labels for all opioids, regardless of their abuse-deterrent properties, have a boxed warning that taking them may be associated with abuse, addiction, misuse, overdose and death. Babies born to women who use them during pregnancy may suffer neonatal withdrawal syndrome and older children may overdose, possibly fatally, from taking them unintentionally. To be released as 5mg, 15mg and 30mg strength tablets, RoxyBond’s launch date has yet to be determined. Full prescribing information is available here. 

Liver Cancer Indication Approved for Stivarga

Under the U.S. Food and Drug Administration's (FDA) priority review process, Stivarga® (regorafenib - Bayer) was approved on April 26, 2017, to treat hepatocellular carcinoma (HCC) for patients previously treated with Nexavar® (sorafenib - Bayer). Both drugs are oral tyrosine kinase inhibitors (TKIs) that work in different ways. Stivarga interferes with several enzymes that promote cancer growth, including some in the vascular endothelial growth factor (VEGF) pathway. In the phase III RESOURCE clinical trial, overall survival time for HCC patients who took 160mg of Stivarga per day for the first 21 days of each 28-day cycle averaged 10.6 months as compared to 7.8 months for study participants taking an inactive placebo. Patients in both groups also received supportive care, such as pain management. Stivarga has prior FDA indications as second-line therapy for metastatic colorectal cancer and for gastrointestinal stromal tumors (GIST). Its labeling has a boxed warning that it may cause liver damage, so liver function must be monitored carefully during its use. Complete prescribing information for Stivarga is available here. 

Thymoglobulin Approved to Prevent Acute Kidney Transplant Rejection

Sanofi’s Thymoglobulin® [anti-thymocyte globulin (rabbit)] has received a second U.S. Food and Drug Administration (FDA) indication — for preventing acute rejection of transplanted kidneys. It is given along with immunosuppressant therapy, as well as antibacterials, antifungals or antivirals if needed. It has been FDA approved since 1998 for treating kidney transplant rejection. Recommended dosing to prevent rejection is 1.5mg/Kg of body weight administered once a day as an intravenous (IV) infusion. It is administered over six hours on the first day and then over four hours on following days. The first infusion begins before blood flow is established to the transplanted kidney and treatment lasts between four days and seven days. The labeling for Thymoglobulin includes a boxed warning that it should be administered only in a hospital and by clinicians who are experienced with its use due to the risk it might suppress immune function too much. Both platelet count and white blood cell count should be monitored during therapy and after treatment is discontinued. Thymoglobulin’s prescribing information is available here. 


Praluent Approved for Once-a-Month Dose

On April 24, 2017, the U.S. Food and Drug Administration (FDA) approved a once-monthly dose for the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, Praluent® (alirocumab). Jointly developed by Regeneron Pharmaceuticals and Sanofi, Praluent treats adults who have heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease (ASCVD) and who require additional lowering of low-density lipoprotein (LDL) cholesterol despite diet modifications and the maximum dose of a HMG-CoA reductase inhibitor (statin). Praluent is available in syringes or auto-injector pens, each pre-filled with 75mg or 150mg of the drug. For the once-monthly dose, two of the 150mg doses will be given at the same time but at different sites on the abdomen, thighs or upper arms. Prescribing information is available here. 

Rydapt Approved for Acute Myeloid Leukemia and Systemic Mastocytosis

On April 28, 2017, Novartis received approval from the U.S. Food and Drug Administration (FDA) for Rydapt® (midostaurin) for the first-line treatment of adults with FMS-like tyrosine kinase 3 mutation-positive (FLT3+) acute myeloid leukemia (AML) as detected by an FDA-approved test, in combination with chemotherapy. It is also approved to treat adults with aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM-AHN) or mast cell leukemia (MCL). The recommended dose for AML is 50mg twice daily with food. For ASM, SM-AHN and MCL, the recommended dose is 100mg twice daily with food. Novartis plans on launching Rydapt in the near future. It will be available through open distribution. Full prescribing information is available here. 

Tymlos Approved to Treat Osteoporosis

Tymlos™ (abaloparatide) was approved by the U.S. Food and Drug Administration (FDA) on April. 29, 2017, to treat postmenopausal women who have osteoporosis and who also have a high risk of fracture. A human parathyroid hormone related peptide (PTHrP[1-34]) analog, its recommended dose is one 80mcg subcutaneous injection into the abdomen each day. A boxed warning on its labeling warns that using Tymlos may increase the risk of osteosarcoma (bone cancer). Tymlos is available in pre-filled, disposable pen devices containing 30 doses (a total of 3,120mcg) of Tymlos in a total 1.56mL of solution.  Using it for longer than a total of two years is not recommended, whether or not use is continuous. The manufacturer, Radius Health, plans to launch Tymlos in late-May 2017; it will be available through open distribution. Full prescribing information is available here.  

Alunbrig Approved for Non-Small Cell Lung Cancer

Takeda Oncology’s Alunbrig™ (brigatinib) received accelerated approval from the U.S. Food and Drug Administration (FDA) on April 28, 2017. An oral tyrosine kinase inhibitor (TKI), Alunbrig is  indicated for treating patients who have metastatic anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer (NSCLC) and who have progressed on or are intolerant to Xalkori® (crizotinib – Pfizer/EMD Serono). Alunbrig is available in 30mg and 90 mg tablets.  Recommended dosing is 90mg per day for one week, followed by 180mg per day, if the patient can tolerate the higher dose. Takeda Oncology plans on launching Alunbrig in mid-May. It will be available through a limited network of specialty pharmacies that includes Accredo. Complete prescribing information is available here. 

 

 

1May

States of Emergency Due to Flooding in Missouri and Oklahoma

  • Staff
  • fsbp411   All   FSBP  

The Governors of Missouri and Oklahoma have declared States of Emergency impacting all counties in each state due to flooding.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

28Apr
 Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Brineura Approved for Late Infantile Neuronal Ceroid Lipofuscinosis Type 2

The U.S. Food and Drug Administration (FDA) approved Brineura™ (cerliponase alfa) on April 27, 2017. It is an enzyme replacement therapy for children at least three years old who have a rare form of Batten disease known as late infantile neuronal ceroid lipofuscinosis type 2 (CLN2). It helps affected children maintain the ability to crawl or walk. Brineura is infused under sterile conditions directly into cerebrospinal fluid of the brain using an implanted reservoir and catheter. The recommended dose is 300mg administered over four and one-half hours every two weeks. BioMarin Pharmaceuticals plans to begin sales within six weeks. Distribution will be through hospitals only. Prescribing information is available here. 

  • Brand (Generic) Name: Brineura (cerliponase alfa)
  • Manufacturer: BioMarin Pharmaceuticals
  • Date Approved: April 27, 2017
  • Indication: To slow the loss of the ability to walk or crawl (ambulation) in symptomatic pediatric patients three years of age and older with late infantile neuronal ceroid lipofuscinosis type 2 (CLN2)
  • Dosage Forms Available:  150mg/5mL (30mg/mL) solution, two single-dose vials per carton co-packaged with Intraventricular Electrolytes Injection 5mL in a single-dose vial for intraventricular infusion
  • Launch Date: Early June 2017
  • Estimated Annual Cost: Pricing information not yet available.
  • Specialty Status:  Brineura will be added to Express Scripts specialty drug list.
  • Batten disease includes a collection of hereditary neurological disorders that affect only two to four babies in every 100,000 live births. 
  • Patients with CLN2 lack the enzyme tripeptidyl peptidase-1 (TPP1), which causes developmental delays, muscle spasms, seizures, vision loss and other neurological symptoms. Only about 20 infants per year are born with CLN2 in the United States. Symptoms typically begin between the ages of two and four years, patients gradually lose function, including speech and most cases are fatal before the age of 12 years.
  • Brineura is the first drug FDA approved to treat CLN2. Continuing studies will test its use for children under two years of age and its long-term effects over 10 years.
  • Before Brineura is given, patients should be pre-treated with an antihistamine, a fever reducer and/or a corticosteroid. After administration, electrolyte infusions are recommended.

 

27Apr
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Generics to Vytorin Launched

The U.S. Food and Drug Administration (FDA) approved AB-rated generics to Merck’s Vytorin® (ezetimibe and simvastatin), a product approved to lower high blood cholesterol. Generic exclusivity was not granted. Shipments of the generics have already begun from at least three companies, Dr. Reddy’s Laboratories, Impax and Teva.

  • Brand Drug: Vytorin® (ezetimibe and simvastatin – Merck)
  • Indication: For use as an adjunctive therapy to diet to treat patients with primary or mixed hyperlipidemia. It is also approved as an adjunct to other lipid-lowering treatments for patients with homozygous familial hypercholesterolemia (HoFH).
  • Generic Manufacturer(s): Dr. Reddy’s Laboratories, Impax, Teva
  • Launch Date: April 26, 2017
  • Dosage Forms Available: Tablets (ezetimibe/simvastatin): 10mg/10mg, 10mg/20mg, 10mg/40mg, 10mg/80mg
  • Annual U.S. Sales: 7 million for the twelve month period that ended on Feb. 28, 2017, according to IMS Health.
  • Vytorin, a combination of two drugs, was first approved by the FDA in 2005. Simvastatin (Zocor®, generics) belongs to a class of cholesterol-lowering medications known as HMG-CoA reductase inhibitors, or “statins”. Ezetimibe (Zetia®, generics) is a unique drug that inhibits the absorption of cholesterol by the small intestine.

 

19Apr
“FSBP Members - Coming Soon To Your Mailbox

“FSBP Members - Coming Soon To Your Mailbox"

  • AFSPA Staff
  • FSBP  

Your Quest Diagnostic Lab Card is in route to you! 

A Lab Card packet containing a welcome letter, two (2) Lab Cards and four (4) stickers to put on your FSBP ID card(s) or medical files at your Doctor’s office, and a document explaining how the Lab Card program works. 

While waiting for your Lab Card, you can print a temporary one by visiting www.Labcard.com, select the option “print a temporary card” or request one by email at [email protected].

Questions?  Call one of our Health Benefits Officers at 202-833-4910 for assistance.

As always, thank you for being a valued FSBP member!

 

18Apr
Clinical News and Notes

Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

MedWatch Update

Aranesp, Epogen and Procrit

The U.S. Food and Drug Administration (FDA) has rescinded the risk evaluation and mitigation strategy (REMS) for the erythropoiesis-stimulating agents (ESAs) Aranesp® (darbepoetin alfa – Amgen), Epogen® (epoetin alfa – Amgen), and Procrit® (epoetin alfa – Johnson &Johnson). Beginning in 2004, FDA requested labeling updates, physician communications and other regulatory changes after continuing reports of severe side effects from ESAs. They may increase the risk of serious anemias, adverse cardiovascular events, worsened kidney disease and tumor progression or recurrence for some cancers types. In 2011, a REMS was implemented, requiring healthcare professionals who prescribe and hospitals that dispense ESAs for cancer patients to enroll in training under the APPRISE Oncology Program. It also requires that patients be counseled about risks and that both patients and prescribers sign forms acknowledging the risks prior to initiating ESA therapy. After analyzing more recent information, which includes usage patterns, FDA has withdrawn the REMS and discontinued the APPRISE Oncology Program. Additional information is available here.

 

 

 

14Apr
Product Recall

Product Recall

  • Express Scripts
  • Prescription   FSBP  

Express Scripts Managing EpiPen® (epinephrine injection, USP) and EpiPen Jr® (epinephrine injection, USP) Auto-Injectors Recall

Epinephrine is the first-line treatment for a life-threatening allergic reaction (anaphylaxis) and access to this product is critical in the event of an emergency. Meridian Medical Technologies, a Pfizer company and Mylan’s manufacturing partner for EpiPen Auto-Injector, has announced a voluntary recall for select lots of EpiPen® (epinephrine injection, USP) and EpiPen Jr® (epinephrine injection, USP) Auto-Injectors.  The recalled lot numbers are below and were distributed from December 15, 2015 through July 1, 2016. 

Express Scripts Pharmacy has mailed member notification letters this week.

Additional Information:

Product: EpiPen®  (epinephrine injection, USP) Auto-Injectors and EpiPen Jr® (epinephrine injection, USP) Auto-Injectors

  • Dosage: EpiPen® is 0.3 MG; EpiPen Jr® is 0.15 mg
  • Indication: treatment for a life-threatening allergic reaction (anaphylaxis)
  • Manufacturer: Meridian Medical Technologies
  • Lots impacted for EpiPen Jr®:
  • Lot: 5GN767/Expiry: April 2017
  • Lot: 5GN773/Expiry: April 2017
  • Lot:  6GN215/Expiry: Sep. 2017
  • Lots impacted for EpiPen®:
  • Lot: 5GM640/ Expiry: May 2017
  • Lot: 6GM081/ Expiry: September 2017
  • Lot:  6GM198/ Expiry: October 2017
  • Lot: 5GM631/ Expiry: April 2017
  • Lot: 6GM088/ Expiry: October 2017
  • Lot: 6GM087/ Expiry: October 2017
  • Lot: 6GM082/ Expiry: September 2017
  • Lot: 6GM199/ Expiry: October 2017
  • Lot: 6GM072/ Expiration Date: September 2017
  • Lot: 6GM091/ Expiration Date: October 2017
  • Type of recall: Voluntary
  • Reason for Recall: due to the potential that these devices may contain a defective part that may result in the devices’ failure to activate.
  • Return/Replacement information: Patients with unused EpiPen or EpiPen Jr. Auto-Injector product bearing the recalled lot number should contact Stericycle at 877-650-3494, Monday through Friday 8 a.m. - 10 p.m. ET, or Saturday and Sunday 8 a.m.-5 p.m. ET.  Stericycle will provide a voucher number to cover the cost for replacing each 2 pak of recalled product. Stericycle will also facilitate the return of the recalled product for Mylan.

 

13Apr
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Ingrezza Approved for Tardive Dyskinesia

On April 11, 2017, Neurocrine Biosciences received approval from the U.S. Food and Drug Administration (FDA) for Ingrezza™ (valbenazine) capsules for the treatment of adults with tardive dyskinesia (TD). The initial dose is 40mg once daily. After a week, it can be increased to the recommended dose of 80mg once daily. Neurocrine plans on a May 1, 2017 launch. It will be available through a limited network of specialty pharmacies that does not include Accredo. Full prescribing information is available here.  

  • Brand (Generic) Name: Ingrezza™ (valbenazine)
  • Manufacturer: Neurocrine Biosciences
  • Date Approved: April 11, 2017
  • Indication: Treatment of adults with tardive dyskinesia
  • Dosage Forms Available: 40mg capsules
  • Launch Date: Ingrezza will be launched on May 1, 2017
  • Estimated Annual Cost: Neurocrine plans to announce the price for Ingrezza on its launch date.
  • Specialty Status: Ingrezza will be added to Express Scripts’ specialty drug list.
  • Tardive dyskinesia, which is characterized by abnormal, involuntary movements, affects as many as 500,000 patients in the U.S.
  • Ingrezza is a vesicular monoamine transporter 2 (VMAT2) inhibitor.
  • Austedo™ (deutetrabenzine – Teva) and Xenazine® (tetrabenazine – Valeant Pharmaceuticals, generics) are also VMAT2 inhibitors; however they are only approved for treating chorea associated with Huntington’s disease.
  • Prescribing information for both Austedo and Xenazine contains a boxed warning concerning the risk of depression and suicidality. Ingrezza’s labeling does not contain a similar boxed warning.
  • Austedo is expected to receive an expanded indication to treat tardive dyskinesia by August 30, 2017.

 

10Apr
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Full Approval and Extended Indication for Ibrance

On March 31, 2017, the U.S. Food and Drug Administration (FDA) converted the initial accelerated approval of Pfizer’s Ibrance® (palbociclib) to regular approval. It now has full approval, along with any aromatase inhibitor (such as anastrozole, exemestane or letrozole), for the initial treatment of postmenopausal women who have advanced or metastatic hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer. Ibrance was the first cyclin-dependent kinase 4/6 (CDK 4/6) inhibitor to receive FDA approval. The drug works by interfering with parts of cancer cell division. It has had accelerated approval for the first-line indication since February 2015, but only in combination with letrozole. Results from the Phase 3 PALOMA-2 trial showed that the average progression-free survival (PFS) time for women who took the combination of Ibrance with letrozole was a little over two years as compared to about 14.5 months for those taking a placebo with letrozole. It also has approval, combined with Faslodex® (fulvestrant - AstraZeneca) injection, as first-line therapy to treat HR+/HER2- breast cancer that has worsened after previous endocrine-based treatment. The recommended dosing is on 28-day cycles with one 125mg capsule taken daily on the first 21 days, only. The Ibrance dose may be reduced if side effects occur. Prescribing information is available here.   


Sovaldi and Harvoni Approved for Pediatric Hepatitis C 

On April 7, 2017, FDA approved the use of Gilead’s Sovaldi® (sofosbuvir) and Harvoni® (ledipasvir/sofosbuvir) for treating hepatitis C virus (HCV) infections in patients as young as 12 years of age, or at least 77 pounds (35kg). Both are oral direct-acting antiviral drug regimens for treating HCV infections. Harvoni can be used in children who have genotype 1, 4, 5 or 6 chronic HCV infections. Sovaldi is indicated for use, in combination with ribavirin, in pediatric patients with genotype 2 or 3 chronic HCV infection. According to the Centers for Disease Control and Prevention (CDC), an estimated 23,000 to 46,000 children in the U.S. are infected with HCV, usually infected at birth. Updated prescribing information is available here:

 

5Apr
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Austedo Approved for Chorea Associated with Huntington’s Disease

On April 3, 2017, Teva received approval from the U.S. Food and Drug Administration (FDA) for Austedo™ (deutetrabenazine) for the treatment of chorea associated with Huntington’s disease (HD). The recommended starting dose is 6mg once daily. The dose should be titrated up at weekly intervals by 6mg per day to a maximum dose of 24mg twice daily. Total daily doses of 12mg or above should be divided into two doses. Teva plans on launching Austedo within the next 3 weeks. It will be available through a limited network of specialty pharmacies that does not include Accredo. Full prescribing information can be found here. 

  • Brand (Generic) Name: Austedo™ (deutetrabenazine)
  • Manufacturer: Teva Pharmaceutical Industries
  • Date Approved: April 3, 2017
  • Indication: Treatment of chorea associated with Huntington’s disease
  • Dosage Forms Available: 6mg, 9mg and 12mg tablets
  • Launch Date: By April 25, 2017
  • Estimated Annual Cost: The wholesale acquisition cost (WAC) of Austedo is,000 per year for the recommended dose of 24mg twice daily.
  • Specialty Status: Austedo will be added to Express Scripts’ specialty drug list.
  • Huntington’s disease (HD) is a fatal neurodegenerative disorder that affects more than 35,000 Americans. Chorea, which occurs in approximately 90% of patients with HD, is associated with abnormal, involuntary movements.
  • Austedo is a vesicular monoamine transporter 2 (VMAT2) inhibitor.
  • Xenazine® (tetrabenazine – Valeant Pharmaceuticals, generics), another VMAT2 inhibitor, has been the only drug approved for HD since 2008. Xenazine is dosed three times daily compared to twice daily for Austedo.
  • Similar to Xenazine, the labeling for Austedo contains a boxed warning concerning the risk of depression and suicidality. However, the risk of depression and suicidality is lower with Austedo compared to Xenazine.
  • Austedo is expected to receive an expanded indication to treat tardive dyskinesia by Aug. 30, 2017. Tardive dyskinesia, which is characterized by abnormal, involuntary movements, affects as many as 500,000 patients in the U.S.
  • A third VMAT2 inhibitor, Ingrezza (valbenazine – Neurocrine Biosciences), is expected to be approved for tardive dyskinesia by April 11, 2017.

 

3Apr
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and Welcome to April 2017! What a privilege and a responsibility it is to play a role in serving more than 67,000 AFSPA members every day. I am honored by the trust that each person places in the Foreign Service Benefit Plan (FSBP) and our other programs.

April is designated as World Autism Month. This annual event sets aside time to help increase understanding of Autism Spectrum Disorder. Applied Behavior Analysis (ABA) has proven to be successful in the treatment of autism. It uses the principles of learning and motivation from the scientific study of behavior. FSBP now covers medically necessary assessment and treatment of Autism Spectrum Disorder with ABA. FSBP pays 90% of the Plan allowance when services are delivered by an in-network behavioral health provider or a provider outside the 50 United States, and 70% of the Plan allowance for out-of-network providers. The covered providers must possess specific licenses or certifications in ABA therapy, as explained in the FSBP Brochure. All treatment must be preauthorized, even if rendered outside the USA. We are pleased to provide a benefit that supports treatment for autism.

FSBP has updated our Notice of Privacy Practices (NPP), effective April 1, 2017. The Notice of Privacy Practices describes how your medical information may be used and disclosed. It also explains how you can get access to this information.

The NPP describes:

  1. How your confidential medical information (i.e., Protected Health Information [PHI]) may be used and disclosed;
  2. How you can get access to your PHI; and
  3. FSBP's responsibilities. 

Please review the NPP carefully. For the reference, this updated NPP appears on the “All About FSBP” web page, under the "Your right to access your protected health information" section. It also appears:

  • On FSBP’s website footers;
  • On Member Portal;
  • On My Online Services (MOS - the shared Coventry/Aetna and FSBP website);
  • In new FSBP member packets; and
  • In other FSBP member communications, where applicable.

If you have any questions about the content of the updated NPP, please call a Health Benefits Officer at 202-833-4910.

Lastly, you may know from our 2016 Summer Newsletter that AFSPA strives to “walk the walk” in terms of wellness and fitness. This past March, AFSPA held a health fair for its employees, hosted by Virginia Hospital Center. The staff were able to check their blood pressure, create their own stress ball, and test their flexibility. We provided numerous resources on wholesome eating and proper nutrition. One handout even cited information on healthy food options at popular fast food restaurants. The AFSPA staff enjoyed the opportunity to interact with the various health professionals. Like you, we are taking “Simple Steps” to lead a healthier lifestyle.

As a reminder, please look for your 2017 AFSPA in Action Spring Newsletter to arrive in your mailboxes soon. I hope you enjoy the season. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU

CEO, AFSPA

Executive Director, Senior Living Foundation

 

 

3Apr
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Qudexy XR Indicated to Prevent Migraine Headaches

Upsher-Smith Laboratories’ Qudexy® XR (topiramate) extended-release capsules got FDA approval on March 30, 2017, to prevent migraine headaches for patients at least 12 years old. Previously approved to manage some types of seizures, Qudexy XR will be taken once daily at bedtime to block migraines. Its starting dose is 25mg, which is increased over four weeks or longer to a maintenance dose of 100mg per day. Medication Guides for Qudexy XR and other drugs like it warn that the drugs may cause fever, mood changes and vision problems. Patients taking Qudexy XR for any reason should not stop it suddenly. Prescribing information is available here. 

 

30Mar
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Zejula Approved for Recurring Ovarian Cancer Treatment

Tesaro, Inc. received priority-review approval for Zejula™ (niraparib) from the U.S. Food and Drug Administration (FDA) on March 27, 2017. It is indicated for maintenance treatment of women who have responded at least partially to platinum-based chemotherapy for recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer. Although it is a poly ADP-ribose polymerase (PARP) inhibitor, Zejula does not require testing for a biomarker, such as BRCA gene mutations, like other PARP inhibitors do. Recommended dosing is 300mg (three capsules) orally once a day until the cancer worsens or side effects are unbearable. Launch is planned for late April and cost will not be disclosed until then. Distribution will be through a limited network. Full prescribing information is available here. 

  • Brand (Generic) Name: Zejula™ (niraparib)
  • Manufacturer: Tesaro, Inc.
  • Date Approved: March 27, 2017
  • Indication: Maintenance treatment of women with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete response (CR) or partial response (PR) to platinum-based chemotherapy.  
  • Dosage Forms Available: 100mg oral capsules
  • Launch Date: Expected in late April 2017
  • Estimated Annual Cost: Not yet known
  • Specialty Status: Zejula will be added to Express Scripts' specialty drug list.
  • According to the National Cancer Institute, approximately 22,000 cases of ovarian cancer - most beginning in the fallopian tubes - are diagnosed each year in the U.S. Depending on the state at diagnosis, five-year survival rates range from about 30% to around 90%.
  • PARP inhibitors destroy cancer cells or limit their growth by interfering with an enzyme cancer cells need to repair damage caused by drug treatment. 
  • Zejula will compete with two other FDA-approved PARP inhibitors. Lynparza™ (olaparib - AstraZeneca), which was approved in December 2014, is used as monotherapy for patients with advanced ovarian cancer that already has been treated with three or more lines of chemotherapy. Also as a single agent, Rubraca® (rucaparib – Clovis Oncology) was FDA approved in December 2016 for advanced ovarian cancer that has been treated at least twice with chemotherapy. However, both Lynparza and Rubraca are used for patients who have BRAC deletions verified by FDA-approved companion diagnostic testing.
  • Zejula does not require genetic testing before its use. 

 

 

30Mar
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Bavencio Approved for Merkel Cell Carcinoma

On March 23, 2017, EMD Serono and Pfizer received approval from the U.S. Food and Drug Administration (FDA) for Bavencio® (avelumab) for the treatment of adult and pediatric patients 12 years of age and older with metastatic Merkel cell carcinoma (mMCC). Bavencio is a programmed death receptor-ligand 1 (PD-L1)-blocking antibody. Recommended dosing is 10mg/kg as an intravenous (IV) infusion every 2 weeks. Bavencio was launched upon approval. It is available through a limited network of specialty pharmacies and distributors that does not include Accredo or CuraScript Specialty Distribution. Full prescribing information is available here.  

  • Brand (Generic) Name: Bavencio® (avelumab)
  • Manufacturer: EMD Serono (a subsidiary of Merck KGaA) and Pfizer
  • Date Approved: March 23, 2017
  • Indication: Treatment of adult and pediatric patients 12 years of age and older with metastatic Merkel cell carcinoma.
  • Dosage Forms Available: 200mg/10mL (20mg/mL) solution in single-dose vials for intravenous infusion.
  • Launch Date: Bavencio was launched upon approval.
  • Estimated Annual Cost: Bavencio is expected to cost approximately 6,000 per year.
  • Specialty Status: Bavencio will be added to Express Scripts’ specialty drug list.
  • Each year in the U.S., approximately 1,600 patients are diagnosed with MCC. Metastatic MCC is an aggressive type of skin cancer with less than 20 percent of patients surviving beyond five years.
  • While chemotherapy is currently used to treat mMCC, Bavencio is the first FDA-approved therapy for this cancer type.
  • Bavencio is a programmed death receptor-ligand 1 (PD-L1)-blocking antibody. It is an immunotherapy that helps the body’s immune system attack cancer cells.
  • Merck's Keytruda® (pembrolizumab), Bristol-Myers Squibb’s Opdivo® (nivolumab) and Genentech’s Tecentriq® (atezolizumab) are other PD-1/PD-L1 blocking antibodies that are currently available on the market.
  • Bavencio was approved two months ahead of schedule under FDA’s accelerated approval, breakthrough therapy and priority review programs. 
  • FDA approval was based on a Phase II trial in patients with mMCC that demonstrated that 33 percent of patients treated with Bavencio had complete or partial shrinkage of their tumors. EMD Serono and Pfizer are conducting confirmatory studies to verify that the drug provides a clinical benefit in these patients. 
  • An expanded approval for advanced or metastatic urothelial carcinoma is expected by August 27, 2017.

 

30Mar
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Xadago Approved for Parkinson’s Disease

On March 21, 2017, the U.S. Food and Drug Administration (FDA) approved Newron Pharmaceuticals’ Xadago® (safinamide) as an add-on treatment for patients with Parkinson’s disease who are currently taking levodopa/carbidopa and experiencing “off” episodes. An “off” episode is a time when a patient’s medications are not working well, causing an increase in Parkinson’s symptoms, such as tremor and difficulty walking. Treatment with Xadago should be started at 50mg per day. This daily dose may be increased to 100mg per day, if needed. According to US WorldMed, the company that will market the drug in the U.S., availability and prescribing information are not yet available.

  • Brand (Generic) Name: Xadago® (safinamide)
  • Manufacturer: Newron Pharmaceuticals
  • Date Approved: March 21, 2017
  • Indication: Xadago was approved for use as an add-on treatment for patients with Parkinson’s disease who are currently taking levodopa/carbidopa and experiencing “off” episodes.
  • Dosage Forms Available: 50mg and 100mg film-coated tablets
  • Launch Date: A launch date has not been established at this time.
  • Estimated Annual Cost: Product pricing is not yet available.
  • Parkinson's disease is the second most common chronic progressive neurodegenerative disorder in the elderly after Alzheimer’s disease, affecting 1-2% of individuals aged ≥ 65 years worldwide.
  • It is estimated more than one million Americans live with Parkinson's disease and 50,000 new cases are diagnosed each year.
  • Xadago blocks the activity of monoamine oxidase-B (MAO-B), an enzyme that breaks down dopamine. Low dopamine levels may lead to problems with balance, movement, muscle control and other symptoms of Parkinson’s disease.
  • Due to its high selectivity of Xadago to the MAO-B enzyme, it does not have any dietary restrictions.
  • Other selective MAO-B inhibitors include resagaline (Azilect® – Teva/generic) and selegiline (Depreny®, Eldepryl®, Emsam®, Zelapar®, generics).

 

20Mar
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Additional Indication for Keytruda

The U.S. Food and Drug Administration (FDA) approved Keytruda® (pembrolizumab – Merck) for use in certain patients with classical Hodgkin lymphoma (cHL). On March 14, 2017, Keytruda gained an indication for use in patients whose cHL either has not responded to other therapies or has recurred despite at least three previous treatments. For cHL, the recommended adult dose is 200mg. For children, the dose is 2mg/kg up to a maximum of 200mg. Keytruda is given as an intravenous (IV) infusion once every three weeks until cHL gets worse or the drug’s side effects become unbearable. If cHL does not progress, treatment can continue for as long as two years. Originally approved in 2014 to treat advanced melanoma, Keytruda also has indications for non-small cell lung cancer and head and neck cancers. It is a human programmed death receptor-1 (PD-1)-blocking antibody that boosts the immune system’s ability to attack cancer cells. Complete prescribing information is available here.

Generics to Minastrin 24 FE Chewable Tablets Now Available

On March 16, 2017, Lupin announced the launch of its A-rated generics to Minastrin® 24 Fe chewable tablets. The oral contraceptive 28-day pack contains 24 norethindrone acetate and ethinyl estradiol (1mg / 0.02mg) chewable tablets and four non-hormonal ferrous fumarate tablets (75mg). While approved by FDA in May 2016, Lupin has now launched its generic with the trade name of Mibelas 24 Fe. Teva also launched an authorized generic to this product, which is essentially the brand drug repackaged into generic-looking packaging. According to IMS Health, Minastrin 24 Fe chewable tablets had U.S. sales of approximately 0 million for the 12 months ending December 2016.

Repatha Cardiovascular Outcomes Issues Document Available

Repatha® (evolocumab – Amgen) is a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor antibody that is highly effective at lowering low-density lipoprotein cholesterol (LDL-C) levels. On March 17, 2017, Amgen’s FOURIER study (n = 27,564) was published in the New England Journal of Medicine. The study shows that when Repatha was added to statin therapy (± Zetia,) the risk of the composite endpoint of cardiovascular (CV) death, myocardial infarction (MI), stroke, hospitalization for unstable angina, or coronary revascularization was reduced by 15% among patients who had clinically evident atherosclerotic cardiovascular disease (ASCVD) compared with patients who received only background statin therapy (± Zetia). This Issues Document summarizes Repatha’s clinical outcomes trial, provides a patent litigation update concerning Repatha and Praluent® (alirocumab – Sanofi/Regeneron) and highlights how Express Scripts’ Pharmacy and Therapeutics (P&T) committee will review the FOURIER data, make appropriate alterations in utilization management (UM) programs and continue to assess the formulary status within this class of medications.  The Issues Document is available here. 

MedWatch
Viberzi

On March 15, 2017, FDA issued a MedWatch alert for Allergan’s Viberzi® (eluxadoline) tablets. Since Viberzi’s U.S. approval in May 2015 to treat irritable bowel syndrome with diarrhea (IBS-D), FDA has investigated 120 reports of pancreatitis among patients using it. At least 76 patients had to be hospitalized and two patients died. Specifically, patients who have had their gallbladders removed are at increased risk. FDA is recommending that physicians prescribe medications other than Viberzi for patients without gallbladders. Additionally, it suggests that patients discuss alternative treatment choices with their doctors. Patients who take Viberzi are cautioned to watch for signs of pancreatitis, such as nausea and vomiting or severe abdominal/stomach pain that may also affect the back or right shoulder, whether or not their gallbladders have been removed. FDA’s full Safety Communication is available here.    

 

14Mar

The Governors of Maryland, New Jersey, New York, Connecticut, and Virginia have declared States of Emergency

  • Staff
  • FSBP   fsbp411   All  

The Governors of Maryland, New Jersey, New York, Connecticut, and Virginia have declared States of Emergency due to Winter Storm Stella impacting all counties in each state. Express Scripts (FSBP's Pharmacy Benefit Manager) has activated the Emergency Access to Benefits/Refill Too Soon override process for the impacted areas with an effective date of March 14, 2017 and expiration date of April 13, 2017 that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

14Mar
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Kisqali Approved to Treat Breast Cancer

The U.S. Food and Drug Administration (FDA) approved Kisqali® (ribociclib -- Novartis) on March 13, 2017. Kisqali is indicated as first-line treatment for postmenopausal women who have metastatic or advanced hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) breast cancer. It selectively inhibits cyclin-dependent kinase (CDK) 4 and 6 (CDK4/6), enzymes that promote the growth and spread of cancer cells. It will be used in combination with an aromatase inhibitor, such as anastrozole, exemestane or letrozole. Recommended dosing is on four-week cycles, with 600mg (three tablets) of Kisqali taken once daily every day for 21 days, then stopped for the next seven days. The aromatase inhibitor is taken continually without a break. Kisqali will be distributed through an open network. Its complete prescribing information is available here. 

  • Brand (Generic) Name: Kisqali® (ribociclib)
  • Manufacturer: Novartis
  • Date Approved: March 13, 2017
  • Indication: Treatment of postmenopausal women with hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) advanced or metastatic breast cancer.
  • Dosage Forms Available: 200mg tablets
  • Launch Date: Novartis plans to launch within a few days of approval.
  • Estimated Annual Cost: The wholesale acquisition cost of a 28-day supply of the 600mg dose is,950 or approximately 2,700 per year.
  • Specialty Status:  Kisqali will be added to the Express Scripts specialty drug list
  • According to the American Cancer Society, approximately 250,000 cases of invasive breast cancer are diagnosed, annually.  More than 70 percent of those cases are HR+/HER2-.
  • In the main clinical study, average progression-free survival was about nine months longer for participants taking Kisqali plus letrozole compared with patients taking letrozole by itself (25.3 months vs. 16.0 months).
  • Kisqali may cause QT prolongation, which is an abnormal heartbeat that may lead to death.  A baseline electrocardiogram (ECG) should be taken before treatment begins, about halfway through the first line treatment cycle, at the start of the second cycle and then periodically during treatment.  Additionally, electrolyte levels should be tested at the beginning of the first six cycles and then at regular intervals. 
  • Liver function also should be checked before starting therapy, every two weeks during the first two cycles, at the start of the next four cycles and then as considered appropriate.
  • The only other CDK4/6 inhibitor currently FDA approved for treating breast cancer is Pfizer's lbrance (palbociclib).  It is indicated for use only with letrozole, not with other aromatase inhibitors.  It does not, however, require heart or liver monitoring.
  • FDA designated Kisqali as a breakthrough therapy and approved it ahead of schedule under priority review.

 

14Mar

AFSPA opens at 10:30AM - 3/14/17

  • Staff
  • fsbp411   All   FSBP  

AFSPA is opening at 10:30am (EDT), today, Tuesday, March 14, 2017.

Thank you.

 

14Mar

AFSPA is opening late today

  • Staff
  • fsbp411   All   FSBP  

Due to inclement weather and following the decision by the Office of Personnel Management, AFSPA will open on a delayed schedule today, Tuesday, March 14, 2017. We will assess staff levels on an ongoing basis with the goal of commencing regular business operations as soon as possible.

Thank you.

 

 

 

13Mar
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Noctiva Approved to Treat Nighttime Urination

The U.S. Food and Drug Administration (FDA) approved Serenity Pharmaceutical’s Noctiva™ (desmopressin) nasal spray on March 3, 2017. It is indicated to treat adults who have nocturnal polyuria. Also called nocturia, the condition wakes patients with the need to urinate twice or more during the night. An analog of the hormone vasopressin, Noctiva temporarily increases the amounts of water the kidneys reabsorb to decrease urine output during the night. Recommended dosing is one spray per day around one-half hour before bedtime. It will be dispensed in containers holding a 30-day supply of either 0.83mcg or 1.66mcg strength. A boxed warning on its labeling and a Medication Guide for patients caution that it may cause hyponatremia (abnormally low levels of blood sodium). Before it is prescribed, the patient should have a 24-hour urine collection test to measure nighttime urine production. Patients using it will need to have sodium levels checked before starting Noctiva, within one week, after one month and then at regular intervals. Several other brand and generic desmopressin products, including oral, injectable and nasal forms, are available in the United States. However, only Noctiva currently is approved for treating patients with nocturia. Launch and pricing plans have not yet been announced. Complete prescribing information is available here.  

New Indication and Boxed Warning for Technivie

Based on results from the phase III AGATE-1 clinical trial, the US Food and Drug Administration (FDA) has approved a new indication for AbbVie’s Technivie® (ombitasvir/paritaprevir/ritonavir). It now can be used, along with ribavirin, to treat patients who have both type 4 chronic hepatitis C and compensated cirrhosis. After 12 weeks, nearly all study participants (all were taking the Technivie/ribavirin regimen) achieved a sustained virologic response (SVR). Extending treatment for an additional four weeks did not improve SVR rates. Recommended dosing is two Technivie tablets taken once each morning. Ribavirin is divided into two daily doses and taken with food. Dosing for ribavirin is determined by the patient’s weight --1,000mg per day for patients who weigh less than 75 Kg (165 pounds) or 1,200mg per day for those who weigh more. The FDA also added a boxed warning that using Technivie could activate hepatitis B virus (HBV) for patients who have or who have had HBV. Patients should be tested for HBV before, during and for several months after treatment. Revised prescribing information is available here. 

 

13Mar
AFSPA Closing Early at 4:30pm EST (3/13/17)

AFSPA Closing Early at 4:30pm EST (3/13/17)

  • Staff
  • All   FSBP   fsbp411  

Due to an expected winter storm, AFSPA will be closing its offices at 4:30pm EST today, Monday, March 13, 2017. The goal is to allow AFSPA staff to get home safely in advance of any bad weather. As a reminder, AFSPA follows the Federal government schedule for openings and closures. AFSPA will update its phone system, website, and Facebook regarding any weather-related closings resulting from inclement weather.

 

6Mar
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Combination Diabetes Drug Approved

Qtern® (dapagliflozin/saxagliptin) tablets were approved by the U.S. Food and Drug Administration (FDA) on Feb. 27, 2017. Qtern is indicated, together with diet modifications and exercise, to treat adults who have type 2 diabetes that is not controlled by dapagliflozin (Farxiga®) alone. Patients already taking dapagliflozin and saxagliptin (Onglyza®) separately also are candidates for the combination product. Dapagliflozin is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor that helps the body to eliminate more blood sugar in urine. Saxagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, promotes release of natural insulin and blocks release of glucose when blood sugar levels are high. A Medication Guide that accompanies Qtern warns patients that dapagliflozin potentially can increase the risk of dehydration, genital yeast infections, heart failure and/or bladder cancer. Additionally, the guide cautions that patients taking saxagliptin may be slightly more likely to have inflammation of the pancreas. Kidney function should be tested before beginning therapy and occasionally throughout treatment. AstraZeneca plans to launch Qtern later in 2017, but no cost information is available, yet. Recommended dosing is one tablet, containing 10mg of dapagliflozin and 5mg of saxagliptin, taken once each morning. Complete prescribing information is available here.  

Dust Mite Allergy Drug, Odactra, Approved

On March 1, 2017, FDA approved Odactra for adults between 18 years and 65 years of age who have nasal inflammation (allergic rhinitis) that may be accompanied by eye inflammation (conjunctivitis) from an allergy to dust mites. It is oral immunotherapy which contains small amounts of dust mite allergens. In clinical studies, symptoms for patients using it decreased about 16% to 18%. Full results may take up to 14 weeks to be achieved, however. Taken as sublingual tablets, Odactra dissolves under the tongue. Recommended dosing is once a day continually, with the first dose in a physician’s office or clinic to be sure the allergens in Odactra do not result in serious side effects. A boxed warning on the labeling cautions patients that severe allergic reactions, such as potentially life-threatening drops in blood pressure and breathing difficulties, are possible with its use. ALK-Abello will be distributing Odactra. Launch and pricing plans as well as the prescribing information have not yet been released.

 

6Mar
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • FSBP   All  

Welcome to March 2017! Spring means new beginnings. AFSPA is working on our annual Spring newsletter. We believe it is important to stay connected with our members and provide the latest health information. Please expect to see the Spring newsletter in your mailbox in the upcoming months.

The year 2017 is very important for us as it marks 75 years since the Foreign Service Benefit Plan (FSBP) was established. In 1942, the American Foreign Service Protective Association (AFSPA) began offering health insurance to those in the Foreign Service. Now we have evolved to serve many agencies with a Foreign Affairs involvement, such as DOD, DHS, CIA, etc. We are very proud of offering worldwide coverage for over seven decades. We designed a special logo to commemorate this milestone occasion. You can view it on the FSBP web page throughout the entire year. Click here to view the 75th Anniversary logo now. Caring for your Health Worldwide for 75 years has been an honor and a privilege. Thank you for your loyalty to the Plan.

Springtime also is a time we finalize our taxes. Filing taxes is often stressful and even more so while living abroad. AFSPA partners with Beers, Hamerman, Cohen & Burger, P.C. to offer our members special discounts and top-notch tax services. You may remember reading their articles regarding the Affordable Care Act’s impact for members living abroad in past newsletters.  AFSPA members are able to work with one of five CPA tax accountants, each with at least ten years’ accounting experience. You receive a complimentary 20-minute consultation and a 10% discount off standard hourly rates. Email [email protected] or call 203-787-6527 to utilize these services today. Simply identify yourself as an AFSPA member – retired or active – when you contact the firm. Take advantage of this worthwhile tax services today.

Lastly, March is National Nutrition Month. It focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. This would be a great time to explore the Mediterranean Wellness Program offered to all FSBP members. The eight week interactive online program gives you access to a registered dietician. It also offers a support manual with information to help manage your weight. If you didn’t know, the Mediterranean Wellness Program counts as a Healthy Action for those completing the Simple Steps to Living Well Together Program. So start your path to better eating and earn a incentive credit today. Please refer to the 2017 FSBP Brochure, Section 5(h) to explore the many other programs that can help members with nutrition goals, including our Weight Management Program, Health Coaching Program, and  TherapEase Cuisine, just to name a few. And, don’t forget the Plan’s Nutritional Counseling benefit.  See your Brochure in Section 5(a) for more information on this benefit.

A reminder, we mailed the IRS Form 1095-B to FSBP members last week. Please note, the 1095-B form is not needed to file your tax return but it should be kept in your 2016 tax file.

We hope your family has a happy and healthy Spring. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

 

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation  

 

2Mar
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Xermelo Approved to Treat Diarrhea of Carcinoid Syndrome and Generics to Pristiq Launched

Xermelo Approved

On Feb. 28, 2017, the U.S. Food and Drug Administration (FDA) approved Lexicon Pharmaceuticals’ Xermelo™ (telotristat ethyl) tablets. It will be used along with a somatostatin analog, such as octreotide, to manage diarrhea associated with carcinoid syndrome for adults whose diarrhea is not controlled adequately by a somatostatin analog, alone. The first drug to be FDA approved in the new class of tryptophan hydroxylase inhibitors, Xermelo reduces the excess secretion of serotonin caused by the tumors. Recommended dosing is one tablet three times a day with food. Generally, long-acting forms of somatostatin analogs are injected intramuscularly (IM) once monthly; short-acting forms are given subcutaneously (SC) two times to four times a day. If a short-acting somatostatin analog is used, it should be injected at least one-half hour after Xermelo is taken. Beginning March 6, 2017, Xermelo will be available through a select group of specialty pharmacies that does not include Accredo. Complete prescribing information is available here. 

  • Brand (Generic) Name: Xermelo™ (telotristat ethyl)
  • Manufacturer: Lexicon Pharmaceuticals
  • Date Approved: Feb. 28, 2017
  • Indication: To treat adults who have carcinoid syndrome diarrhea that somatostatin therapy alone has inadequately controlled
  • Dosage Forms Available: 250mg tablets
  • Launch Date: March 6, 2017
  • Estimated Annual Cost: The wholesale acquisition cost (WAC) of Xermelo will be approximately,300 per year.
  • Specialty Status:  Xermelo will be added to Express Scripts’ specialty drug list.
  • Neuroendocrine tumors contain both nerve cells and cells that produce hormones
  • A rare type of neuroendocrine cancer, carcinoid tumors usually begin in the digestive tract or lungs. They develop slowly and their early symptoms are similar to those of many other conditions. Most cases are not diagnosed until the tumors have spread – often to the liver. According to the American Society of Clinical Oncology, about 12,000 American adults are diagnosed with carcinoid tumors each year.
  • Many patients with carcinoid tumors develop carcinoid syndrome, which partly results from excessive production of the neurotransmitter, serotonin. Symptoms include abdominal pain, breathing difficulty, severe diarrhea, facial flushing and heart problems
  • By blocking the activity of the enzyme tryptophan hydroxylase, Xermelo decreases the production of serotonin and lessens diarrhea
  • Xermelo will be used along with a somatostatin analog, such as octreotide.

Generics to Pristiq Launched

Desvenlafaxine extended-release tablets, generic for Pfizer’s Pristiq®, were launched in the United States on March 1, 2017. A once-daily selective serotonin and norepinephrine reuptake inhibitor (SNRI), it is indicated to treat adults who have depression. A boxed warning advises that it should not be used for children or teens, because they might think about or attempt suicide while taking it. Several companies, including Breckenridge Pharmaceutical, Inc. and Teva Pharmaceutical Industries, will share 180-day exclusivity. In 2016, U.S. sales of Pristiq amounted to about 3 million, according to IMS Health.

  • Brand Drug:Pristiq® (desvenlafaxine, extended-release – Pfizer)
  • Indication: Treatment of adults with major depressive disorder
  • Generic Manufacturers: Breckenridge, Teva and several others expected
  • Dosage Forms Available: 25mg, 50mg and 100mg extended-release tablets. Teva is expected to have 180 days of marketing exclusivity for the 25mg strength
  • Launch Date: March 1, 2017
  • Annual US Sales: 3 million

 

27Feb
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Revlimid Receives New Indication

Revlimid® (lenalidomide), an oral immunomodulatory drug from Celgene, received a new U.S. Food and Drug Administration (FDA) indication on Feb. 22, 2017. In addition to its previous approvals for treating mantle cell lymphoma (MCL), multiple myeloma (MM) and anemia related to transfusions for myelodysplastic syndromes (MDS); Revlimid now is approved for maintenance treatment of patients who have had autologous hematopoietic stem cell transplants (auto-HSCT) for MM. Recommended initial dosing is 10mg daily for 84 days. The dose then is raised to 15mg daily, if the patient can tolerate the higher dose. In clinical studies, progression-free survival ranged from about 1.5 years to about 3.8 years longer for auto-HSCT patients treated with Revlimid than for untreated patients. A Medication Guide and boxed warnings on Revlimid’s labeling caution that using it during pregnancy can cause birth defects or death for the fetus, and that it increases the risks of blood clots, heart attacks, strokes and/or blood abnormalities. Its use is limited through the Revlimid Risk Evaluation and Mitigation Strategy (REMS) Program, which requires patients, pharmacies and prescribers to be authorized before using, dispensing or prescribing it. Revlimid’s revised prescribing information is available here.  

 

21Feb
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

New Indication for Spiriva Respimat

The U.S. Food and Drug Administration (FDA) approved a pediatric indication for Spiriva® Respimat® (tiotropium – Boehringer Ingelheim) on February 15, 2017. Spiriva Respimat is a long-acting muscarinic antagonist (LAMA) that uses a propellant-free device to deliver the drug as a fine, slow mist, which helps patients inhale the medication. Originally approved in September 2014 for treating chronic obstructive pulmonary disease (COPD), it was granted an additional FDA approval a year later for long-term maintenance treatment of asthma patients at least 12 years old. The new indication now allows its use as a controller (maintenance) treatment for asthma patients as young as six years old. Recommended dosing is two inhalations once a day. The best level of improvement may take four weeks to eight weeks of therapy to achieve. Updated prescribing information is available here. 

 

16Feb
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Siliq Approved for Psoriasis

Siliq™ (brodalumab — Valeant) was approved by the U.S. Food and Drug Administration (FDA) on February 15, 2017. It is a monoclonal antibody that selectively binds to the interleukin (IL)-17 receptor. It is indicated to treat adults who have moderate-to-severe plaque psoriasis. Siliq should be used in patients who are eligible for systemic (oral or injected) treatment or phototherapy, but already have tried systemic treatments that either stopped working or did not work at all. Recommended dosing is one subcutaneous (SC) injection (210mg) once a week for three doses, and then once every two weeks. Siliq has a boxed warning that it may cause patients to consider or try suicide. Its use will be regulated under a Risk Evaluation and Mitigation Strategy – Siliq REMS. Patients, physicians and pharmacists all must be authorized before using, prescribing or dispensing Siliq. Valeant plans on launching Siliq in the second half of 2017. It will be available through open distribution; Accredo Specialty Pharmacy will be dispensing Siliq. Complete prescribing information is available here. 

  • Brand (Generic) Name: Siliq™ (brodalumab)
  • Manufacturer: Valeant Pharmaceuticals
  • Date Approved: Feb. 15, 2017
  • Indication: Treatment of moderate to severe plaque psoriasis for adult patients who are candidates for systemic therapy or phototherapy and who have failed to respond or have lost response to other systemic therapies.
  • Dosage Forms Available: 5mL single-use pre-filled syringes each containing 210mg of Siliq
  • Launch Date: Second half of 2017
  • Estimated Annual Cost: Pricing information is not yet available.
  • Specialty Status:  Siliq will be added to Express Scripts' specialty drug list
  • Plaque psoriasis is an autoimmune inflammatory condition that causes itchy, white patches on the skin. It affects approximately 3% of adults – over 7 million people – in the U.S.
  • By blocking the IL-17 receptor, Siliq interrupts the process of inflammation to reduce psoriasis activity.
  • In clinical trials, psoriasis was completely cleared for over 60% of the patients treated with Siliq for 12 weeks. More than eight of 10 actively treated patients showed 75% or more improvement.
  • Labeling for Siliq has a boxed warning that it may cause patients using it to think about or attempt suicide.
  • Siliq will compete with Cosentyx® (secukinumab – Novartis) and Taltz® (ixekizumab – Lilly), which bind to the IL-17A cytokine, as opposed to Siliq, which binds to IL-17 receptors.

 

15Feb

Member Portal Services Restored

  • Yancy Meiller, IT Manager
  • fsbp411   All   FSBP  

Dear Members,

Our Member Portal services have been restored. Thank you for your patience.
 

Yancy Meiller
IT Manager
 

 

15Feb

MEMBER PORTAL CURRENTLY DOWN

  • Yancy Meiller, IT Manager
  • FSBP   fsbp411   All  

Dear Members,

Please be advised we are currently experiencing technical difficulties with our Member Portal. We are working to restore services as soon as possible. This has not affected the security of the data. We appreciate your patience and we apologize for the inconvenience this has caused.

If you would like to receive notification once this issue is resolved, please use the secure form here:
https://www.afspa.org/secureform.cfm?formname=Contact%20AFSPAconnect
Thank you,
Yancy Meiller
IT Manager

 

14Feb
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Gammaplex 10% Approved for Immune Deficiencies

On February 6, 2017, the U.S. Food and Drug Administration (FDA) approved Gammaplex® 10% (immune globulin intravenous [human], 10% liquid). It is indicated to treat adults who have primary immunodeficiency (PI) or chronic immune thrombocytopenic purpura (ITP). The manufacturer, Bio Products Laboratory, also markets Gammaplex® 5% (immune globulin intravenous [human], 5% liquid in the United States. Intravenous immunoglobulins (IVIGs), are used as replacement for patients who have immunoglobulin deficiencies. They are dosed by weight. For treating PI, one Gammaplex 10% infusion is recommended every three to four weeks. Recommended dosing for the treatment of ITP is one infusion on each of two successive days when needed to increase platelet count. In clinical studies, the average infusion time for the 10% strength was about one hour – approximately one-half the average time for an infusion of Gammaplex 5%. Labeling for all IVIG products includes warnings that they may cause blood clots, kidney damage or kidney failure. Complete prescribing information for Gammaplex 10% is available here.

 

13Feb

THE GOVERNOR OF CALIFORNIA HAS DECLARED A STATE OF EMERGENCY

  • Staff
  • FSBP   All  

The Governor of California has declared a State of Emergency for the following counties due to flooding: Butte, Sutter and Yuba.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com  or by calling 1-800-818-6717) or request a local fill as needed.

 

12Feb
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Emflaza Approved for Duchenne Muscular Dystrophy

On February 9, 2017, the U.S. Food and Drug Administration (FDA) approved Marathon Pharmaceuticals’ Emflaza™ (deflazacort). It is indicated to treat patients with Duchenne muscular dystrophy (DMD) who are five years of age and older. Emflaza is an oral corticosteroid that decreases both immune and inflammatory activity to relieve symptoms of DMD and also to delay progression of the disease. The recommended dose is 0.9mg/kg once daily. Emflaza is expected to be launched in four to six weeks. It will be available through a limited network of specialty pharmacies that does not include Accredo. Full prescribing information is available here.  

  • Brand (Generic) Name: Emflaza™ (deflazacort)
  • Manufacturer: Marathon Pharmaceuticals
  • Date Approved: Feb. 9, 2017
  • Indication: To treat patients who have Duchenne muscular dystrophy (DMD) and who are at least five years old
  • Dosage Forms Available:  6mg, 18mg and 36mg oral tablets and 22.75mg/mL oral suspension
  • Launch Date: Emflaza is expected to be available within four to six weeks.
  • Estimated Annual Cost: Pricing information is not available at this time.
  • Specialty Status:  Emflaza will be added to Express Scripts' specialty drug list
  • Although rare, DMD is the most common form of muscular dystrophy — with about 400 to 600 new cases diagnosed in the United States each year. A condition almost exclusively affecting boys and young men, it causes progressive muscle weakening that usually leads to paralysis during the teen years and death in early adulthood.
  • Several corticosteroids are used to treat DMD, but Emflaza is the first to be specifically approved to treat the condition.
  • In clinical studies that lasted as long as two years, patients taking Emflaza lost less muscle strength than those taking a placebo.

 

9Feb
Clinical Matters News Flash

Clinical Matters News Flash

  • Express Scripts
  • Prescription   FSBP  

Parsabiv Approved to Treat Secondary Hyperparathyroidism

Amgen announced on February 7, 2017, that the U.S. Food and Drug Administration (FDA) had approved Parsabiv™ (etelcalcetide). It is indicated to treat hyperparathyroidism (HPT) caused by hemodialysis for adults with chronic kidney disease (CKD). Secondary HPT is a condition that results from over production of parathyroid hormone (PTH) from the parathyroid glands, which are stimulated by low kidney function. In response, additional calcium and other minerals are lost from bones into the blood. Parsabiv acts like calcium at receptors on the parathyroid glands to decrease PTH release. Given as an intravenous (IV) infusion, it can be injected into the tubing used for dialysis after each dialysis treatment ends. Recommended initial dose is 5mg three times a week. Maintenance doses range from 2.5mg to 15mg three times a week as long as calcium blood levels are too high. Prescribing information is available here. 

  • Brand (Generic) Name: Parsabiv™ (etelcalcetide)
  • Manufacturer: Amgen
  • Date Approved: Feb. 7, 2017
  • Indication: Secondary hyperparathyroidism (HPT) in adult patients with chronic kidney disease (CKD) on hemodialysis
  • Dosage Forms Available:  Single-use vials containing 2.5mg, 5mg or 10mg of Parsabiv
  • Launch Date: Launch date isn’t known at this time.
  • Estimated Annual Cost: Pricing information is not available at this time
  • According to the National Kidney Foundation, the majority of more than 460,000 U.S. adults using dialysis will develop HPT.
  • In clinical studies, targeted reductions in PTH were met by at least 52% of patients being treated with Parsabiv as compared with only 5% to 11% of those receiving a placebo.
  • Both calcium and PTH levels should be tested after beginning Parsabiv, with dosing changes about once a month during therapy
  • Parsabiv works similar to Amgen's oral product, Sensipar® (cinacalcet), which is expected to face generic competition in September 2018.

 

8Feb

THE GOVERNOR OF LOUISIANA HAS DECLARED A STATE OF EMERGENCY

  • Staff
  • All   FSBP   fsbp411  

The Governor of Louisiana has declared a State of Emergency for the entire state of Louisiana due to severe storms.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed

 

6Feb
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

ArmonAir RespiClick and AirDuo RespiClick  Asthma Inhalers Approved

The U.S. Food and Drug Administration (FDA) has awarded Teva Pharmaceutical Industries Ltd. approvals for two new dry-powder inhalers. ArmonAirTM RespiClick® (fluticasone propionate) and AirDuoTM RespiClick® (fluticasone propionate/salmeterol) were approved on Jan. 27, 2017. Indicated for maintenance treatment of asthma for patients who are at least 12 years old, they will be released later in 2017. Both contain the corticosteroid, fluticasone propionate. Since using corticosteroids orally can lead to oropharyngeal candidiasis (fungal infections of the mouth and throat), patients using either ArmonAir RespiClick or AirDuo RespiClick are advised to rinse out their mouths with plain water after each inhalation. Recommended dosing for each is one inhalation two times a day. Neither is intended for relief of acute asthma attacks. Patients with serious reactions to milk should not use them. ArmonAir RespiClick’s prescribing information is available here.   

Because it also contains the long-acting beta2 agonist (LABA), salmeterol, AirDuo RespiClick’s labeling has boxed warnings that it increases the risk of death due to asthma and that using it may also raise the chance of hospitalization for children and teens. It should be reserved for patients whose asthma is not well managed by another maintenance medication for asthma. Full prescribing information for AirDuo RespiClick is available here.  

Expanded Indication for Latuda

In a press release dated Jan. 28, 2017, Sunovion Pharmaceuticals disclosed that it had received FDA approval for Latuda® (lurasidone) to treat schizophrenia for patients between 13 years and 18 years old. Recommended dosing is one tablet daily taken with food. Latuda can be used alone or in combination with other drugs, such as lithium. Clinical studies of its effectiveness for teens lasted six weeks. Therefore, prescribers are advised to evaluate the need for treatment if therapy lasts longer. Latuda, an atypical antipsychotic, also is approved to treats adults who have schizophrenia or major depression related to bipolar disorder. Updated prescribing information is available here. 

Opdivo Gains New Indication

On Feb. 2, 2017, Bristol-Myers Squibb’s Opdivo® (nivolumab) was FDA approved for treating locally advanced or metastatic urothelial carcinoma (mUC) that has progressed either during or after platinum-containing chemotherapy. It also may be used within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. A form of bladder cancer, mUC affects about 70,000 Americans a year. Over one-half of patients experience a relapse after treatment. To treat mUC recurrence, the recommended dose of Opdivo is 240mg infused intravenously (IV) once every two weeks until the patient no longer responds or no longer tolerates side effects. Opdivo is a programmed death receptor-1 (PD-1) inhibitor. As an immuno-oncology agent, it helps the body’s immune system attack cancer cells. Since its initial U.S. approval to treat metastatic melanoma in December 2014, Opdivo has been approved, either alone or in combination with other oncology drugs, to treat several other cancer types, including metastatic non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC). Updated prescribing information is available here.  

Over-the-Counter Status for Xyzal

Xyzal® (levocetirizine - Sanofi) was FDA approved for over-the-counter (OTC) status on Jan. 31, 2017. Expected to be available before the spring allergy season, the OTC product will be marketed as Xyzal® Allergy 24HR. Used to treat both seasonal and chronic allergies, it will be available as 5mg tablets that are indicated for adults, teens and children as young as six years old. A liquid form containing 0.5mg/mL may be used for children as young as two. One dose per day is taken in the evening.  

 

1Feb
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • FSBP   All  

Greetings and Welcome to February 2017! As you know, Open Season ended several months ago but the Foreign Service Benefit Plan (FSBP) continues to receive new enrollees and gain new members. Over 1500 new people chose to enroll in FSBP this year and we appreciate you trusting us with your health. These new members are seeking what our existing membership has enjoyed for many years – personalized service. The result is more phone calls to us, longer wait times and, in some unfortunate cases, the perception of diminished service. We apologize for any long wait times on the telephone. Your calls are important to us. We are adding more staff to continue offering the unparalleled service that our worldwide membership requires.

On another note, FSBP members will receive the IRS Form 1095-B by March 2, 2017, due to an extension from the original January 31st date granted by the IRS. This form confirms that you had minimal essential coverage while you were enrolled in FSBP in 2016. If you have questions about the IRS Form 1095-B, or about lost or incorrect forms, please contact us at 202-833-4910 or at [email protected]. Please do not contact OPM, your employing agency, or your retirement office, about IRS Form 1095-B. It is FSBP’s responsibility to make corrections to and answer questions about IRS Form 1095-B. Please note, the 1095-B form is not needed to file your tax return but it should be kept in your tax file for the year 2016.

In addition, Federal employees will receive the IRS Form 1095-C from your employing agency. It documents your agency offered you health coverage in 2016. If you have questions about the IRS Form 1095-C, or about lost or incorrect forms, you should call your agency using the phone number on Line 10 of the IRS form. Annuitants who were employed any portion of the year will receive an IRS Form 1095-C from their former employer. Otherwise, annuitants should not expect to receive this form. Click here for more information on IRS Form 1095-B and IRS Form 1095-C. Click here to visit the IRS website.

Lastly, February is American Heart Month. According to the American Heart Association, cardiovascular disease — including heart disease, stroke, and high blood pressure — is responsible for one out of every three deaths. It is the No. 1 killer of American women and men, and it is a leading cause of serious illness and disability. If you have high blood pressure, I encourage you to take steps to control it. Make sure to complete your routine physical examination, which FSBP covers at 100% when you visit an in-network provider or a provider outside the 50 United States. Monitoring your blood pressure is the best form of prevention.

We hope your family stays safe, warm, and healthy this winter. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation  

 

31Jan

Deadline to Claim 2016 Wellness Incentive(s)

  • Staff
  • FSBP   fsbp411   All  

To those members who participated in the Foreign Service Benefit Plan’s (FSBP) Simple Steps Living Well Together Program and Wellness Incentive in 2016, congratulations!  You took steps in making your wellness a priority.  However, some of you still have not claimed your 0 Wellness Incentive Reward(s) for completing one or more of the steps (Health Risk Assessment and Biometric Screening) outlined in the Living Well Together Program

You have only until March 6, 2017 to select and redeem your incentive(s).  After this date, you will not be able to redeem your incentive(s) for 2016.

To redeem your Wellness Incentive(s), please visit:

  • www.AFSPA.org/FSBP and select “My Online Services” (MOS) to log on to MOS
  • Select “Wellness Tools”
  • Select “WellBeing Solutions”
  • Click on the trophy in the upper right hand corner and select ‘My Rewards’

The 0 e-certificate incentive rewards you select when redeeming your incentives(s) will be emailed to you at the email address you provided during registration.

Please note the following change for the Simple Steps Living Well Together Program and Wellness Incentive for 2017:

Based on guidance from the Office of Personnel Management (OPM), we can no longer incent members with e-certificates that are not restricted to medical purchases.  As a result, when you complete one of the steps in our Living Well Together Program as outlined in the 2017 Plan Brochure, the FSBP will deposit money into a Wellness Incentive Fund Account.

The money deposited into your Wellness Incentive Fund Account is to help reimburse you for some medical costs, called “Eligible Medical Expenses”.  These include things like your deductible, coinsurance, and copayments that are your out-of-pocket expenses as outlined under Internal Revenue Service (IRS) Code Section 213(d).

 

31Jan
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

New Strength Approved for Narcan Nasal Spray

Narcan® (naloxone) Nasal Spray was approved by the U.S. Food and Drug Administration (FDA) in a 2mg dose on Jan. 25, 2017. Made by Adapt Pharma, it joins a 4mg strength that was launched in February 2016, for emergency treatment of known or suspected opioid overdose. The first dose should be given as soon as breathing difficulty or unconsciousness suggests that an overdose has been taken. Emergency help then should be contacted immediately. One spray (2mg) should be administered, in opposite nostrils, every two to three minutes until the patient recovers or emergency medical help arrives. To be packaged as two single-dose inhalers per box, Narcan Nasal Spray can be used for both adults and children. Complete prescribing information is available here.


Lower Strength Linzess Approved

On Jan. 26, 2017, Allergan and Ironwood Pharmaceuticals announced that their jointly marketed product, Linzess® (linaclotide) had been FDA approved as a new lower-strength. Like the 145mcg capsules, which were approved in 2012, the new 72mcg capsules are indicated to treat adults who have chronic idiopathic constipation (CIC). Over 30 million Americans are believed to have CIC, which has no apparent cause. Recommended dosing for CIC is one 72mcg or 145mcg capsule at least one-half hour before breakfast each day. A 290mg strength is approved for treating adults who have irritable bowel syndrome with constipation (IBS-C). A guanylate cyclase-C (GC-C) agonist, Linzess increases the amount of fluids in the intestines, speeds up movement of bowel contents and lessens abdominal pain. Due to the possibility that it may cause dehydration, Linzess should not be used for patients under the age of 18. The 72mcg strength is projected to be released in first quarter 2017. Updated prescribing information is available here.

 

27Jan

IRS Forms 1095-B and 1095-C

  • Staff
  • All   Benefit-Information   FSBP   fsbp411  

At the beginning of last year, Foreign Service Benefit Plan (FSBP) enrollees received the IRS Form 1095-B from the American Foreign Service Protective Association, underwriter for the FSBP, showing that you were covered under the FSBP.

You will receive the form again beginning in 2017 indicating that you had minimal essential coverage for the months in 2016 that you were enrolled in the FSBP.

If you have questions about the information on IRS Form 1095-B, or about lost or incorrect forms, you should contact us at (202) 833-4910 or at: [email protected]. Please do not contact OPM, your employing agency, or your retirement office about IRS Form 1095-B. OPM and the agencies will not be able to answer questions about the information on IRS Form 1095-B. It is our responsibility to make corrections to and answer questions about IRS Form 1095-B.

Federal employees also will receive the IRS Form 1095-C regarding their offer of health coverage from their employing agency. If you have questions about the information on IRS Form 1095-C, or about lost or incorrect forms, you should call your agency using the phone number provided on Line 10 of the IRS form. Annuitants who were employed a portion of the year will receive an IRS Form 1095-C also from your former employer. Otherwise, annuitants will not receive this form.

Click here for “Health Care Coverage Forms for Federal Employees Health Benefits – Fast Facts”.

Click here for “Health Care Coverage Forms for Annuitants – Fast Facts”.

 

27Jan

The governor of Georgia has declared a State of Emergency

  • staff
  • FSBP   fsbp411   All  

The governor of Georgia has declared a State of Emergency impacting the following counties due to tornadoes:  Atkinson, Baker, Berrien, Brooks, Calhoun, Clay, Colquitt, Cook, Crisp, Dougherty, Lowndes, Mitchell, Thomas, Turner, Wilcox and Worth.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

26Jan

Important Changes to Direct Billing Arrangements in China, Germany and Panama

  • Staff
  • FSBP   fsbp411   All  

AFSPA, underwriter for the Foreign Service Benefit Plan (FSBP), is reviewing and updating Agreements of Affiliation (AOA) with all of the international health care facilities in our Direct Billing Arrangements (DBA) to:

1) Confirm compliance with privacy regulations and
2) Confirm correct administrative and billing contacts.

Some China, Germany, and Panama agreements needed to be updated and will no longer be valid after February 28, 2017. Once a facility signs our updated AOA, we will add them back to our Direct Billing Arrangement.

Effective March 1, 2017, FSBP members will be required to pay out-of-pocket for services received from these facilities and submit a claim to the Plan. However, as an alternative, if a facility allows it, members can request a direct payment of benefits to the facility.  Members should submit a direct payment of benefits authorization for each claim filed by completing the bottom portion of our claim form, which can be downloaded at:

https://afspa.org/fsbp_home.cfm.

We will mail notifications to members when and if facilities sign updated AOA’s, reinstating the Direct Billing Arrangement.  In addition, we will post notices on our website and Facebook.

The facilities are listed below. 

 

Country

Cities

Facility Name

China

Beijing,Guangzhou, Shanghai

United Family Clinics (multiple locations)

  • Beijing United Family Hospital
  • Beijing United Family Rehabilitation Hospital
  • United Family CBD Clinic
  • United Family Financial Street Clinic
  • United Family Guancqumen Clinic
  • United Family Jianguomen Clinic
  • United Family Liangma Clinic
  • New Hope Clinic Center
  • United Family Shunyi Clinic and
  • United Family Wadaokou Clinic          
  • Guangzhou United Family Yue Xiu Clinic
  • Shanghai United Family Hospital           
  • Shanghai United Family Clinic                
  • Shanghai He Man Jia Clinic Co

Germany

Mainz

Universitätsklinik Mainz

Germany

Erlangen

Universitätsklinikum Erlangen

Germany

Frankfurt

Universitäts Klinikum Frankfurt Goethe-Universität

Germany

Darmstadt

Klinikum Darmstadt

Germany

Heidelberg

Universitätsklinikum Heidelberg

  • Frauenklinik Heidelberg                                 
  • Kinderklinik Heidelberg                      
  • Kopfklinik Heidelberg                          
  • Ludolf Krehlklinik

Germany

Mannheim

Theresienkrankenhaus und St. Hedwig-Klinik

Germany

Hanau

Klinikum Hanau

Germany

Berlin

Krankenhaus Waldfriede

Panama

Panama City

Hospital Punta Pacifica

Panama

Panama City

Hospital Nacional

Panama

Panama City

Hospital Santa Fe

 

 

 

 

23Jan
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

FDA Approval for Vantrela ER

Teva Pharmaceuticals Inc. announced on January 18, 2017, that it has received approval from the U.S. Food and Drug Administration (FDA) for Vantrela™ ER (hydrocodone) extended-release tablets. Vantrela ER, a CII scheduled opioid, is formulated to reduce the risk of abuse by ingestion, inhalation, and injection. It is indicated to treat intense pain that needs constant long-term drug treatment and that has not been controlled with other therapies. The tablets, which will be available in 15mg, 30mg, 45mg, 60mg and 90mg strengths, should not be chewed, crushed or dissolved. Recommended dosing is once every 12 hours with upper limits of 90mg per dose and 180mg per day. All opioids, including Vantrela ER, have several boxed warnings, including risks for abuse, addiction, overdose and respiratory depression. They caution about neonatal withdrawal syndrome for babies born to women who used opioids while pregnant, as well. Vantrela ER will be dispensed with a Medication Guide, under a Risk Evaluation and Mitigation Strategy (REMS). Teva has not yet announced its launch or pricing plans. Complete prescribing information is available here.  

Express Scripts is currently investigating the data around Vantrela ER for possible inclusion in the long-acting opioid step therapy rule.

Rhofade Approved to Treat Rosacea

Rhofade™ (oxymetazoline) cream 1% was FDA approved on January 18, 2017, for treating adults who have rosacea. Specifically, it is to be applied once a day to alleviate the facial erythema (redness) often caused by rosacea, a common chronic skin condition that causes acne, dryness and redness. Allergan plans to launch Rhofade in May 2017. Full prescribing information is available here. 

Express Scripts is currently investigating the data around Rhofade for a possible utilization management strategy.

FDA Approves Trulance for Chronic Constipation

On January 19, 2017, FDA approved Synergy Pharmaceutical’s Trulance™ (plecanatide) to treat adults who have chronic constipation without an apparent cause. Known as chronic idiopathic constipation (CIC), the condition is believed to affect as many as 33 million individuals in the United States. It is characterized by infrequent (three or less per week), incomplete and/or difficult bowel movements. Trulance stimulates an enzyme, guanylate cyclase-C (GC-C) that activates secretion of fluids in the gastrointestinal (GI) tract. One result is softer GI contents, which move through the intestines easier and faster. Taken once a day, Trulance will be available as 3mg tablets that can be crushed to mix with soft foods for those who cannot swallow whole tablets. Its labeling includes a boxed warning that children who take it may become seriously dehydrated. Thus, it is not indicated for patients under the age of 18 years. Launch is planned for later in the first quarter of 2017.


Fifth Indication for Imbruvica

AbbVie announced on Jan. 19, 2017, that FDA had granted accelerated approval, based on results from phase 2 studies, for Imbruvica® (ibrutinib) to treat relapsed or recurring marginal zone lymphoma (MZL). A form of non-Hodgkin’s lymphoma, MZL is estimated to affect fewer than 1,000 Americans, mostly older adults. Eligible patients will need to have systemic treatment and they previously have been treated with an anti-CD20 drug, such as Rituxan® (rituximab – Biogen / Genentech). An oral Bruton’s tyrosine kinase inhibitor, Imbruvica also is approved for treating certain patients with chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), small lymphocytic lymphoma (SLL) and Waldenström’s macroglobulinemia (WM). It is supplied as 140mg oral capsules. Depending on the condition being treated either three capsules (420mg) or four capsules (560mg) are taken once a day. Full prescribing information for Imbruvica is available here. 

Atopic Dermatitis Issues Document Available

Atopic dermatitis (AD), a form of eczema, is an inflammatory skin disease that affects approximately 10% to 20% of children and 1% to 3% of adults. AD presents as itchy and dry skin which can lead to lichenification (leathery skin) and lesions. Incidence of AD is highest in infancy with 60% of cases occurring within the first year of life, and 90% within the first five years of life. The strongest risk factor for AD is a family history for atopic (allergic)diseases such as AD, asthma and allergic rhinitis. Currently, moisturizers are an important part of treatment. Established medications for AD include topical corticosteroids, followed by topical calcineurin inhibitors (i.e., Elidel® [pimecrolimus 1% cream], Protopic® [tacrolimus 0.03% and 0.1% ointment, generic]). Short-term phototherapy and systemic immunosuppressive therapy (e.g., cyclosporine, azathioprine, methotrexate) is recommended if flares cannot be adequately controlled. The approval of topical Eucrisa™ (crisaborole ointment, 2% – Pfizer) in December 2016 and the anticipated approval of Dupixent (dupilumab subcutaneous injection – Regeneron / Sanofi) in March of 2017 provide newer therapy options. The intent of this Issues Document is to describe medicines in the atopic dermatitis market and to recognize that Express Scripts is evaluating potential utilization management programs for newer AD therapies. The Issues document is available here. 

 

19Jan
Message from the COO

Message from the COO

  • Kyle Longton
  • All   FSBP  

To Our Valued Members,

We have been experiencing a high call volume in recent days, particularly for the Foreign Service Benefit Plan. Many of our new members are reaching out with questions regarding their benefits and the programs we offer. I apologize for the long wait times and delays in service.

To be transparent, AFSPA is going through growing pains. We added nearly 2000 members in a two month period. This has created additional challenges in managing the increased amount of calls. The phone system provides you with an estimated wait time, and I understand many have experienced longer waits that estimated. In response to these challenges, we have increased the number of staff answering member calls. Our goal has been to offer “unparalleled service” to all members. But with the recent growth, we have fallen short of this in some instances, and for that, I am personally and truly sorry.

Many of our newly enrolled members are still waiting for their ID cards to arrive. Our ability to send the cards depends on when we receive enrollment paperwork from the Federal payroll offices, and more than a month after the end of Open Season we continue to receive paperwork. We make every effort to process enrollments and changes as quickly as possible, and Aetna mails cards to members within two weeks after receiving the enrollment information.   

For current members seeking information on the status of claims, I encourage you to visit My Online Services at https://member.cvty.com. If you have other questions or are a new member, you can call us at 202-833-4910 or use the links to secure forms on our website at www.afspa.org/secureforms.cfm. Answer two or three questions and you will be at the right form. These forms are tracked through a ticket system in our office, and multiple people have access to the forms. This ensures that your message will not get lost or delayed because someone is out of the office. The increased membership has affected our response time to written correspondence as well, but we strive to provide timely responses to all inquiries.

Please note that our office will be closed on Friday, January 20, 2017, due to activities related to the Presidential Inauguration. We will resume normal business hours on Monday, January 23, 2017, at 8:30 am.

I encourage you to let us know how we can serve you better. Assisting our members and improving the member experience is our first priority. Thank you for trusting us with your care.

 

Sincerely,

Kyle Longton

Chief Operating Officer

 

17Jan
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Arymo ER Abuse-Deterrent Morphine Approved

On January 9, 2017, the U.S. Food and Drug Administration (FDA) approved Arymo™ ER (morphine sulfate) extended release. A C-II scheduled drug, it is indicated for managing severe pain that needs constant treatment and that is not controlled by other treatments. The manufacturer, Egalet Corp., plans to launch Arymo ER during the first quarter of 2017. It will be available as 15mg, 30mg and 60mg extended-release tablets that are designed to resist abuse. The polymer-matrix tablets are difficult to break or crush, and they congeal when exposed to liquids. Even so, Arymo ER has the same boxed warning that is on all opioids -- that taking it may be associated with abuse, addiction, misuse, overdose and death. Babies born to women who use it during pregnancy may suffer neonatal withdrawal syndrome and older children may overdose from accidentally taking it. Recommended dosing for patients new to opioid therapy is one 15mg tablet every 8 hours to 12 hours. Full prescribing information for Arymo ER is available here.

 

13Jan

The governor of Oklahoma has declared a State of Emergency

  • Staff
  • All   FSBP   fsbp411  

The governor of Oklahoma has declared a State of Emergency impacting all counties in Oklahoma due to Winter Storm Jupiter.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

 

10Jan

The governor of Nevada has declared a state of Emergency

  • Staff
  • FSBP   fsbp411   All  

The governor of Nevada has declared a State of Emergency for the following counties due to severe flooding: Douglas, Lyon, Storey, Washoe and the City of Carson City with an effective date of January 9, 2017 and expiration date of February 8, 2017.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

10Jan
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Generic to Emend Capsules Launched

On January 4, 2017, Sandoz announced the launch of its AB-rated generic to Merck’s Emend® (aprepitant capsules), a product indicated for use in combination with other antiemetic agents, in patients 12 years of age and older, for the prevention of acute and delayed nausea and vomiting associated with chemotherapy. It is also approved for the prevention of postoperative nausea and vomiting in adults. Sandoz’ generic is available as 40mg, 80mg, and 125mg capsules. U.S. sales of Emend capsules were approximately million for the twelve months ending October 2016. Shipments of the generics have already begun.

Generic to Kaletra Oral Solution Approved

On January 3, 2017, Lannett Company announced that it received U.S. Food and Drug Administration (FDA) approval for its AB-rated generic to AbbVie’s Kaletra® (lopinavir/ritonavir oral solution), 80mg/20mg per mL. Kaletra is an HIV-1 protease inhibitor indicated for use in combination with other antiretrovirals for the treatment of HIV-1 infection in adults and children (14 days and older). The oral solution must be taken with food. Generics to AbbVie’s Kaletra capsules and tablets have not yet been approved. Lannett plans on launching its generic lopinavir/ritonavir oral solution in the near future.

Lucentis Approved for Myopic Choroidal Neovascularization

Genentech announced the FDA approval of Lucentis® (ranibizumab injection) 0.5mg for the treatment of patients with myopic choroidal neovascularization (mCNV) on January 5, 2017. This condition is a complication of severe near-sightedness that can lead to blindness. Recommended dosing for mCNV is 0.5mg (0.05mL) by intravitreal (eye) injection once monthly for up to three months. Lucentis is a vascular endothelial growth factor (VEGF) inhibitor that was first approved in 2006 for treating diabetic macular edema (DME). It is also approved to treat wet age-related macular degeneration, macular degeneration due to obstructed retinal veins and DME in patients who have diabetic retinopathy. Full prescribing information is available here. 

FDA Approvals for 2016 Issues Document Available

In 2016, the Food and Drug Administration (FDA) approved 24 new medications, known as new molecular entities (NMEs) and therapeutic Biologic License Applications (BLAs), which is significantly lower that the all-time high of 56 new medications approved in 2015. This document is intended to provide a brief overview of FDA’s approval activity for 2016. The “FDA Approvals for 2016” Issues Document is available here. 

 

9Jan

State of Emergency in Georgia, North Carolina, South Carolina and Virginia

  • Staff
  • All   FSBP   fsbp411  

The Governor of Georgia has declared a State of Emergency for the following counties due to Winter Storm Helena: Baldwin, Banks, Barrow, Bartow, Bibb, Butts, Carroll, Catoosa, Chattooga, Cherokee, Clarke, Clayton, Cobb, Columbia, Coweta, Crawford, Dade, Dawson, DeKalb, Douglas, Elbert, Fannin, Fayette, Floyd, Forsyth, Franklin, Fulton, Gilmer, Gordon, Greene, Gwinnett, Habersham, Hall, Hancock, Haralson, Harris, Hart, Heard, Henry, Jackson, Jasper, Jones, Lamar, Lincoln, Lumpkin, Madison, McDuffie, Meriwether, Monroe, Morgan, Murray, Muscogee, Newton, Oconee, Oglethorpe, Paulding, Pickens, Pike, Polk, Putnam, Rabun, Richmond, Rockdale, Spalding, Stephens, Talbot, Taliaferro, Taylor, Towns, Treutlen, Troup, Union, Upson, Walker, Walton, Warren, White, Whitfield and Wilkes.

The Governors of North Carolina, South Carolina and Virginia have declared States of Emergency due to Winter Storm Helena impacting all counties in each state.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

4Jan
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Happy New Year and Welcome to 2017! We want to welcome all our newly enrolled Foreign Service Benefit Plan (FSBP) members. It is an honor to be your chosen health plan. We are offering many new services to start your new year off in the right direction. Please take the time to review your full Plan brochure. However, I wanted to tell you about a few featured benefits in this first monthly message of the year.

Telehealth is an important new 2017 benefit for our members. It provides 24/7, on demand access to medical professionals via phone, mobile, and video. Unlike the Nurseline, which remains an important benefit, our Telehealth benefit provides for a virtual visit with a provider. Doctors can treat and prescribe medications for common health issues such as: colds, flu, fever, rash, ear infections, and migraines. You even can “see” a therapist for ongoing counseling. We provide this progressive delivery system with no cost to you - yes, you have a 

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3FACH 3M 3-WEGEHAHN 43-KRAEUTEROEL 4-DMAP 4PROTECTION 4-WEGEHAHN A.T. A.VOGEL AAGAARD AAPO AAR AARANE AB ABC ABCE ABDE ABDECKKAPPE ABDECKTUCH ABDECKTUECHER ABDOMILON ABDOMINAL ABDOMINALVERBAND ABDUKTIONSKEIL ABDUKTIONSKISSEN ABE ABEND ABENDKRAEUTERTEE ABENDROT ABENDSONNE ABENDSTIMMUNG ABFALLBEUTEL ABFUEHR ABFUEHRKAPSELN ABHAENGE ABIES ABILAINE ABILIFY ABITIMA ABLAUFSCHLAUCH ABLAUFSET ABLE ABLEITUNGSSCHLAUCH ABM ABNEHMEN ABNEHMENDER ABNOBAVISCUM ABRI ABROPERNOL ABROTANUM ABS ABSAUGGERAET ABSAUGKATHETER ABSAUGSCHLAUCH ABSAUGSYSTEM ABSAUGUNTERBRECHUNG ABSCHLUSS ABSCHMINK ABSCHNUERBINDE ABSINTHIUM ABSINTHIUM/CARYOPHYLLI ABSORBER ABSORBITOL ABSORIN ABSTRICHSPATEL ABTEI ABWASCHBUERSTE ABWURFBEHAELTER ABWURFBEUTEL AC ACADEMIE ACALYPHA ACANTE ACAREX ACB ACC ACCOROMBA ACCU ACCUFUSER ACCULINK ACCUPAQUE ACCUPRO ACCUPRON ACCUSPORT ACCUTEST ACCUTILITY ACCUTREND ACCUVAC ACCUZIDE ACE ACE+SELEN ACEBUTOLOL ACECROMOL ACEMETACIN ACEMETADOC ACEMUC ACENORM ACER ACERBON ACERCOMP ACEROLA ACEROLA-C ACERPES ACESAL ACETABS ACETOCAUSTIN ACETOLYT ACETYL ACETYLCHOLINCHLORID ACETYLCYSTEIN ACETYLSALICYLSAEURE ACETYST ACHATWASSER ACHIEVE ACHILLEA ACHILLESBANDAGE ACHILLO ACHILLODYN ACHILLOTRAIN ACHIMED ACHISAN ACHROMYCIN ACHSELEINLAGE ACHSELKRUECKE ACHSELSTUETZE ACHT ACIBUCHA ACIC ACICLO ACICLOBETA ACICLOSTAD ACICLOVIR ACID ACIDOFLOR ACIDOPHILUS ACIDRINE ACIDUM ACIDUMPHOS ACIMETHIN ACIMOL ACIRUFAN ACIVIR ACKERMINZE ACLIMAT ACLINDA ACLOSS ACN ACNIX ACNU ACOCYNTHIS ACOIN ACONIRELL ACONIT ACONITUM ACONITUM/CHINA ACONITUM/NICOTIANA ACONITYSAT ACORUS ACOS ACRIBIOVISC ACRIDECA ACRIFLU ACRIHYLON ACRIPUR ACRISIL ACRIVISCOSE ACRYL ACRYLASTIC ACT ACTAEA ACTICOAT ACTIFLUX ACTIHAEMYL ACTILYSE ACTIMAX ACTIMEB ACTINIDIN ACTIPOL ACTISORB ACTIVA ACTIVAIR ACTIVE ACTIVELLE ACTIVLINE ACTIVOGLAND ACTIZYME ACTONEL ACTOS ACTOVEGIN ACTRAPHANE ACTRAPID ACTREEN ACU ACUBRAIN ACULAR ACUTE ACUTEK ACYCLOVIR ADALAT ADAMIN ADAPPLICATOR ADAPT ADAPTER ADAPTIC ADATOCEL ADDEL ADDIGRIP ADDITION ADDITIVA ADEKIN ADELHOLZER ADELWOEHRER ADENOLIN-ENTOXIN ADENOMA ADENOMTROPFEN ADENOSCAN ADENOSIN ADENOSYN ADEPS ADEPT ADERPLUS ADHAES ADHAESIONS ADHATODA ADHESIVE ADICLAIR ADIPORELL ADIPOROE-PLEX ADL ADLUMIA AD-MUC ADOCOMP ADOCOR ADONIS ADREKAR ADRENALIN ADRENAM ADRIARINE ADRIBLASTIN ADRIBLASTINA ADRIMEDAC ADS ADSORBONAC ADUMBRAN ADVANCE ADVANTAN ADVEL ADVENTS ADVERSUTEN ADVIT AEGROSAN AEGYPTISCHES AEQUAMEN AERIUS AERO AEROBEC AEROBIN AEROCEF AEROCHAMBER AERODESIN AERODIOL AERODUR AERODYNE AEROMAX AEROPLUS AEROSOL AEROSOLATOR AEROSOLMASKE AEROSOLVERNEBLER AEROSONIC AEROTEX AEROXON AERZTE AERZTEKREPP AESCORIN AESCOSULF AESCU AESCULAN AESCULINUM AESCULO AESCULUS AESCUSAN AESCUVEN AESTASE AETHERIA AETHERISCHE AETHIOPS AETHOXYSKLEROL AETHUSA AF AFA AFFENKOPFPILZ AFONILUM AFPRED AFRA AFRAMED AFRIKANISCHES AFRO AFRODOR AFTER AFTERBURNER AFUEHR AG AGAMADON AGANIA AGAPURIN AGARICUS AGARIKIN AGAROLETTEN A-GEN AGENA AGENERASE AGGRASTAT AGGRENOX AGILAN AGIOCUR AGIOLAX AGIOSLIM AGIOSTOP AGIT AGNESIN AGNO AGNOLYT AGNUCASTON AGNUFEMIL AGNURELL AGNUS AGONTAN AGOPTON AGRAPHIS AGRIMONIA AGROPYRON AGRUM AGRUMFRUECHTE AH3 AHA AHAVA AHD AHORN AHORNSIRUP AHP AIDS AILANTHUS AILGENO AIR AIRCAST AIRE AIRGO AIRLAID AIRLOC AIROL AIRPLANEFIT AIRWAVES AJONA AJUTA AKADERM AKE AKILDIA AKILEINE AKILWINTER AKINETON AKIPIC AKKU AKLONIN AKNE AKNE-CORDES AKNEDERM AKNEFUG AKNEMYCIN AKNENORMIN AKNEROXID AKNESYX AKNICHTHOL AKNOSAN AKRINOR AKROTHERM AKTIFERRIN AKTIV AKTIVANAD AKTIVIERUNGSBAD AKTIVIN AKTREN AKU AKUPRESSUR AKUPUNKTURMATTE AKUPUNKTURNADELN AKUSTIKA AKUT AKUTUR AKWA ALACETAN ALADDIN ALASENN ALBAPEARL ALBICANSAN ALBIOTIC ALBOTHYL ALBRECHT ALBUMINIMETER ALBUMO ALBUMOHEEL ALBUSTIX ALCANGROL ALCEA ALCHEMILLA ALCINA ALCO ALCODERM ALCOHOL ALCON ALCOTEST ALCOTUBE ALDACTONE ALDARA ALDIAMED ALDURAZYME ALEGRO ALEIMA ALEPA ALERG ALESAN ALETE ALETEMIL ALETRIS ALEVE ALEX ALEXAN ALFACID ALFALFA ALFALFAGRUEN ALFAMEDIN ALFASON ALFERM ALFERMCOMBI ALFLUEWID ALFUZOSIN ALGEMARIN ALGEN ALGENFIT ALGENPLUS ALGENTRIOFIT ALGEROTEX ALGESAL ALGIRA ALGISITE ALGODREAM ALGOMED ALGOPLAQUE ALHO ALIKSIR ALINA ALIONE ALIPURO ALK ALKA ALKALA ALKALI ALKALINE ALKAMED ALKERAN ALKMENE ALKO ALKOHOL ALKOHOLCOMPUTER ALKOHOLTEST ALKOHOLTESTER ALKOHOLTESTGERAET ALKOHOLTUPFER ALKOTIP ALL ALLCON ALLDAYS ALLDRESS ALLEGRO ALLENDORFF ALLERBIO ALLERGAN ALLERGENICS ALLERGIE ALLERGIEN ALLERGIKA ALLERGIKER ALLERGIPURAN ALLERG-JURAT ALLERGO ALLERGOCOVER ALLERGOCROM ALLERGODIL ALLERGOKATT ALLERGOPOS ALLERGOSOFT ALLERGOSPASMIN ALLERGOVAL ALLERGOVIT ALLERKINES ALLES ALLEVYN ALLGAEUER ALLGAMED ALLGENTABLETTEN ALLIANCE ALLICUR ALLIOBOLAN ALLIOSAN ALLITEC ALLIUM ALLIUM/CUPRUM ALLO ALLOBETA ALLOFERIN ALLO-PUREN ALLOPURINOL ALLOWIEB ALLPRESAN ALLSET ALLSICUR ALLTOTAL ALLUNA ALLVORAN ALLYA ALMA ALMAG ALMARYS ALMASAN ALMASED ALMINERAL ALMIRID ALMOGRAN ALMSONNE ALNA ALNAVIT ALOACTIV ALOCAP ALOCLAIR ALOE ALOEAKTIV ALOECAN ALOEFIT ALOELIXIR ALOMIDE ALOSAN ALOVA ALOVISA ALOVITA ALP ALPA ALPAROMA ALPECIN ALPEN ALPENCOSMED ALPENKRAEUTER ALPENVEILCHEN ALPHA ALPHABELLADONNA ALPHABRYON ALPHACEA ALPHACEPA ALPHACHELIDON ALPHACID ALPHACONIUM ALPHACYCLAM ALPHADENDRON ALPHADERM ALPHAESCIN ALPHAFLAM ALPHAGAN ALPHAGRAPH ALPHALEUN ALPHALILIUM ALPHALOAD ALPHAMELIS ALPHARUTIN ALPHASAN ALPHASELEN ALPHASOLIDAGO ALPHASOLUSIN ALPHASTROPHAN ALPHATROPIN ALPHAVERATRUM ALPHAVIRGIN ALPHAZINCUM ALPIA ALPICORT ALPIN ALPINAMED ALPINE ALPRAZOLAM ALPROX ALRHEUMUN ALSIFEMIN ALSIGINSENG ALSIKELP ALSINE ALSIVISION ALSOL ALSTONIA ALT ALTERAGE ALTHAEA ALTMUEHLTALER ALTOIDS ALU ALUDERM ALUDROX ALUMED ALUMEN ALUMINA ALUMINIUM ALUMINIUMSCHIENE ALUMINIUMSTAB ALUPENT ALUSTAL ALVEMA ALVEOFACT ALVEOLARTAMPONADE ALVESIN ALVOGYL ALWAYS ALYMPHON ALZ ALZHEIMER AM AMACARE AMADO AMADOL AMAFIT AMAFRESH AMAGESAN AMAGUARD AMALAKI AMAN AMANTA AMANTADIN AMANTAGAMMA AMARA AMARYL AMASAN AMAZING AMBATEX AMBE AMBENE AMBER AMBERPHARM AMBI AMBIENTE AMBISOME AMBRA AMBRAX AMBRE AMBRIL AMBRO AMBROBETA AMBRODOC AMBRODOXY AMBROHEXAL AMBROINFANT AMBROLOES AMBROSIA AMBROXIN AMBROXOL AMBU AMC AMCIDERM AMEDA AMEISEN AMERICAN AMETHYST AMETYCINE AMEU AMI AMICA AMIELLE AMIKACIN AMILOCOMP AMILORETIK AMILORID AMILOZID AMIN AMINEURIN AMINO AMINOBOL AMINOCARIN AMINOCOMP AMINOFIT AMINOFUSIN AMINOL AMINOMEL AMINOMIX AMINOPAED AMINOPAN AMINOPHYLLIN AMINOPLASMAL AMINOPLUS AMINORELL AMINORHEUM AMINOS AMINOSAEURE AMINOSAEUREKOMPLEX AMINOSAEUREN AMINOSTERIL AMINOTRANS AMINOVEN AMIODAREX AMIODARON AMIODURA AMIOGAMMA AMIOHEXAL AMIOXID AMISULPRID AMISULPRIDLICH AMITRIPTYLIN AMIXX AMLO AMLODIPIN AMMI AMMONAPS AMMONIAK AMMONIUM AMNION AMOCID AMOCLAV AMOL AMOR AMOSEPT AMOSVITAL AMOXCLAV AMOXI AMOXIBETA AMOXICILLIN AMOXICLAV AMOXIDOC AMOXIDURA AMOXIHEXAL AMOXILLAT AMOXIMERCK AMOXIPLUS AMOXIWIEB AMOXYPEN AMPHISEPT AMPHO AMPHODYN AMPHOTERICIN AMPICILLIN AMPUTIERTEN AMPUWA AMSIC AMSIDYL AMV AMYLIUM AMYRIS AMYTIS AN- ANA ANABOL ANABOX ANACARDIUM ANACHOLIN ANAECAIN ANAEMIE-GASTREU ANAEMODORON ANAESTHECOMP ANAESTHESIN ANAESTHESULF ANAFORM ANAFRANIL ANAGALLIS ANAGENNAN ANALDEHNER ANALGIN ANALOG ANALSONDE ANAMINI ANANAS ANAPA ANAPEN ANAPLUS ANASTIL ANATHERUM ANATIM ANATOMICFOAM ANCID ANCO ANCOTIL ANDANTE ANDERE ANDOLOR ANDORN ANDREA ANDRIOL ANDROCARE ANDROCUR ANDRODERM ANDROFIT ANDROGENOTROP ANDROTOP ANEFUG ANEL ANEMET ANESTAGO ANETHUM ANEURIN ANEXATE ANFOKALI ANGASS ANGELICA ANGELIKAOEL ANGELIKAS ANGELIKAWURZEL ANGELINOCT ANGELIQ ANGELS ANGIBOSAN ANGIN ANGINA ANGINETTEN ANGINOMYCIN ANGINOVIN ANGIO ANGIOGRAPHIE ANGIO-INJEEL ANGIONORM ANGIOPAS ANGIOTON ANGI-TRUW ANGOCIN ANGOPECT ANGORA ANGURATE ANGUSTURA ANHAENGE ANHALONIUM ANIFER ANIFLAZYM ANIS ANISAN ANISSAMEN ANISTEE ANISUM ANKESIL ANLEITUNG ANNA ANNAS ANNOX ANOKRYO ANORE ANOREX ANSCHLUSS ANSCHLUSSSCHLAUCH ANSCHLUSSTUELLE ANSPRITZADAPTER ANSTICHLEITUNG ANSUDOR ANTABUS ANTACIDUM ANTAGONIL ANTELEPSIN ANTEPAN ANTHERICUM ANTHOCYAN ANTHOZIANE ANTHRACHINON ANTI ANTIADIPOSITUM ANTIALLERGICUM ANTICALCINATOR ANTICHOLIUM ANTIDOTUM ANTIFALTEN ANTIFECT ANTIFLAMMIN ANTIFLUID ANTIFOCAL ANTIFOG ANTIFUNGOL ANTIHYDRAL ANTIHYPERTONICUM ANTIKATARAKTIKUM ANTIMAST ANTIMIGREN ANTIMONIT ANTIMONIT/ECHINACEA ANTIMONIUM ANTINEPHRIN ANTINEURALGICUM ANTINEURALGIE ANTINICOTICUM ANTIOX ANTIOXIDANS ANTIOXIDANT ANTIOXIDANTIEN ANTIOXIRELL ANTIPARKIN ANTIPHONE ANTIPLAK ANTIPYAEMISYN ANTIRHEUMATICUM ANTIRHEUMATIKUM ANTIRUTSCHTABLETT ANTISCABIOSUM ANTISEPTIC ANTISEPTIKA ANTISKLEROSIN ANTISLIP ANTISMO ANTISTAX ANTISTIN ANTISTRESS ANTISVET ANTITOXIN ANTITUSSIVUM ANTJES ANTODOX ANTONELLA ANTOXAL ANTRA ANTUSSAN ANUS ANUSPRAETER ANUSPRAETIN ANUVITAL ANWENDER ANXUT ANZEMET ANZIEHHANDSCHUHE ANZIEHHILFE ANZIEHSTAB AOK AOQILI AORTA AOSEPT AP APARSONIN APATIT APENTA APERISAN APERNYL APEX APFEL APFELESSIG APFELPEKTIN APFELTEE APFELTRAUM APHRO APHRODISIA APHRODITE API APIBAL API-ENERGIE APIFORM APIHERBA APIMID APIS APIS/ARNICA APIS/LEVISTICUM APIS/RHUS APISARTHRON APISERUM APISINUM APL APLIDAL APLONA APO APOAKTIV APOBEST APOBON APOCANDA APOCARE APOCYNUM APOFAM APO-GO APOLINE APOLLINARIS APOLLO APOMORPHIN APOMORPHINUM APONAL APONORM APONTI APOPLEXIE APOROVEN A-PORT APOSERIS APOTENS APOTHEKE APOTHEKEN APOTHEKER APOTHEKERS APOVITAL APP APPENDICITIS APPENDIX APPLE APPLEPHENON APPLICA APPLIKATIONSHILFE APPLIKATIONS-SET APPLIKATOR APPLIX APRICAL APRIKOSEN APRIKOSENKERN APRIKOSENKERNOEL APROVEL APS APSOMOL APTAL APTAMIL AQEO AQSIA AQUA AQUA+TS AQUABELLA AQUACEL AQUACORT AQUAFARM AQUAFIT AQUAFLO AQUAGLIDE AQUAPAK AQUAPHOR AQUAPHORIL AQUAPRED AQUAPROTECT AQUARETIC AQUAROBAL AQUAROMA AQUASAFE AQUASIV AQUATEC AQUAVIT AQUIFY AQUILEGIA AQUILINUM AQUO-CYTOBION AQUOSA AQUO-TRINITROSAN ARA ARABIN ARAD ARALIA ARALIS ARAMETA ARANDISIT ARANEA ARANESP ARANICYN ARANIFORCE ARANISAN ARANKA ARAVA ARBID ARBO ARBUZ ARCADE ARCANUM ARCASIN ARCHANGELICA ARCON ARCOXIA ARCTIC ARCTIS ARCTIUM ARCTUVAN ARCUS ARDEYAKTIV ARDEYCERYL ARDEYCHOLAN ARDEYCORDAL ARDEYDORM ARDEYHEPAN ARDEYSEDON ARDEYTROPIN ARDO ARDOCORE AREDIA ARELIX ARETENSIN ARGAMINT ARGAN ARGANOEL ARGENTIT ARGENTRIX ARGENTUM ARGENTUM/BERBERIS ARGENTUM/QUARZ ARGENTUM/ROHRZUCKER ARGENTUM/STIBIUM ARGILETZ ARGININ ARGININHYDROCHLORID ARGUMIN ARGUN ARGUVIT ARGYLE ARHAMA ARIANNA ARICEPT ARILIN ARIMIDEX ARION ARIOSAN ARISTOCHOL ARISTOLOCHIA ARIVEN ARIXTRA ARKAIM ARKO ARKOSOL ARKOTONICZ ARKTISMOOR ARLEVERT ARM- ARMBADEWANNE ARMBANDUHR ARMBINDE ARMGURT ARMHEBEL ARMINOL ARMLEHNE ARMMANSCHETTE ARMPOLSTER ARMSCHIENE ARMSCHLINGE ARMSTRUMPF ARMTRAGEGURT ARMTRAGETUCH ARNICA ARNICA/AURUM ARNICA/BETULA ARNICA/FORMICA ARNICA/LEVISTICUM ARNICA/PLUMBUM ARNICA/SYMPHYTUM ARNIFIT ARNIKA ARNIKABLUETEN ARNIKAMAC ARNIKAMILL ARNIKASALBE ARNIMONT AROMA AROMABAD AROMABALSAM AROMAIR AROMASIN AROMATHERAPIE AROMATUCH ARONAL ARONAL/ELMEX ARONIA AROXETIN ARRAN ARRETIL ARRHYTHMIE-GASTREU ARSENICUM ARSENUM ARTANE ARTELAC ARTEMISIA ARTEOPTIC ARTERENOL ARTERIA ARTERIA-CYL ARTERIAE ARTERIENABBINDER ARTERIENKLEMME ARTERIOPAS ARTERIOTONIN ARTERIOTROP ARTH ARTHOTEC ARTHREASE ARTHREX ARTHRI ARTHRIBOSAN ARTHRIFID ARTHRINOWAN ARTHRISAN ARTHRISELECT ARTHRITIS ARTHRO ARTHRODYNAT ARTHROFIX ARTHROKATT ARTHROKEHLAN ARTHRON ARTHRORELL ARTHROROBAL ARTHROSE ARTHROSENEX ARTHROSETTEN ARTHROSEW ARTHROTABS ARTHROTANA ARTHROVIT ARTICAST ARTICULATIO ARTICULATIONES ARTICURELL ARTIFLEX ARTIGEL ARTISCHOCKE ARTISCHOCKEN ARTISCHOCKENSAFT ARTISTEP ARTROSKIN ARTROSTIM ARUBA ARUFIL ARUM ARUNDO ARUTIMOL ARUVIT ARYNX ARZNEIBAD ARZNEIMITTELVERNEBLER ARZT ARZTSEIFE AS ASA ASAB ASACOLITIN ASARUM ASCENSIA ASCHE ASCLEPIAS ASCOPLEX ASCORBINSAEURE ASCORELL ASCORVIT ASCOTOP ASENDRA ASEPTEX ASEPTISOL ASEPTODERM ASEPTOMAN ASEPTOPUR ASGO ASHVAGANDHA ASHWAGANDARISHTA ASIAMENT ASIEN ASKINA ASL+45F ASL+45FM ASL+45M ASLAN ASMALERT ASMANEX ASMAPLAN ASPAGUSIN ASPARAGIN ASPARAGINASE ASPARAGININ ASPARAGUS ASPARGOS ASPASMON ASPECTON ASPENIN ASPERGILLUS ASPERULA ASPHALINE ASPIRATIONSKANUELE ASPIRIN ASPIRINE ASPISOL ASPR ASPRO ASS ASSALIX ASSISTENT ASSITAN ASSPLANT ASSUGRIN ASSURA ASTERIAS ASTHMA ASTHMAKHELL ASTHMALITAN ASTHMALYTICUM ASTHMAROBAL ASTHMAVOWEN ASTHMOPROTECT ASTONIN ASTRA ASTRAGALUS ASTRO ASTRONAUTENKOST ASTROSON ATABA ATACAND ATARAX ATE ATEBETA ATEHEXAL ATEIA ATEL ATEM ATEMARON ATEMFREI ATEMGOLD ATEMKALK ATEMLUFTBEFEUCHTER ATEMMASKE ATEMMUSKELTRAINER ATEMSCHUTZMASKE ATEMTRAINER ATEMUR ATENDOL ATENIF ATENO ATENOGAMMA ATENOLOL ATENOS ATG ATHEROSAL ATHLETICARE ATITEN ATLAS ATMADISC ATMOLIT ATMOPORT ATMOS ATMOVAC ATMUNGSSENSOR ATODERM ATODIANE ATOS ATOSIL ATP ATRAC ATRACURIUM ATRALOC ATRAUCAN ATRAUMAN ATRIDOX ATRIX ATRO ATROPA ATROPIN ATROPINOL ATROPINSULFAT ATROPINUM ATROSAN ATROVENT ATTENDS ATTITUDE ATTRACTIVE AU AUDIOZON AUDREY AUFBAU AUFBAUCREME AUFBAUKALK AUFBAUNAHRUNG AUFBEWAHRUNGSBEHAELTER AUFFANGBEUTEL AUFHAENGER AUFHAENGEVORRICHTUNG AUFLAGE AUFRICHTEGURT AUFRICHTEHILFE AUFRICHTER AUFRICHTHILFE AUFRICHTSESSEL AUGEN AUGENABDECKUNG AUGENBADEWANNE AUGENBINDE AUGENDUSCHE AUGENFREMDKOERPER AUGENGUT AUGENKLAPPE AUGENKOMPRESSEN AUGENKRAFT AUGENNAHRUNG AUGENPIPETTE AUGENSALBENSTAEBCHEN AUGENSCHIELKAPSEL AUGENSCHUTZ AUGENSPUELFLASCHE AUGENTONIKUM AUGENTROPFEN AUGENTROPFENZAEHLER AUGENTROPFENZAEHLER. AUGENTROPFPIPETTE AUGENTROPFPIPETTEN AUGENTROST AUGENVITAMINE AUGENWATTE AUGMENTAN AUGMENTIN AUGMENTINE AURA AUREAL AUREOMYCIN AURIBOSAN AURICULARIA AURIDERM AURIMED AUROANALIN AURO-CYL AUROGUTT AUROLIQUID AUROMERE AURONOL AUROPLATIN AURORIX AUROVITAN AURUFORM AURUM AURUM/ AURUM/APIS AURUM/BELLADONNA AURUM/CARDIODORON AURUM/EQUISETUM AURUM/HYOSCYAMUS AURUM/LAVANDULA AURUM/PRUNUS AURUM/STROPHANTHUS AURUM/VALERIANA AURUMHEEL AUSLAUFHAHN AUSSTREIFBEUTEL AUSTAUSCHPADS AUSTAUSCHSET AUSTERN AUSTERNSCHALEN AUSTRALIAS AUSWECHSELGRIFF AUTAN AUTO AUTOCLIX AUTODERM AUTODROP AUTOGENES AUTOGRAPH AUTOJECT AUTOKISSEN AUTOKLAVBAND AUTOLENDEN AUTOLET AUTOMATIK AUTOMIX AUTOPEN AUTOPRESSUR AUTOSANA AUXCILLIN AVALON AVALOX AVANDAMET AVANDIA AVEDORM AVENA AVENE AVENT AVENTURIN AVIARIA A-VICOTRAT AVIGILEN AVOCADO AVODART AVONEX AXE AXIS AXURA AYA AYRE AYUR AYURFILTER AYURFLOW AYURSANA AYURVEDA AYURVEDISCH AYURVEDISCHE AYURVEDISCHER AYURVEDISCHES AYURVITAL AYWET A-Z AZA AZACTAM AZAFALK AZAMEDAC AZARON AZATHIODURA AZATHIOPRIN AZEAT AZINAT A-ZINK AZOPT AZUBRONCHIN AZUDOXAT AZULFIDINE AZULIPONT AZULON AZUMETOP AZUNAFTIL AZUPAMIL AZUPENTAT AZUPERAMID AZUPROSTAT AZUR AZURANIT AZUTANA B BA BABIX BABY BABY- BABYBAD BABYBASICS BABYCONTROL BABYFELL BABYFLASCHE BABYFLASCHENWAERMER BABYFUSS BABYGARNITUR BABYHAARBUERSTE BABYHALER BABYKOSTWAERMER BABYLAX BABYLOEFFEL BABYMESSMATTE BABYMULDE BABY-R BABYS BABYSAUGER. BABYSCHERE BABYSWEET BABYTRAGEGURT BABYWAAGE BABYWATCH BABYZAHNBUERSTE BAC BAC. BACHBLUETEN BACILLINUM BACILLOCID BACILLOL BACILLUS BACK BACKSWING BACLOFEN BACTERIUM BACTIGRAS BACTISUBTIL BACTOFIT BACTOFLOR BACTOPLEX BACTOREDUCT BACTRACID BACTROBAN BAD BADE BADEBRETT BADEBUERSTE BADEDAS BADEHOCKER BADEKONZENTRAT BADELIFT BADELIFTER BADEOEL BADESALZ BADESCHWAMM BADESITZ BADESTRUMPF BADETHERMOMETER BADEWANNEN BADEWANNENBRETT BADEWANNENDREHSITZ BADEWANNENEINSTEIGEGRIFF BADEWANNENEINSTIEGHILFE BADEWANNENGLEITSCHUTZ BADEWANNENGRIFF BADEWANNENHOCKER BADEWANNENLIFT BADEWANNENLIFTER BADEWANNENSITZ BADEWANNENSTUHL BADEWANNENVERKUERZER BADHELFER BADIAGA BAERENLAUCH BAERENTRAUBE BAERENTRAUBEN BAERENTRAUBENBLAETTER BAERLAPPKRAUT BAERLAU BAERLAUCH BAERLAUCHGEIST BAEUCHLEIN BAHIA BAKEN BAKTERIEN/VIRENFILTER BAKTERIENFILTER BAKTOBOD BAKTOLAN BAKTOLIN BALANCE BALDRIAN BALDRIANTINKTUR BALDRIANWURZELTEE BALDRIAPUR BALDRILIND BALDRIPARAN BALDRIVIT BALDUR BALDURAT BALISA BALKIS BALL- BALLASTFORT BALLASTSTOFF BALLASTSTOFFE BALLKISSEN BALLONKATHETER BALLONREBE BALLONSPRITZE BALLPUMPE BALLSCHALE BALLSPRITZE BALMANDOL BALNEO BALNEOCONZEN BALNEODOR BALNEOVIT BALNEUM BALSAM BALSAMED BALSAMISCHER BALSAMKA BALSAMUM BALSAN BALSAVIT BALTIC BAM BAMBEC BAMBINI BAMBINO BAMBISINI BAMBOLINA BAMBUS BAMBUSA BANANEN BANDAGE BAND-AID BANDSCHEIBENTROPFEN BANISH BANISTERIA BANKHOFERS BAOBAN BAPTIRELL BAPTISIA BARAN BARAZAN BARD BARDEX BARDIA BARDPORT BARETTHAUBE BARIJODEEL BARILUX BARIUM BARIUM/PANCREAS BARME BAROUK BARRAMUNDI BARRIER BARRIERBAC BARR-VENT BARRYCIDAL BART BARTON BARTSCHERE BARYOSAN BARYUM BASAKATT BASAN BASEN BASEN/KERN BASENBALANCE BASENGESUND BASENMISCHUNG BASENPULVER BASENTABS BASIBOSAN BASIC BASICA BASICIN BASILICUM BASILIKUM BASIS BASISBESTECK BASISCREME BASO BASOAKTIV BASOCAPS BASOCEF BASOCIN BASODEXAN BASOIMMUN BASOPLEX BASOSYX BASS BASTI BASTICRAT BASTIVERIT BATH BATHMASTER BATRAFEN BATTERIEN BATU BAUCH BAUCHTUCH BAUMHARZ BAUMWOLL BAUSCH BAY BAYCILLIN BAYCIP BAYCUTEN BAYERISCHER BAYERWALD BAYHA BAYMYCARD BAYOEL BAYOTENSIN BAYPEN BAYRISCH BAZOTON BB BC BCAA BCAAS BCE BCG B-D BE BEA BEASY BEATMUNGSBEUTEL BEATMUNGSHILFE BEATMUNGSMASKE BEATMUNGSSYSTEM BEATMUNGSTRICHTER BEATMUNGSTUBUS BEAUTRONIC BEAUTY BEAVER BEBE BEBIVITA BEBO BECEL BECHER BECHERHANDGRIFF BECHT BECHTOSOFT BECKENBODEN BECKENGURT BECKENKAMMBIOPSIENADEL BECKMANN BECLO BECLOBREATHE BECLOHEXAL BECLOMET BECLOMETASON BECLORHINOL BECLOTURMANT BECONASE BEDAN BEDELLIUM BEDIENUNGSANLEITUNG BEE BEEM BEEPOLLEN BEESANA BEESE BEFELKA BEFEUCHTER BEFIBRAT BEGACUTAN BEGAPINOL BEGRIVAC BEHANDLUNGSTISCHDECKE BEHREND BEI BEIFUSSKRAUT BEIFUSSOEL BEIN BEINBALSAM BEINBAND BEINBEUTEL BEINFIT BEINGEL BEINGURT BEINHOCHLEGEKEIL BEINHOCKLAGERUNGSKEIL BEINHOECKER BEINKISSEN BEINLAGERUNGSKEIL BEINLAGERUNGSSCHIENE BEINOL BEINPFLEGE BEIN-UND BEINWELL BEINWELLOEL BEIPACKZETTEL BEISSRING BEISTELLTISCH BEISTELLWAGEN BEKASAN BEKUNIS BEL BELAFIT BELARA BELEBENDES BELEBUNGS BELINE BELLA BELLADONNA BELLADONNA/BETULA/FORMICA BELLADONNYSAT BELLARAVIL BELLASAN BELLE BELLFIT BELLIS BELLOCQ BELLOVAC BELLYBUTTON BELNIF BELOC BELSANA BELUEFTUNGSFILTER BELUEFTUNGSKANUELE BEMON BENALAPRIL BENCASE BENDIGON BENEFLUR BENEVIT BENI BENJA BENNY BENOPOL BENOSID BENPERIDOL BENRATHER BENTA BENURON BENZAKNEN BENZBROMARON BENZIDAL BENZOCAIN BENZODERM BENZOE BENZOYT BENZPEROX BEOFENAC BEPANTHEN BEPANTHOL BEPPY BERBERELL BERBERIL BERBERIS BERBERIS/APIS BERBERIS/HYPERICUM BERBERIS/MERCURIALIS BERBERIS/NICOTIANA BERBERIS/PROSTATA BERBERIS/PRUNUS BERBERIS/PYRIT BERBERIS/QUARZ BERBERIS/SEPIA BERBERIS/URTICA BERBERIS/UTERUS BEREITSCHAFTS BERGAMOTTE BERGAMOTTEMINZE BERGAMOTTEOEL BERGAMOTTOEL BERGASOL BERGAUF BERGBLUME BERGBOHNE BERGBOHNEN BERGGEIST BERGISCHER BERGLAND BERIGLOBIN BERIPLAST BERLICORT BERLIFINE BERLINSULIN BERLIPEN BERLOCID BERLOCOMBIN BERLOSIN BERLTHYROX BERNIT BERNITER BERNSTEIN BERODUAL BEROMUN BEROTEC BERTHIERIT BERTRAMWURZEL BERUEHRUNGEN BERUHIGUNGS BERUHIGUNGSSAUGER BERYLLIUM BESITRAN BESPAR BESS BESSER BEST BEST4FEET BESTECK BESTECKGRIFFE BESTECKHALTER BESTECKTEIL BESUCHERKITTEL BESUCHERMANTEL BETA BETABION BETACREME BETADERMIC BETADORM BETADRENOL BETAGALEN BETAGENTAM BETAHISTIN BETAIN BETAISODONA BETAM BETAMANN BETAMETHADOC BETAMETHASON BETAPRESSIN BETARELIX BETARIEM BETASALBE BETASELEN BETASEMID BETASEPTIC BETASERC BETAVERT BETNESOL BETNOVATE BETONICA BETOPTIMA BETRIEBSVERBAND BETT BETTBEISTELLTISCH BETTBEUTEL BETTBEUTELHAENGER BETTBEUTELHALTER BETTBEZUG BETTBOGEN BETTCARE BETTDECKENHALTER BETTEINLAGE BETTEINLAGEPLATTE BETTER BETTFIXIERGURT BETTGALGEN BETTHAENGER BETTHALTERUNG BETTISCH BETTLAKEN BETTLEITER BETTNACHTTISCH BETTNAESSER BETTPFANNE BETTPLATTE BETTSCHIRM BETTSCHUTZEINLAGE BETTSTOFF BETTTISCH BETTVERKUERZER BETULA BETULA/ARNICA BETULA/MANDRAGORA BEURER BEUTELDRESS BEUTELSYSTEM BEVERLY BEVIT BEWA BEWAEHRTE BEWEGUNGSBAD BEXTRA BEZA BEZABETA BEZACUR BEZADOC BEZAFIBRAT BEZAGAMMA BEZAMERCK BEZAPHAM BEZUG BF BH BIALIND BI-APISERUM BIATAIN BIAVID BIAXIN BIBERNELLWURZELTEE BIBI BIBICHECK BICAL BICANORM BICIRON BICLAR BIDET BIENE BIENENPROPOLIS BIENENSALBE BIENENWACHS BIENENWIRKSTOFF-KUR BIENENZELL BIERHEFE BIERSCHE BIERTREBER BIESTMILCH BIFIDUS BIFINORMA BIFITERAL BIFLUORID BIFOMYK BIFON BIG BIKALM BIKINI BIKLIN BILIMED BILIPEPTAL BILIRUBINUM BILISAN BILISCOPIN BILLROTH BILLROTHBATIST BILLROTH-BATIST BILLY BILOBENE BILOMED BILSOM BILTRICIDE BINDE BINDEGEWEBE BINOTAL B-INSULIN BIO BIOALGIN BIOASTIN BIOBOLAN BIOBRAN BIOBRONCH BIOBRONCHAL BIOBRONCHIAL BIOCARD BIOCARE BIOCARN BIOCATH BIOCEAN BIOCHEMIE BIOCHEMISCHE BIOCHOLANGEN BIOCINA BIOCLAVID BIOCLUSIVE BIOCOMFORT BIOCORIN BIOCOS BIODERMATIN BIODRAIN BIOENERGY BIOESSENTIAL BIOFA BIOFANAL BIOFAST BIOFAX BIOFEM BIOFENAC BIOFLAVONOID BIOFLEX BIOFLOR BIOFLOW BIOFLUTIN BIOFRID BIOGASTRIUM BIOGOL BIOKALZIUM BIOKLIMAN BIOKNIT BIOKOSMA BIOKRANIA BIOKUR BIOLABOR BIOLAN BI-O-LAS BIOLAVAN BIOLECTRA BIOLIND BIOLINE BIOLIPON BIOLOGISCHE BIOLOIRE BIOLON BIOMAGNESIN BIOMALT BIOMARIS BIOMEDICA BIOMIN BIOMINERAL BIOMO BIOMOL BIOMONDE BIOMUNYL BION BIONAIRE BIONASE BIONATURE BIONECTEUR BIONESS BIONEURAL BIONI BIONORICA BIONORM BIONX BIOPATCH BIOPHAN BIOPLANT BIOPLUS BIOPSIE BIOPSIE-EINMALPISTOLE BIOPSIENADEL BIOPSY BIOPTO BIOPTON BIOPTRON BIOPULS BIOQUICK BIOREDUX BIORENAL BIORO BIOS BIOSAFT BIOSAN BIOSANA BIOSANUM BIOSCALIN BIOSEDON BIOSELF BIOSELNIUM BIOSEPTYL BIOSKIN BIOSORB BIOSORBIN BIOSPIRULINA BIOSUN BIOTAB BIOTHYM BIOTIN BIOTONSIN BIOTRANS BIOTROL BIOTTA BIOTUSS BIOVIT BIOVITAL BIOWARM BIOX BIOXERA BIOXTRA BIOZELL BIOZELLKRAFT BIOZENTAL BIPENSAAR BIPERIDEN BIPLATRIX BIPRETERAX BIRDS BIRKAVIT BIRKE BIRKEN BIRKENBLAETTER BIRKENKOHLE BIRKIN BIRNBALL BIRNSPRITZE BIRUTAN BISACODYL BISCHOFSKRAUT BISCO BISKIRCHNER BISMOLAN BISMUTUM BISMUTUM/ BISMUTUM/STIBIUM BISO BISOAPS BISOBETA BISOBLOC BISOGAMMA BISOHEXAL BISOLICH BISOLVON BISOMERCK BISOPLUS BISOPROLOL BITTER BITTERER BITTERKRAFT BITTERMELONE BITTERORANGE BITTERORANGEN BITTERSALZ BITTERSTERN BIVACYN BIVIOL B-KOMPLEX BL BLACK BLAEHUNGSTEE BLANCOPROCT BLANEL BLANX BLASEN BLASENINSTILLATIONS BLASENKRAFT BLASEN-NIEREN-TEE BLASENPFLASTER BLASENSCHLAUCH BLASENSCHWAECHE BLASENSPRITZE BLASENTANG BLASINA BLAU/WEISS BLAUER BLAUSIEGEL BLEIB BLEMACIT BLEMAREN BLEMASTRIP BLEMATHIN BLEMINOL BLEND BLENDERM BLEO BLEOMEDAC BLEOMYCIN BLEOMYCINUM BLEPHAMIDE BLEPHASOL BLINDENARMBINDE BLINDENGEHSTOCK BLINDENSTOCK BLINDENTASTSTOCK BLINK BLINKY BLISTERFILM BLISTEX BLITZY BLOC BLOCKBATTERIE BLOCOTENOL BLOO BLOOMFIELD BLOONBANDAGE BLOPRESS BLU BLUE BLUECATH BLUEGREEN BLUELINE BLUESTAR BLUETEN BLUETENHONIG BLUETENPOLLEN BLUETENPRACHT BLUETENREGEN BLUETENTRAUM BLUETEST BLUHOSON BLUMEN BLUTDRUCK BLUTDRUCKMESSER BLUTDRUCKMESSGERAET BLUTDRUCKTROPFEN BLUTEGEL BLUTGEFAESSTROPFEN BLUTHOCHDRUCK BLUTLANZETTE BLUTLANZETTEN BLUTORANGE BLUTORANGEN BLUTSENKUNGS BLUTSPENDESET BLUTSTILLENDE BLUTSTILLER BLUTZUCKERMESSGERAET BM BMI BMT BN BOCATRIOL BOCKSHORNKLEE BOCKSHORNKLEESAMEN BOCKSHORNSAMEN BOCO BODE BODENNETZ BODENSTATIV BODENWAAGE BODIVAL BODY BODYCONTROL BODYLOTION BODYSOL BODYSTOCKING BODYTECT BODYWELL BOECKER BOEHLER BOEHM BOHNENHUELSENTEE BOHNENKRAUT BOHNENSCHALEN BOHNENSCHALENTEE BOLDO BOLERO BOLETUS BOLUS BOMACOR BOMACORIN BOMAGALL BOMALEB BOMALIT BOMAPECT BOMARTHROS BOMASPAST BOMAVEN BOMBASTIK BOMIX BONA BONAFILM BONAFLOR BONALIN BONAPLAST BONASANIT BONASILK BONATROPHEEN BONDIOL BONDRONAT BONE BONEFOS BONEVIT BONFORMIN BONFOTIN BONICUR BONITAM BONITO BONIVENTRAL BONLINE BONODENT BONOLAT BONSAL BONSANA BONSOFT BONYPLUS BOOSTER BOOSTRIX BOOT BORA BORAGO BORAX BORDSPANNUNGSLEITUNG BORGON BORN BORO BOROCARPIN BORRETSCH BORRETSCHOEL BORT BOSANA BOSO BOSOCARE BOSOLASER BOSORELAX BOSOTHERM BOSTON BOSWELLIA BOTANICAL BOTHROPS BOTOX BOVISAN BOVISTA BOWIE BOXAZIN BOXBANDAGE BOXBERGAL BOXO BOXOCALM BOXOGETTEN BOXOLIP BOXONAL BRACHIAPAS BRACKAL BRAEUNUNGS BRAIN BRAINTABS BRAMIN BRAND BRANDIAZIN BRANDWUNDEN BRANOLIND BRASIVIL BRASSICA BRATAPFEL BRATENGABEL BRATENWENDER BRAUN BRAUNALGE BRAUNALGEN BRAUNODERM BRAUNOL BRAUNOSTAT BRAUNOVIDON BRAVITA BRAZIL BRAZILIAN BREAST BREATHE BRECHSCHALE BREISAUGER BRELOMAX BREMSENBREMSE BRENARIN BRENCH BRENNESSEL BRENNESSELBLAETTER BRENNESSELKRAUT BRENNPUNKT BREPEG BRESBEN BREUSS BREVIBLOC BREVIMYTAL-NATRIUM BREVOXYL BREXIDOL BRICANYL BRIDGE BRIEFTRAEGERKISSEN BRILLE BRILLEN BRILLENPUTZTUECHER BRINKMANN BRISERIN BRISK BRITE BRIXLI BRO BROCCOLI BROKKOLI BROMALICH BROMAZ BROMAZANIL BROMAZEP BROMAZEPAM BROMBEERBLAETTER BROMBEERE BROMELAIN BROMHEXIN BROMOCREL BROMOCRIPTIN BROMUC BROMUM BRONCH BRONCHALIS BRONCHI BRONCHIAL BRONCHIALBALSAM BRONCHICUM BRONCHIKATT BRONCHILON BRONCHI-PERTU BRONCHIPRET BRONCHISELECT BRONCHITTEN BRONCHITUSSIN BRONCHO BRONCHOBAL BRONCHOBESCH BRONCHOBEST BRONCHOCEDIN BRONCHOCORT BRONCHOFORTON BRONCHOLIND BRONCHOPARAT BRONCHOPAS BRONCHOPLIN BRONCHOPRONT BRONCHORETARD BRONCHOSKOPIE BRONCHOSPASMIN BRONCHOSPRAY BRONCHOSTAD BRONCHOSTOP BRONCHOSYX BRONCHOWERN BRONCHOWIEB BRONCHUS BRONZ BROSCHUERE BROTAUFSTRICH BROTMESSER BROT-UND BROXO BROXODENT BROXX BRUCHBAND BRUECKEN BRUECKENAUER BRULAMYCIN BRUNNENKRESSE BRUNOS BRUNS BRUSHPICK BRUSHSAFE BRUSHSTICKS BRUSTGLAS BRUSTHUETCHEN BRUST-HUSTEN-TEE BRUSTKORB BRUSTKREBSVORSORGE BRUSTSAUGSCHALEN BRUSTSCHALE BRUSTSELBSTUNTERSUCHUNG BRUSTWAERMER BRUSTWARZENPFLASTER BRUSTWARZENSALBE BRYACONEEL BRYONIA BRYOPHYLLUM BRYORHEUM BS BTA BTF BU BUCAIN BUCCO BUCCOTEAN BUCH BUCHANAN BUCHHALTER BUCHWEIZEN BUCHWEIZENKISSEN BUCHWEIZENKRAUT BUCHWEIZENSCHALEN BUCHWEIZENSPELZ BUCOVIT BUDECORT BUDENOFALK BUDES BUDESONID BUDIAIR BUEBCHEN BUENOSON BUERLECITHIN BUERO BUERSTE BUFEDERM BUFEDIL BUFEXAMAC BUFFET BUFLO BUFLOHEXAL BUFLOMEDIL BUFO BUFORANA BUGGY BULBOTRUW BULBUS BULLRICH BULLRICHS BUNTE BUPHTHALMUM BUPIVACAIN BURATON BURINEX BURNAID BURSA BURSAE BUSAN BUSCOPAN BUSEN-SAUGSCHALE BUSILVEX BUSP BUTAVATE BUTLER BUTTERMILCH BUTTON BUTYLSCOPOLAMIN BUXUS BVK C C1 CABASER CABASERIL CABREUVA CABRILACTA CACTUS CACTUS/CRATAEGUS CACTUS/MAGNESIUM CADION CADMIUM CAEDAX CAELO CAELYX CAESIUM CAFECITO CAFERGOT CAIGUA CAINCA CAJEPUT CAL CALABAR CALADIUM CALAMUS CALANIS CALANT CALASEPT CALCADYN CALCAREA CALCI CALCIDE CALCIFLAVON CALCIGAMMA CALCIGEN CALCIHEXAL CALCILAC CALCIMAGON CALCIMED CALCIPARIN CALCIPARINE CALCIPOT CALCIPRO CALCIPULPE CALCIRETARD CALCITEST CALCITONIN CALCITRAT CALCITRIDIN CALCITRIOL CALCIUM CALCIUM+SOFTGELS CALCIUMACETAT CALCIUMASCORBAT CALCIUMCARBONAT CALCIUMCHLORID CALCIUMFOLINAT CALCIUMPANTOTHENAT CALCIVIT CALCIVITAN CALCIVITASE CALCOHEEL CALCORT CALCUFEL CALCULI CALDEMIN CALENDOL CALENDULA CALENDULA/STIBIUM CALENDULIN CALENDUMED CALIBRI CALIFORNIA CALIGALOC CALIMER CALIMERO CALITRIG CALIX CALLUSAN CALMURID CALO CALOGEN CALOREEN CALRINORM CALSEA CALSHAKE CALTHA CALTRATE CALVAKEHL CALXYL CALYCAST CAMBREN CAMBRICBINDE CAMED CAMELIA CAMELLIA CAMILLEN CAMILODERM CAMP CAMPANULA CAMPHODERM CAMPHOPIN CAMPHORA CAMPHORA/HYPERICUM CAMPHORIN CAMPO CAMPRAL CAMPTO CAMU CAMUFLAVON CANAL CANCIDAS CANDAZOL CANDEREL CANDICOL CANDIDA CANDIO CANEA CANEPHRON CANESTEN CANGUST CANIFUG CANINA CANKEROL CANTHARIS CANVAS CAPD/DPCA CAPILLARON CAPO CAPOZIDE CAPRI CAPRIDERM CAPRIS CAPRISANA CAPRYLSAEURE CAPSAMOL CAPSELLA CAPSICUM CAPSOFT CAPTIMER CAPTIN CAPTO CAPTOBETA CAPTODOC CAPTOFLUX CAPTOGAMMA CAPTOHEXAL CAPTOL CAPTOMERCK CAPTOPRESS CAPTOPRIL CAPTOWIEB CAPUSAN CAPVAL CARAGENOL CARAMEL CARASIN CARBA CARBABETA CARBADURA CARBAFLUX CARBAGAMMA CARBAGLU CARBAMANN CARBAMAZEPIN CARBIMAZOL CARBIUM CARBO CARBOBELLA CARBOFLEX CARBOLSAEUREWATTE CARBON CARBONET CARBONEUM CARBONICUM CARBONYLGRUPPEN CARBOPLAT CARBOPLATIN CARBOSTESIN CARCI CARCINOMA CARCINOSINUM CARD CARDAMOM CARDAMOMUM CARDANAT CARDAPTIN CARDIA CARDIAC CARDIAGEN CARDIAVIS CARDIBISANA CARDIGRAND CARDINORMA CARDIO CARDIODETECT CARDIODORON CARDIODORON/MAGN. CARDIOFORT CARDIOJECT CARDIOPLEGIN CARDIOPLEGISCHE CARDIOPROTECT CARDIOSELECT CARDIOSPERMUM CARDIOSYX CARDIOTONIC CARDIOTONICUM CARDIOWELL CARDIVITRAL CARDIZYM CARDULAR CARDUOKATT CARDUUS CARE CAREFREE CARELINE CAREMILLAGE CARENAL CAREPLAN CARESHORT CARESOX CAREVENT CAREX CARICA CARIGARD CARISOFT CARITO CARLINA CARMEN CARMEX CARMI-CYL CARMINAGAL CARMINATIVUM CARMISAN CARMOL CARN CARNEBOLAN CARNIFIT CARNIGEN CARNIPURE CARNISIN CARNITIN CARNITINAGIL CARNIZYM CARNOSIN CAROCALZ CAROCAPS CAROSAN CAROSEZIN CAROTA CAROTABEN CAROTAKUERBIS CAROTANA CAROTIN CAROTININ CAROTINOID CAROTINORA CAROTINY CAROTTI CARPELLUM CARPEX CARRERO CARROT CARTILADE CARTILAGO CARTILAGO/ CARUM CARUSO CARVE CARVOMIN CARYOPHYLLUS CASCARA CASHTEST CASODEX CASPAR CASSADAN CASSETTE CASSINI CASSIS CASSIUS CASTELL CASTELLANI CASTOR CASTOREUM CASTUFEMIN CATAPRESAN CATARRH CATHA CATHBAG CATHEJECT CATHEJELL CATHOFIX CATLENBURGER CATUABA CAULOPHYLLUM CAUSTARGENT CAUSTICUM CAVAFIX CAVALIER CAVERJECT CAVI CAVIAR CAVILON CAVINTON CAVUM CAYE CAYENNE CC CCI CD CE CEANOTHUS CEBION CEC CECEM CECENU CECLORBETA CEDAX CEDERN CEDRON CEDROX CEDUR CEF CEFABENE CEFABOL CEFABRONCHIN CEFACLOR CEFACOR CEFACYNAR CEFADIAN CEFADOLOR CEFADRIN CEFADROXIL CEFADYN CEFADYSBASIN CEFAFLORIA CEFAGASTRIN CEFAGIL CEFAGLANDOL CEFAKLIMAN CEFAKTIVON CEFALEKTIN CEFALUFFA CEFALUNA CEFALYMPHAT CEFAMADAR CEFAMANIT CEFANALGIN CEFANEPHRIN CEFANGIPECT CEFANORM CEFAPLENAT CEFAPULMON CEFARHEUMIN CEFASABAL CEFASCILLAN CEFASEDATIV CEFASEL CEFASEPT CEFASILYMARIN CEFASPASMON CEFASSIN CEFASULFON CEFATEC CEFATOX CEFATROPIN CEFAVALE CEFAVENIN CEFAVORA CEFAWELL CEFAZINK CEFAZOLIN CEFERRO CEFIXDURA CEFIXIM CEFOTAXIM CEFOTRIX CEFTAZIDIM CEFTORAL CEFTRIAXON CEFU CEFUDURA CEFUHEXAL CEFURAX CEFURO CEFUROX CEFUROXIM CEKIND CELANCE CELASAN CELEBREX CELERIT CELESTAMINE CELESTAN CELESTONE CELIPRO CELIPROGAMMA CELIPROLOL CELL CELLACARE CELLACAST CELLAGON CELLAPHEROL CELLCEPT CELLCO CELLCRISTIN CELLIDRIN CELL-LIFE CELLMUSTIN CELLOFIT CELLONA CELLOSORB CELLPRO CELLUFIT CELLUFRESH CELLUGEL CELLULESS CELLULITE CELLULITIS-HYDRO CELLUMED CELLUPRO CELLURON CELLUSANA CELLUTEX CELLUVISC CELOFTAL CELSITE CELTIC CELYOUNG CEMEN CENAMAN CENCHRIS CENTAUREA CENTAURIUM CENTELLA CENTROVISION CENTRUM CEOLAT CEPA CEPHACLOR CEPHALEX CEPHALEXIN CEPHALOPLANT CEPHAZOLIN CEPHORAL CEPOREXIN CEPOREXINE CEPROVIT CERA/AESCULUS CERALEX CERASORB CERATUM CERAZETTE CERE CEREBELLUM CEREBRAL CEREBRETIK CEREBROLYSIN CEREBROLYSINE CEREBRUM CEREGINKGO CEREPAR CERES CERIUM CERIVCALSTUETZE CERIVIKEHL CERNEVIT CERNILTON CEROLA CEROLETTEN CERSON CERTIDOM CERTODYN CERTOLANAT CERTOMYCIN CERTONAL CERUCAL CERULAFIT CERUMENEX CERUSSIT CERUTIL CE-RUTINION CERVI CERVICADYN CERVICALNACKENKISSEN CERVICALSTUETZE CERVIDUR CERVIFLEX CERVIKALSTUETZE CERVILASTIC CERVIX CESOL CESRADYSTON CETALERG CETAPHIL CETEBE CETEC CETEGNOST CETERIFUG CETI CETIDERM CETIDURA CETIL CETILICH CETIRIGAMMA CETIRIZIN CETRARIA CETROTIDE CEVE CEVITECT CGF CH CHAI CHALCEDON CHALKOPYRIT CHALKOSIN CHAMO CHAMOCA CHAMOMILLA CHAMOMILLA/MALACHIT CHAMOMILLA/NICOTIANA CHANGE CHAP CHAPARRA CHARANTEA CHASER CHECKMATE CHEIRANTHUS CHEK-STIX CHELATED CHELIDONIUM CHELIDONIUM/COLOCYNTHIS CHELIDONIUM/OXALIS CHELONE CHEMO CHEMODOPPELSPIKE CHEMOSAFETY CHENOFALK CHENOPODIUM CHEPHAPYRIN CHEPLAREN CHERRY CHESEBROUGH CHI CHIANA CHIANTASAN CHIARA CHIBA CHIBRO CHIBROXIN CHICCO CHILE CHILLI CHIMAPHILA CHIN CHINA CHINASORIN CHINES. CHINESISCHE CHINESISCHER CHINESISCHES CHINHYDRON CHINIDIN CHININ CHININUM CHINOMILLE CHINOSOL CHIONANTHUS CHIPLISTE CHIROCAIN CHIROFOSSAT CHIRON CHIROPLEXAN CHIRUNET CHITOBALANCE CHITOBALLAST CHITODENT CHITOSAN CHITOSANRISE CHLORAETHYL CHLORALDURAT CHLORALHYDRAT CHLORAMIN CHLORAMPHENICOL CHLORELLA CHLORHEXAMED CHLORHEXIDIN CHLORHEXIDINDIGLUCONAT CHLORMADINON CHLORO CHLOROCHIN CHLOROPHYLL CHLOROPHYLLIN CHLOROPHYLLINUM CHLOROPHYLLUM CHLORPROTHIXEN CHLORUM CHOANOL CHOCOLATE CHOL CHOLA CHOLAGOGUM CHOLANGITIS CHOLARIST CHOLAX CHOLE CHOLE-CYL CHOLECYSMON CHOLEODORON CHOLESTABYL CHOLESTAN CHOLESTERIN CHOLESTERINREDUKTION CHOLESTERINTEE CHOLESTERINUM CHOLHEPAN CHOLIN CHOLINCITRAT CHOLIT CHOLKUGELETTEN CHOLO CHOLOFALK CHOLOSOM CHOLSPAS CHOLSPASMIN CHOLSPASMINASE CHOMELANUM CHONDROFIT CHONDROGLUC CHONDROIDINSULFAT CHONDROITIN CHONDRON CHONDROSAMIN CHONDROSAN CHORAGON CHOREA-GASTREU CHRISOCAST CHRISTMAS CHROM CHROMIUM CHRONOCARD CHRUETERMAENNLI CHRYSANTHEMENTEE CHRYSANTHEMUM CHRYSIN CHRYSOLITH CHRYSOPRAS CHUCHUHUASI CHUFAFIT CHUFAS CHUPA CHX CIALIS CIATYL CIBACALCIN CIBACEN CIBADREX CIBAFLAM CIBALGIN CICA CICALEINE CICHORIUM CICLORAL CICUTA CIDEGOL CIDEX CIDEZYME CIKAFLOGO CIL CILANTRIS CILEST CILESTRI CILEX CILOXAN CIM CIME CIMEBETA CIMEHEXAL CIMETIDIN CIMI CIMICIFUGA CIMIFUGA CIMISAN CINA CINAEBOSAN CINERARIA CINIS CINNABARIS CINNAMOMUM CINNARIN CINNARIZIN CIONIT CIPRALEX CIPRAMIL CIPRO CIPROBAY CIPROBETA CIPRODOC CIPRODURA CIPROFAT CIPROFLOX CIPROFLOXACIN CIPROGAMMA CIPROHEXAL CIPROX CIRCANOL CIRCLEMATE CIRCULO CIRCULUS CIRCUVIT CIRRHOSIS CIS CISDAY CISPLATIN CISSUS-OSSA CISTROSE CISTROSENOEL CISTUS CITADURA CITALICH CITALO CITALOPRAM CITEMUL CITOPLAST CITRADENT CITRADERM CITRAMESIA CITRAMIN CITRIDENTAL CITRIDERMAL CITRO CITROBIOTIC CITROFLAVON CITROKEHL CITRONE CITRONELL CITRONELLA CITRONEN CITRONENOEL CITROPEPSIN CITROPLUS CITRUS CITRUSFASER CITRUSGARTEN CITY C-KOMP CL CLA CLABIN CLAFORAN CLAIRE CLAMOXYL CLARIS CLARITYNE CLARO CLARODERM CLASSIC CLASSIC/1 CLASSIC/2 CLASSIQUE CLAUDEN CLAUDICAT CLAUPAREST CLAVE CLAVERSAL CLAVICULA CLAVICULABANDAGE CLEAN CLEANAL CLEANLET CLEANLIKE CLEANSATION1 CLEANSING CLEAR CLEARASIL CLEARBLUE CLEARLINK CLEARPLAN CLEARTEST CLEARVIEW CLEMATIS CLEMENTINE CLEMENTINEN CLENS CLEOPATRA CLEOPATRAS CLEXANE CLH CLICK CLICKFINE CLIMAFEM CLIMATRACH CLIMAX CLIMEN CLIMODIEN CLIMOPAX CLIN CLINDA CLINDABETA CLINDAHEXAL CLINDAMYCIN CLINDA-SAAR CLINDASTAD CLINDATOP CLINHAND CLINIC CLINIFLEX CLINIMIX CLINISTIX CLINIT CLINITEK CLINITEST CLINOFEM CLINOLEIC CLINOMEL CLINOMINT CLINOVIR CLINUTREN CLIO CLIONARA CLIPS CLIVARIN CLOBEGALEN CLODERM CLODRON CLOMHEXAL CLOMIFEN CLOMIPRAMIN CLONID CLONIDIN CLONISTADA CLONT CLORINA CLOSIN CLOTRASONE CLOTRI CLOTRIGALEN CLOTRIMAZOL CLOZAPIN CLUSTOID CLYSO CLYSSIE CM CM3 CMW CO CO2 COACH COAGU COAPROVEL COASE COATEL COAXIAL COBALANCE COBALTUM COBAN COCCULUS COCCUS COCHLEA COCHLEARIA COCOS COD CODAN CODEIN CODEINSAFT CODEINTROPFEN CODEINUM CODI CODICAPS CODICOMPREN CODIOVAN CODIPERTUSSIN CODIPRONT CODMAN COE COECUM COELIA COELIO COENAL COENZYM COENZYME COFFALON COFFEA COFFEINUM COFFETYLIN COGITAN CO-HYPERT CO-HYPOT COLA COLCHICUM COLCHIFORM COLCHYSAT COLD COLDASTOP COLDCREME COLDEX COLDI COLEB COLESTHEXAL COLESTID COLESTYR COLESTYRAMIN COLGATE COLIBACILLINUM COLIBIOGEN COLIFOAM COLIMUNE COLINA COLINSAN COLINTEST-GASTREU COLIQUIFILM COLISTIN COLLACEPT COLLAFOAM COLLAGEN COLLAGENE COLLAMED COLLAPRODIN COLLAR COLLASAN COLLATIN COLLAVIT COLLINSONIA COLLOMACK COLO COLOCYNT COLOCYNTHIS COLOGNOST COLOMATE COLOMBA COLOMYC COLON COLONOBAL COLONSYSTEM COLOPLAST COLO-PLEON COLORTEST COLOSTRAL COLOSTRUM COLOURS COLOVIT COLTEX COLUMBO COLUMNA COMAFUSIN COMBACTAM COMBAREN COMBE COMBI COMBIBAG COMBICLEAN COMBIDERM COMBIFIX COMBIFUSIN COMBIHESIVE COMBIMATE COMBIPLASMAL COMBISOL COMBISTERIL COMBIVIR COMBIZYM COMBUDORON COMBUR COMBUSTIN COMEDONEN-GASTREU COMEDONENQUETSCHER COMFEEL COM-FIT COMFORT COMFREY COMMENFREY COMMIPHORA COMMONFREY COMOCLADIA COMPACT COMPANION COMPASS COMPAT COMPEED COMPINOL COMPLAMIN COMPLE COMPLEN COMPLETE COMPLEVEN COMPLEX COMPLIANCE COMPOSITA COMPOSIX COMPOUNDING COMPRESSANA COMPRESSIONS COMPRI COMPRIDUR COMPRIFIX COMPRIFOAM COMPRIGEL COMPRIHAFT COMPRILAN COMPRINET COMPTENZ COMTESS COMTEX COM-TEX COMULITE CONARGOL CONCENTRATION CONCENTRIN CONCEPLAN CONCERTO CONCHAE CONCHAE/QUERCUS CONCOR CONDENS CONDOM CONDOMI CONDROTECT CONDUBOSIN CONDURANGO CONDYLOX CONFIT CONFLUDIN CONFORM CONFORTID CONIUM CONJUNCAIN CONJUNCTISAN CONJUNCTIVA CONNECTOR CONNI CONPIN CONQUEST CONRAY CONSECURA CONSEPT CONSTAY CONTAC CONTACLAIR CONTAINERFILTER CONTAM CONTAMOUSSE CONTIMIT CONTIPHYLLIN CONTIPLEX CONTOPHARMA CONTRA CONTRACEPTIVUM CONTRACTUBEX CONTRALUM CONTRAMUECK CONTRAMUTAN CONTRANEURAL CONTRAVIR CONTREET CONTROL CONVACARD CONVACARE CONVA-CYL CONVALLARIA CONVALLICINE CONVALLOCOR CONVALLYSAN CONVASTABIL CONVATEC CONVEEN CONVERGAL CONVERLEAN CONVULEX CONVULSOFIN CON-ZELLIN COOL COOLETTE COOLIFANT COOLIKE COOLPAC COOLPLUS COOLY COOPER COPAL COPEGUS COPOLYMER COPRINUS COPRISAN COPYRKAL COR COR/AURUM CORA CORADOL CORAL CORALCARE CORALLIUM CORAMEDAN CORANGIN CORASE CORAUNOL CORAZET CORBIOVIN CORDALIN CORDANUM CORDAPUR CORDAREX CORDARONE CORDES CORDESIN CORDIAK CORDICANT CORDICHIN CORDICIPIN CORDIMIL CORDIODORON CORDYCEPS CORDYSEPS COREGA CORFIDAX CORGOLD CORIANDRUM CORIC CORIFEO CORINDOCOMB CORINDOLAN CORINFAR CORIOLUS CORIOSTA CORMAGNESIN CORNARON CORNEA CORNEA/ CORNEREGEL COROBAL CORO-CALM COROCRAT CORODOC CORONORM COROPHAN CORORELL COROSAN COROTREND COROTROP CORPILIA CORPO CORPOFORM CORPORA CORPUS CORPUSFIT CORR CORSODYL CORSORIN CORSOTALOL CORTI CORTIDEXASON CORTIREL CORTIRELL CORTISON CORTISONUM CORVATON CORVIPAS CORVO COSA COSEAL COSELLE COSIE COSIFORM COSMANI COSMIC COSMILON COSMOFER COSMOMED COSMOPOR COSMOS COSOPT COTAZYM COTEC COTRIM COTRIMOX COTRIMOXAZOL COTRIMSTADA COTTON COTTONAMID COUMADIN COUP COUPEROSE COVAXIS COVERFLEX COVERLET COVERMED COVERSUM COVICUX COVISCAL COXA-CYL COXIT COXSACKIE CP CPS CRAEGIUM CRALONIN CRAMER CRANBERRY CRANBERRYSAFT CRANIO-CYL CRANOC CRATAE CRATAEGAN CRATAEGUS CRATAEGUTT CRATAEGYSAT CRATAEPAS CRATIMAR CRATON CRATOSAN CREALITE CREAM CREAPURE CREASTRIAN CREATIN CREATINE CREAVITAL CREDO CREME CRESOLUM CRESOPHENE CRETA CRH CRI CRINIS CRINITON CRINO CRINOHERMAL CRINONE CRIPAR CRISAN CRISP CRISPOLAC CRISTAL CRIXIVAN CRN CROCUS CROLDINO CROM CROMO CROMOGLICIN CROMOHEXAL CROMOLIND CROMOPP CRONASMA CRO-NI CROTALUS CROTAMITEX CROTON CRP CRUCIAL CRUROHEEL CRUSTALASYN CRUZYLAN CRYODERM CRYOS CRYSTACIDE CRYSTAL CUALA CUBIDYN CUBISON CUBITAN CUFF CUFFDRUCKMESSGERAET CUMIRON CUNNINGHAM CUPARCEN CUPPER CUPRAN CUPRIDIUM CUPRIT CUPRO CUPRO-STIBIUM CUPRUM CUPRUM/NICOTIANA CUPRUM/QUARZ CUPRUM/TABACUM CURA CURACEL CURACELL CURACOLL CURADENT CURADERM CURAFAM CURAFIL CURAFIT CURAFIX CURAFOAM CURAGARD CURAGEL CURALIN CURANTYL CURAPLAST CURAPONT CURAPOR CURAPROX CURARE CURARINA CURASALT CURASEPT CURASILK CURASORB CURASPON CURATEST CURATODERM CURAVEN CURAZINK CURBITA CURCU CURCUMA CURCUMEN CURETTE CURION CURITY CUROSURF CUSHION CUSHY CUSTODIOL CUTANA CUTANINFANT CUTANO CUTANUM CUTASEPT CUTASON CUTFIX CUTHYD CUTI CUTICERIN CUTIFLEX CUTINOVA CUTIPLAST CUTIS CUTISAN CUTISOFT CUTISORB CUTISTAD CUVITAL CUXABRAIN CUXAFENON CUXANORM CVP CYBERSONIC CYCLAMEN CYCLO CYCLOCAPS CYCLOHALER CYCLOPENTOLAT CYCLOPOLAR CYCLOSA CYCLOTEST CYDONIA CYKLOKAPRON CYLLIND CYMEVEN CYMEVENE CYNACUR CYNALIP CYNARA CYNARIN CYNARIX CYNARZYM CYNT CYPRIPEDIUM CYPROTERONACETAT CYRTOPODIUM CYSTAGON CYSTEIN CYSTIBOSIN CYSTICIDE CYSTIN CYSTINOL CYSTIREN CYSTISTAT CYSTIUM CYSTO CYSTOBAG CYSTO-CYL CYSTODRAIN CYSTOFIX CYSTOL CYSTO-MYACYNE CYSTONORM CYSTOPYELON CYSTOSYX CYSTOVISION CYSTUS CYTAMID CYTO CYTOBION CYTOBRUSH CYTOCAN CYTOTEC D D.E.O. D.H.E.A. DA DAAX DABAXIL DABO DACHSFETT DACHSHAAR DAEUMLING DAHLHAUSEN DAILY DAISY DAIVOBET DAIVONEX DAKTAR DAKTARIN DALACIN DALEKTRO DALLMANN DALMADORM DALZOFOAM DAMENBINDEN DAMENKAMM DAMENSTOCK DAMENTAMPONS DAMIANA DAMIN DAMPF DAMPFTHERAPIEGERAET DAMPFZERSTAEUBER DAN DANA DANAFLEX DANAGRIP DANAHAFT DANALAST DANALASTIC DANAMULL DANANET DANATUBE DANAZOL DANE DANG DANKE DANOPROX DANSAC DANTAMACRIN DANTRIUM DANTROLEN DAONIL DAOSAN DAPHNE DAPOTUM DAPSON DAR DARAPRIM DARBO DARCO DARM DARMFLORA DARMINSUFFLATIONSSET DARMKREBS DARMOL DARMROEHRCHEN DARMROHR DARMSPUELPULVER DAROB DARUTO DAS DASAMOOLARISHTA DASYM DATATHERM DATISCA DAUCUS DAUERBINDE DAUERELASTISCHE DAUERELEKTRODEN DAUERLASTIC DAUM DAUMEN DAUMENBANDAGE DAUMENSPANGE DAUNER DAUNOBLASTIN DAUNOBLASTINA DAUNOXOME DAURODUR DAVITAMON DAVITON DAY DAYLONG DAYRUN DAYVIT DC DCCK DCG DCT DDD DEACURA DEASTH DEAZID DEBLASTON DEBORAH DECA DECAPEPTYL DECENTAN DECKBETTENBEZUG DECKEL DECKENROLLE DECKGLAESER DECKGLAS DECODERM DECOMED DECOMYK DECORTIN DECOSTRIOL DECUBITAN DECUBITUS DECULUMAT DECUS DECUSIN DECUTASTAR DEDERON DEDREI DEDROGYL DEEP DEFAETON DEFENCID DEFENSOR DEFIX DEFLATOP DEFLOGRIP DEFLUINA DEFLUX DEGALIN DEGERMIN DEHYDRO DEKRISTOL DEKU DEKUBITUS DELAGIL DELCOPREP DELGESIC DELICIA DELIMMUN DELIX DELMUNO DELONAL DELPHICORT DELTA DELTACUT DELTAFIX DELTALIPID DELTAMAX DELTANEX DELTARAN DELTO-CYL DELUXE DELWA DEMAK DEMES DEMETER DEMETRIN DEMEX DEMUTH DEMYC DENA DENAN DENDOEMS DENIDAL DENISIA DENOSOL DENS DENT DENTA DENTACLIP DENTAGARD DENTAL DENTALKANUELE DENTAMIN DENTANURSE DENTIIS DENTIMER DENTINA DENTIN-GASTREU DENTINOX DENTIPUR DENTIQUICK DENTISAT epamax beipackzettel ciprofloxacin DENTO DENTOCAPS DENTOFIX DENTOFIXIN DENTOMINT DENTOMYCIN DENTOSAFE DENTOSECURA DENTOSMIN DENTOX DENTRIL DENTTABS DENVER DEO DEPAKINE D-EPIFRIN DEPIGOID DEPILAN DEPO DEPONIT DEPOSIT DEPOT DEPRENORM DEPRESSAN DEPRESSOR DEPRILEPT DEPURAN DEQUONAL DER DERBY DERCAP DERCOME DERCUT DERIVAKOL DERIVATIO DERM DERMA DERMABOND DERMACOLOR DERMADOS DERMAFARIN DERMAFLAIR DERMALID DERMALIGHT DERMALIN DERMALLERG DERMALPAD DERMAPHARM DERMAPLAN DERMAPLAST DERMAPON DERMAPULSE DERMAPUNKTUR DERMARELL DERMASAN DERMASENCE DERMASIXT DERMASTIM DERMATEST DERMATHEM DERMATHERMAL DERMATILIN DERMATIX DERMATODORON DERMATOFIDES DERMATOP DERMATOPAN DERMAZELLON DERMESTRIL DERMI DERMICHTHOL DERMICLEAR DERMIFANT DERMILON DERMO DERMOBETA DERMOLISAN DERMOPAIN DERMOPHIL DERMOSKRIPT DERMOSOAP DERMOSOLON DERMOTEKT DERMOWAS DERMOXIN DERMOXINALE DERMOZON DERMUD DERMZWO DEROYAL DESAQUICK DESARELL DESCO DESCODERM DESCOLIND DESCOMED DESCOSAN DESCOSOFT DESDERMAN DESERT DESFERAL DESHISAN DESIDERM DESINFECTA DESINFEKTIONSGERAET DESINFEKTIONSTUCH DESINFEKTIONSWANNE DESITIC DESITIN DESMANOL DESMIN DESMOGALEN DESMOPRESSIN DESO DESODERM DESOFORM DESOMED DESOWASCH DE-SQUAMAN DESTILLIERTES DET DETARTRINE DETIA DETIMEDAC DETRUSITOL DETULIN DEUMAVAN DEUSER DEUTSCHE DEVELOP DEXA DEXABENE DEXABETA DEXAFLAM DEXAGALEN DEXAGEL DEXAHEXAL DEXAMETHASON DEXAMONOZON DEXAMYTREX DEXAPOS DEXAWIEB DEXIUM DEXPA DEXPANOL DEXPANTHENOL DEXTRO DEXTRO-ENERGEN DEXTRO-GASTREU DEXTROMED DEXTRO-O.G.T. DEXTROPUR D-FLUORETTEN DHA DHC DHE DHEA DHU DHUENSCHE DHUENSCHER DI DIA DIA-AKTIVANAD DIABACT DIABADIL DIABAG DIABASS DIABEN DIABESAN DIABESIN DIABEST DIABETA DIABETAN DIABETASE DIABETEC DIABETES DIABETIC DIABETIKER DIABETIKERSOCKEN DIABETO DIABETOBAL DIABETOWELL DIABETRUW DIABUR DIACARD DIACIMMOM DIACLIX DIACOLL DIADERMA DIADERMAPHARM DIADERMINE DIAET DIAETKAPSEL DIAETWAAGE DIAFLOR DIAFORMIN DIAGNOSE DIAGRAN DIALAX DIALVIT DIALYSE DIAMANT DIAMICRON DIAMINT DIAMOND DIAMOX DIANA DIANE DIAPEN DIAPHAL DIAPHRAGMA DIAPROTEIN DIARI DIAROENT DIARRHEEL DIARRHOESAN DIASIP DIASTABOL DIASTIX DIATEMIA DIATROPAN DIAZEP DIAZEPAM DIAZINK DIBEN DIBENZYRAN DIBLOCIN DIBRO-BE DIBROMOL DICHAPETALUM DICHTUNGSRING DICLAC DICLO DICLODOC DICLOFENAC DICLOFENAMID DICLOFENBETA DICLOPHLOGONT DICONPIN DIDIER DIDRONEL DIE DIENAPLEX DIENCEPHALON DIET DIETMAX DIFFERIN DIFFUSYL DIFLUCAN DIFOSS DIFRAREL DIGACIN DIGEST DIGESTIV DIGESTODORON DIGIBAND DIGIMED DIGIMERCK DIGITAL DIGITALIS DIGITALTHERMOMETER DIGITALWAAGE DIGITALYSAT DIGITEMP DIGITOXIN DIGNODOLIN DIGNOKONSTANT DIGOSTADA DIGOTAB DIGOX DIGOXIN DIHYDERGOT DIHYTAMIN DIL DILANACIN DILATATIONSKATHETER DILATREND DILCORAN DILIGAN DILL DILLSAMENOEL DILSAL DILSANA DILTA DILTABETA DILTAHEXAL DILTAPHAM DILTARETARD DILTI DILTIA DILTIAGAMMA DILTIAZEM DILTIUC DILUPLEX DILZANTON DILZEM DILZICARDIN DIM DIMA DIMALO DIMAVAL DIMEN DIMENHYDRINAT DIMETICON DINABASE DI-NATRIUM DINICO DINITROPHENOLUM DINKEL DINKELDECKE DINKELGETREIDE DINKELHOERNCHEN DINKELKISSEN DINKELSPELZ DINKELSPELZKISSEN DINKELSPREU DINO DINOMED DINOSAN DINOSAURIER DINOTHERM DIOPTAS DIOPTEC DIOSCOREA DIOVAN DIPENTUM DIPEPTAMIN DIPHENHYDRAMIN DIPHOS DIPHTHERIE DIPHTHERINUM DIPIPERON DIPROGENTA DIPROSALIC DIPROSIS DIPROSONE DIPSAVIT DIROCATH DISALUNIL DISCARD DISCI DISCI/ DISCI/VISCUM DISCMIGON DISCO-CYL DISCOFIX DISCUS DISETRONIC DISH DISKRAFID DISKRETBEUTEL DISMENOL DISMOCLEAN DISMOZON DISOP DISOPRIVAN DISOTAT DISPACLONIDIN DISPACROMIL DISPADEX DISPASAN DISPATENOL DISPATIM DISPENSER DISPO DISPOMED DISPOSABLE DISPOSIMA DISPOTAN DISTEL DISTELOEL DISTRANEURIN DISYTEST DITEC DITENATE DITRIPENTAT DIU DIUCOMB DIURAMID DIURAPID DIURESAN DIURETHAN DIURETICUM DIURETIKUM DIUREVIT DIURSAN DIVALOL DIVASCAN DIVERTICULOSE DIVYA DK-LINE DLINE DLPA DL-PHENYLALANIN DMPS DMS DMV DNCG DOBENDAN DOBICA DOBROFEN DOBUTAMIN DOC DOCANE DOCIRETIC DOCITEREN DOCITON DOCMA DOCSPORT DOCTORS DODELITH DOEDERLEIN DOGMATIL DOKTUS DOKTUS-DUR DOLANAEST DOLARIST DOLESTAN DOLEX DOLEXAMED DOLGIT DOLI DOLICHOS DOLO DOLOBENE DOLODOC DOLOJECT DOLOMIT DOLOMITE DOLOMO DOLONEURO DOLOPROCT DOLOR DOLORA DOLORMIN DOLOROL DOLORSORIN DOLOTEFFIN DOLOTENS DOLUK DOLVIRAN DOMICIL DOMIDON DOMINAL DOMOTHERM DOMPERIDON DONA DONAFIX DONAVIT DONEURIN DONG DONNA DONTISANIN DONTISOLON DOOLITTLES DOPACARD DOPADURA DOPAFLEX DOPAMIN DOPEGYT DOPERGIN DOPPEL DOPPELDUSCH DOPPELGOLDTROPFEN DOPPELHERZ DOPPELLUMEN DOPPELRING DOPPELS DOPPELSALZRAUTEN DOPRAM DORE DOREGRIPPIN DOREPEROL DORIMED DORITHRICIN DORM DORMALON DORMARIST DORMI DORMICUM DORMIGOA DORMILON DORMO DORMOBAL DORMOCAPS DORMOVERLAN DORMUTIL DORN DOROCOFF DORODERM DORON DORPOLAN DOSEN DOSETT DOSI DOSIERFLASCHE DOSIERPUMPE DOSKAR DOSS DOST DOSTINEX DOUGLAN DOUGLASFICHTE DOVE DOVER DOXA DOXACOR DOXAGAMMA DOXAKNE DOXAM DOXAMAX DOXAURO DOXAZOFLO DOXAZOMERCK DOXAZOSIN DOXE DOXEPIA DOXEPIN DOXIMUCOL DOXO DOXORUBICIN DOXY DOXYCYCLIN DOXYDERMA DOXYDOC DOXYHEXAL DOXYMERCK DOXYMONO DOYLE DPI DPK DR DRACHEN DRACO DRACOFIX DRACOFLEX DRACOHAFT DRACOLASTIC DRACONTIUM DRACOPOR DRACOSILK DRACOSTILL DRACOZELL DRAEGERSCHIENE DRAGEES DRAGSTER DRAGUMED DRAHTSCHERE DRAINA DRAIN-ABLASS DRAINAGE DRAINAGEBEUTEL DRAINAGEFIX DRAINAGESCHLAUCH DRAINAGESET DRAINAPLAST DRAINOBAG DRAINOFIX DRAINVERBINDER DRALINSA DRALLE DRATH DREAM DREBALIN DREH DREHGRIFF DREHHAHN DREHHILFE DREHSCHEIBE DREHSYSTEM DREHTELLER DREI DREIBLATT DREIDORNGLEITSCHUTZKAPPE DREIECKTUCH DREIERLEI DREIFUSSGEHSTUETZE DREIPFEIL DREISACARB DREISAFER DREISAFOL DREISAVIT DREIVIERTELROLLE DRENOL DREPHARM DRESDNER DRI DRIB D-RIBOSE DRIDASE DRIPAC DRITTE DRIX DROGENSPEICHELTEST DROGENTEST DRONANETTEN DRONAPEKT DRONAPSYLL DROP DROPERTEEL DROSERA DROSERAPECT DROSITHYM DRUCKINFUSIONSMANSCH. DRUCKKNOEPFCHEN DRUCKLUFT DRUCKMINDERER DRUCKVERBAND DRUEFUSAN DRUESENSALBE DRUESENTROPFEN DRUGCONTROL DRULA DRY DRYLIN DRYSKIN DRYTEX DS DT DUA DUALIN DUALOK DUCRAY DUCTUS DUESTRULIN DUFTES DUFTFUEHRER DUFTOEL DUFTSAECKCHEN DUFTSTIFT DUKE DUL DULARELL DULCAMARA DULCOLAX DUNASAL DUNE DUNIWELL DUO DUOCAL DUOCOL DUODENALSONDE DUODENALSONDEN DUODENITIS DUODENOHEEL DUODENUM DUOFEM DUOFILM DUOFORM DUOGINK DUOLIP DUOSKIN DUOVAC DUOVENTRIN DUOVENTRINETTEN DUOVISC DUPHASTON DUPLEXON DUPLO DURA DURACARE DURACELL DURACLEAN DURACORON DURACROMAN DURADERMAL DURADIURET DURAFENAT DURAFUNGOL DURAFURID DURAGLUCON DURALIPON DURALOPID DURALOZAM DURAMIPRESS DURAMONITAT DURAMUCAL DURANA DURANIFIN DURANITRAT DURAPENICILLIN DURAPENTAL DURAPHAT DURAPHYLLIN DURAPINDOL DURAPIROX DURAPORE DURAPREDNISOLON DURARESE DURASILYMARIN DURASOL DURASOPTIN DURASPIRON DURATENOL DURAULTRA DURAVOLTEN DURA-Y DURAZANIL DURAZEPAM DURCH DURCHBLUTUNGSBAD DURCHFALL DURCHLAUFKASSETTE DURCHLAUFSET DURCHSTOSSSTAEBCHEN DURELAST DURETA DUREX DURODONT DUROLANE DUROMED DUSCHBAD/BADESCHAUM DUSCHBECKEN DUSCHDAS DUSCHESCHUTZ DUSCHFOLIEN DUSCHGARNITUR DUSCHGEL DUSCHHOCKER DUSCHHUELLEN DUSCHKLAPPSITZ DUSCHMILD DUSCHPFLASTER DUSCHROLLSTUHL DUSCHSCHEMEL DUSCHSCHUTZ DUSCHSCHUTZHUELLE DUSCHSITZ DUSCHSTUHL DUSCHSTUHLTASCHE DUSCHTOILETTENSTUHL DUSCH-UND DUSCHWANDTASCHE DUSCHWANNEN DUSODRIL DUSPATAL DUSPATALIN DUWASOFT DWT DYCEM DYHANKAN DYN DYNA DYNABELT DYNACAST DYNACIL DYNACROSS DYNAIR DYNALKA DYNAMIC DYNAMICS DYNASOL DYNASTAB DYNASTAT DYNEXAN DYNORM DYSCORNUT DYSCRASIN DYSCRASOL DYSKRASIT DYSMEN DYSMENALGIT DYSMENO DYSMENORRHOE DYSMOPAS DYSPORT DYSTO DYSTOPHAN DYSURGAL DYTIDE DZS E E.A.P. E.K.BUERGER EAR EARPLANES EARTHRISE EARTHWISE EASI EASICATH EASIFLEX EASY EASYBELT EASYCARE EASYCONTROL EASYDROP EASYFIX EASYGLIDE EASYHALER EASYPUMP EASYROUND EASYSEPT EATAN EAU EB5 EBASTEL EBENOL EBERRAUTE EBERRAUTIN EBERWURZTEE EBIXA EBRANTIL ECEROLA ECHAN ECHI ECHIFIT ECHIHERB ECHINACEA ECHINACEA/ARGENTUM ECHINACEA/MERC. ECHINACEA/VISCUM ECHINACIN ECHINACINA ECHINACINCHEN ECHINAFORCE ECHINAJECT ECHINAPUR ECHINARELL ECHINASAT ECHINASYX ECHINATUR ECHORAN ECHOVIST ECHT ECHTE ECHTHAAR ECHTROKLIM ECHTRONEPHRIN ECHTRONERVAL ECHTROSEPT ECHTROSPARTIN ECHTROVEN ECHTROVIT ECHTROZYT ECKENZANGE ECLAT ECLIPSE ECOBAG ECOCLICK ECOFLAC ECOFLO ECOJECT ECOLASTIC ECOLICIN ECOLINE ECONOMY ECOPROSTAN ECOSPIKE ECOTAPE ECRINAL ECURAL ED EDEL EDELKASTANIEN EDELSTAHLTOPF EDELTANNEN EDELWEISS EDERMA EDEROL EDISONITE EDITH EDLICH EDRONAX EDTA EEZIMED EFAMOL EFASIT EFEKTOLOL EFEMOLIN EFEROX EFEU EFEXOR EFFECTO EFFEKTON EFFERVIT EFFICIENT EFFILIERSCHERE EFFITAN EFFLUMIDEX EFFO EFFOL EFFORTIL EFRUTI EFTAPAN EFUDIX EGLE EGMOVIT EGROH EGYPTISCHE EHRENPREIS EHRENPREISTEE EIBIOGAL EIBIOPAN EIBIOTON EICHENMOOS EICHENRINDEN EICHHORNIA EICOSAN EICOSAPEN EICOTIN EIDECHSE EIFELBLUETEN EIN EINCREMEHILFE EINFACHGEBLAESE EINHAND EINHANDTELLER EINHEITSKRANKENTRAGE EINKAUFSNETZ EINLAUFHILFE EINLEGERAHMEN EINLEGESOHLEN EINMAL EINMALBETTWAESCHE EINMALHUELLE EINMALNADELN EINMALPOLSTER EINMALSPRITZE EINMALWASCHHANDSCHUH EINMALWASCHLAPPEN EINNAHME EINNEHMEBECHER EINNEHMEGLAS EINNEHMELOEFFEL EINNEHMEROEHRCHEN EINNEHMEROHR EINNEHMEROHR. EINNEHMETASSE EINREIBUNG EINS EINSALPHA EINSATZ EINSATZBECHER EINSCHLAF EINSCHLAF- EINSTEIGEGRIFF EINSTEIGHILFE EINSTIEGHILFE EINWEG EINWEGAUFHAENGER EINWEGSCHUERZEN EIS EISBAEREN EISBEISSERLE EISBEISSRING EISBEUTEL EISBOX EISBRECHER EISEN EISENDRAGEES EISENHUT EISENKAPSELN EISENKRAUT EISENKRAUTTEE EISENSULFAT EISGEL EISKOMPR EISKOMPRESSE EISKRALLE EISPICKEL EISRINGE EISSPRAY EISTASCHE EISTEE EISWASSER EITERBECKEN EIWEISS EIWEISSKONZENTRAT EIWEISSKOST EKA EKASTU EKG EKTEBIN EKULF EKZEM EKZEMASORIN EKZEVOWEN ELACUR ELACUTAN ELAFIX ELAFLEX ELAG ELAINE ELANA ELANCYL ELANTAN ELAPS ELASAN ELASS-FIT ELASTEN ELASTESIV ELASTEX ELASTICOLOR ELASTICON ELASTICOS ELASTIK ELASTIN ELASTISCHE ELASTO ELASTOFIX ELASTOFLEXBINDE ELASTOHAFT ELASTOMULL ELASTOPAD ELASTOPLAST ELASTORIP ELASTRA ELASTUS ELATERIUM ELATEX ELAWOX ELBROL ELCRIT ELDISINE ELDORAL ELEGANCE ELEKIBAN ELEKTRISCHER ELEKTRO ELEKTROBAD ELEKTRODEN ELEKTROKONTINENZ ELEKTROLYT ELEKTROLYTE ELEKTRONISCHE ELEKTROSTIMULATIONS ELEMENTAL ELEMI ELEU ELEUCEA ELEUSAN ELEUTEROCOCC ELEUTHERO ELEUTHEROCOCCUS ELEUTHEROFORCE ELEUTHEROKOKK ELEUTHEROKOKKUS ELEX ELFENDUFT ELFENTRAUM ELFI ELGIPRONA ELIAN ELIDEL ELIGLIDE ELITE ELKO ELLATUN ELLBOGENORTHESE ELL-CRANELL ELLENBOGENBANDAGE ELLENBOGENKISSEN ELLENBOGENPOLSTER ELLENBOGENSCHLINGE ELLENBOGENSCHONER ELLENBOGENSCHUTZ ELLENBOGENSTUETZE ELLSUREX ELMENDOS ELMETACIN ELMEX ELOBACT ELOCOM ELOCON ELODUR ELOFLEX ELOMEL ELOTRANS ELOXATIN ELPENOR ELROQUIL ELSA ELSET ELUGAN ELUTIT ELVI ELYTH ELYZOL ELZOGRAM EM EM-80 EMADINE EMARE EMASEX EMB EMBOCEPT EMBRI EMBRYO EMCORETIC EMEND EMESAN EMESTAR EMKA EMKACREPP EMKALASTIC EMLA EMMI EMOCRAT EMOFORM EMOLONE EMOTION EMOVATE EMS EMSER EMSOPECT EMTRIVA EMU EMUCARE EMZELL ENA ENABETA ENADA ENADALERT ENADURA ENAHEXAL ENALAGAMMA ENALAPRIL ENALIND ENANTONE ENBREL ENCEPHABOL ENCEPUR ENCETROP ENCORE ENDAK ENDEO ENDIARON ENDIMA ENDLOSWINDELN ENDO ENDOCAL ENDOCARDIUM ENDOCLAIR ENDOFALK ENDOGEL ENDOLITH ENDOMETHASONE ENDOMETRIUM ENDOREM ENDORETTE ENDOSOLV ENDOSTAR ENDOTECH ENDOTEST ENDOTINE ENDOXAN ENDOZIME ENDURANCE ENEAS ENELBIN ENELFA ENERFIT ENERGAN ENERGETIC ENERGETICUM ENERGIE ENERGIEBUENDEL ENERGIZER ENERGO ENERGOTIN ENERGY ENERGYON ENFAMIL ENGELSEIFEN ENGELWURZ ENGERIX ENGLISCHES ENGYSTOL ENLIVE ENOXOR ENRICH ENSBONA ENSURE ENTBINDUNGSDUFT ENTERALEN ENTERALITE ENTERO ENTEROFIX ENTEROMAT ENTEROPLANT ENTEROPORT ENTEROSTATYN ENTEROSTATYNE ENTKALKUNGSPATRONE ENTKUPPLUNGSKEIL ENTNAHMESYSTEM ENTOCORD ENTOCORT ENTOXIN ENTRIFLEX ENTRISTAR ENTSAEUERUNGSSALZ ENTSCHLACKUNGS ENTSCHLACKUNGSTEE ENTSPANNUNG ENTSPANNUNGS ENTSPANNUNGSBAD ENTSPANNUNGSBRILLE ENTSPANNUNGSTRAINING ENTSPANNUNGSTUCH ENTWAESSERUNGS ENTWAESSERUNGSTABLETTEN ENTWAESSERUNGSTROPFEN ENTWOEHNUNGSVERSCHLUSS ENTZUENDUNGSTROPFEN ENURESIS-GASTREU ENURO ENUROPLANT ENZBORN ENZENSBERGER ENZIAGIL ENZIAN ENZIANWURZEL ENZIANWURZELTEE ENZYBALAX ENZYM ENZYMAX ENZYME ENZYMFIT ENZYNORM EOG EOLIA EPA EPACELL EPALIPID EPAMAX EPANUTIN EPAQ EPASAN EPHEDRA EPHEDRINUM EPHELIA EPHEPECT EPHYNAL EPI EPICAN EPICARE EPICOMED EPICONDILITIS EPICONDYLITISBANDAGE EPICREME EPIDEMIK EPIDIDYMIS EPIDROPAL EPIDURAL EPIGARD EPIGLU EPIKONDYLITIS EPIL EPILADY EPILIERGERAET EPILOBIUM EPILONG EPINO EPIPEVISONE EPIPHYSIS EPIPHYSIS/ EPIPOINT EPISCORIT EPISOFT EPISPIN EPITRAIN EPIVIEW EPIVIR EPLONAT EPODA EPOGAM EPPENDORFER EPRESAT EPREX EPROLIN EPSI EPUREA EPX EQUALEAN EQUIDAY EQUIDERM EQUILIBRIN EQUIPUR EQUISET EQUISETUM EQUISETUM/FORMICA EQUISETUM/STANNUM EQUISETUM/VISCUM EQUISEVEN EQUISIL ERACIN ERAXIL ERBASIT ERBE ERDBEER ERDBEERE ERDIC ERDMANDEL ERDNUSSOEL ERDRAUCH EREKTIONSHILFE EREKTIONSRING EREMFAT ERENA ERES ERFOKOL ERFRISCHEND ERFRISCHUNGSBAD ERFRISCHUNGSKRAEUTERTEE ERFRISCHUNGSTEE ERFRISCHUNGSTUCH ERFURTH ERGAMISOL ERGANTON ERGENYL ERGO ERGOBEL ERGOCALM ERGODESIT ERGOHAND ERGOLEFRIN ERGOMIMET ERGONOMISCHE ERGONT ERGOTAM ERGOTINUM ERGOTOX ERHOLUNGSBAD ERICA ERIGERON ERIGOTHEEL ERINASOLUM ERIODYCTION ERKA ERKAELTUNGS ERKAELTUNGSBAD ERKAELTUNGSBALSAM ERKAELTUNGSDUFT ERKAELTUNGSOEL ERKAELTUNGSOELBAD ERKAELTUNGSPAKET ERKAELTUNGSSCHUTZ ERKAELTUNGSTEE ERKAELTUNGS-TEE ERKAELTUNGSTROPFEN ERKAELTUNGSTUCH ERKAMETER ERKATEST ERKOLAN ERLANGER ERLEBNIS ERNAEHR.-SONDEN ERNAEHRUNGSDOSIERPUMPE ERNAEHRUNGSRATGEBER ERNAEHRUNGSSET ERNAEHRUNGSSONDE ERNAEHRUNGSSONDEN ERNEU ERO EROS EROSSTIK EROTIM ERSATZ ERSATZBEZUG ERSATZBUERSTENKOEPFE ERSATZGUERTEL ERSATZKASSETTE ERSATZKLINGEN ERSATZPASTEN ERSATZREIBFLAECHE ERSATZWASCHLAPPEN ERSTE ERVAMATIN ERWACHSENEN ERY ERYAKNEN ERYBETA ERYCINUM ERYDERMEC ERYFER ERYHEXAL ERYPO ERYSEC ERYSIDORON ERYTHRO ERYTHROCIN ERYTHROCYTEN ERYTHROGENAT ERYTHROMYCIN ERYTHROXYLUM ERZGEBIRGISCHER ERZGEBIRGSTEE ES ES2 ESBERICARD ESBERICUM ESBERITOX ESCATITONA ESCHMANN ESCHSCHOLZIA ESCLAMA ESCO ESCOR ESEMDENT ESEMFIX ESEMTAN ESIDREX ESIDRIX ESKAZOLE ES-KOMPRESSEN ESMERON ESMUETEE ESPA ESPADOX ESPAFLOR ESPALAT ESPATHYM ESPELETIA ESPOCAN ESPRENIT ESPUMISAN ESS ESSAVEN ESSBESTECK ESSENTIAL ESSENTIALE ESSENTIELLE ESSENZ ESSEX ESSICUM ESSIG ESSIGSAURE ESSIGTABLETTEN ESSITOL ESSLAETZCHEN ESSLATZ ESSLERNBESTECK ESSLOEFFEL ESSTELLER ESSUMAT EST ESTA ESTALIS ESTEEM ESTEEN ESTER ESTESOL ESTHETIQUE ESTO ESTOLAN ESTRABETA ESTRACYT ESTRADERM ESTRADIOL ESTRADOT ESTRADURIN ESTRADURINE ESTRAFEMOL ESTRAGEST ESTRAGON ESTRAMON ESTRAMUSTIN ESTREVA ESTRIFAM ESTRING ESTRIOL ESTRONORM ETALPHA ETCHING ETE ETHACRIDINLACTAT ETHANOL ETHILON ETHINYLESTRADIOL ETHIPARAT ETHYOL ETI ETIDRON ETIDRONAT ETIL ETILEFRIN ETMOCARD ETO ETOMEDAC ETOMIDAT ETOPOPHOS ETOPOSID ETRANS ETRAT ETUI EU EUBIOLAC EUBOS EUCABAL EUCAL EUCALYPTUS EUCALYPTUSOEL EUCAMENTH EUCAMINT EUCARD EUCASIL EUCERIN EUCORDINA EUCOTOL EUDORLIN EUFLAT EUFLUX EUGALAC EUGLUCON EUKA EUKALISAN EUKALYPTUS EUKALYTUS EUKAMILLAT EUKAMINT EULATIN EU-MED EUMEL EUMINZ EUNERPAN EUNOVA EUPANTOL EUPATORIUM EUPHON EUPHORBIA EUPHORBIUM EUPHRASIA EUPHYLLIN EUPHYLLINE EUPHYLONG EUPLIX EURIXOR EURO EURODERM EURODOS EUROFIX EUROFLASH EUROFOLIC EUROFORM EUROMED EURON EUROPFLASTER EUROPOR EUROPURAN EUROREEL EUROSILK EUROSTRIPS EUROTAN EUROTEC EUROTRASP EUSAPRIM EUSEDON EUSOVIT EUSPIRAX EUTHYROX EUTIROX EUTRA EUVALON EUVEGAL EVA EVAC EVAI EVATEST EVAZOL EVE EVELLO EVERCELL EVERSTALER E-VICOTRAT EVILETTEN EVINA EVION EVIPROSTAT EVISCO EVISTA EVIT EVITAPLUS EVITOCOR EVOLENZ EVRA EWIROPLEX EWIRS EWIRSANA EXADROP EXAKT EXAL EXAM EXANGINA EXANTA EXCALIBUR EXCEL EXCIPIAL EXCITANS EXCITHOL EXEL EXELON EXEU EXHIRUD EXITOP EXMYKEHL EXO EXODERIL EXOTIC EXPAFUSIN EXPECTYSAT EXPIT EXPLORER EXRHEUDON EXSATIVA EXTENDED EXTENSION EXTENSIONSVERBAND EXTENSSIONSSCHIENE EXTERNE EXTIN EXTRA EXTRANIT EXTRAVENT EXTROPIN EXTRUFIX EXU EXULOCK EXUVAC EYCOPAD EYE EYEPLEX EYEVISION EYOT EZ E-Z EZETROL F F.E.M.I.N. F.X. FA FABAO FABRAZYME FABRIFOAM FACE FACHBUCH FACTOR FADENENTFERNUNGSMESSER FADENSCHERE FADENTRENNMESSER FADENTRENNSCHERE FADENZIEH FADENZIEHMESSER FADIAMONE FADUL FAELTCHEN FAGOPYRUM FAGORUTIN FAGUSAN FAHRGESTELL FAHRRAD FAKTU FALICARD FALIMINT FALITHROM FALITONSIN FALK FALKAMIN FALTENSCHLAUCH FALTKOMPRESSEN FALTSTOCK FAMILIEN FAMO FAMOBETA FAMONERTON FAMOTIDIN FAMTOL FAMU FAMULON FAMVIR FANGO FANGOPRESS FANGOTHERM FANTASY FARCO FARESTON FARFARA FARIAL FARINA FARLUTAL FARMA FARMACYROL FARMATINT FARMISTIN FARMORUBICIN FARMORUBICINA FAROS FAS FASAX FASCIA FASCICULUS FASHY FASTACT FASTEN FASTENKRAEUTERTEE FASTENTEE FASTJEKT FAT FATBALANCE FATOLIN FAULBAUMRINDE FAULENZERDIAET FAUSTAN FAVISTAN FAVOREX FCPL FDH FE FEBICHOL FEBRO-CYL FEDVEC FEEDING FEEL FEGACOREN FEIGENKAKTUS FEILE FEINFILTER FEINGOLD FEINGOLDS FEINSTAUBFILTER FEINWASCHMITTEL FEL FELDEN FELDENE FELICE FELIS FELIX FELLA-ENTOXIN FELLAUFLAGE FELLSCHUHE FELLSTIEFEL FELO FELOBETA FELOCOR FELODIPIN FELOGAMMA FEM FEMAPLUS FEMARA FEMAVIT FEMBOWLS FEMCAP FEMCON FEMENA FEMI FEMIBION FEMICUR FEMIGOA FEMIKLIMAN FEMILAN FEMILLA FEMIN FEMININ FEMINON FEMISANA FEMME FEMODENE FEMOJECT FEMOSTON FEMOVAN FEMPRESS FEMRANETTE FEMSEPT FEMSOFT FEMTEST FEMUR FEMVITAL FENCHEL FENCHELFRUECHTETEE FENCHELKAUTABLETTEN FENCHELOEL FENCHELTEE FENG FENIKO FENINT FENISTIL FENIZOLAN FENOBETA FENOFANTON FENOFIBRAT FENSUM FEPYR FERITY FERMATHRON FERMENTO-DUODENAL FERNWEH FERRIPROX FERRISOR FERRLECIT FERRO FERRODIX FERRODONA FERROGAMMA FERROINFANT FERROKAPSUL FERRUM FERSEN- FERSENKEIL FERSENKISSEN FERSENLAGERUNGSKISSEN FERSENPOLSTER FERSENRING FERSENROLLE FERSENSCHONER FERSENSCHUH FERSENSCHUTZ FERSENST FERSENSTUECK FERSENSTUECKE FERTI FERTIGSPRITZE FERTIGVERBAENDE FERTILSCAN FESTKANTMULLBINDE FETO FETTANALYSEWAAGE FETTBALANCE FETTBURNER FETTE FEUCHTES FEUCHTHALTENDE FEUCHTIES FEUCHTIGKEITS FEUERWEHR FEVARIN FIAGUTT FIAMELIS FIBER FIBLAFERON FIBRAFLEX FIBREX FIBREZYM FIBROMA FIBROSTIMULIN FIBULO FICHTE FICHTEN FICHTENNADEL FICIN FICORTRIL FIDESAN FIEBER FIEBERHAFTE FIEBERSAUGER FIEBERTHERMOMETER FIEBERZAEPFCHEN FIGUR FIGURA FIGUREFORM FIGURTEE FILETMESSER FILIX FILLAWANT FILTER FILTERBLAETTCHEN FIL-ZELLIN FILZPOLSTER FIMA FIMACOR FINALGON FINALLY FINARTRO FINEURAL FINGER FINGERENDGELENKSCHIENE FINGERFLEX FINGERGELENKVERBAND FINGERHUELSEN FINGERKUPPEN FINGERKUPPENVERBAND FINGERLING FINGERPULSOXIMETER FINGERPULSUHR FINGERRING FINGERSCHIENE FINGER-TEMP FINGERTIP FINGERVERBAND FINIGRANA FINIL FINLEPSIN FINNISCHES FIRIN FIRST FISCHE FISCHERSTOCK FISCHOEL FISCHOELKONZENTRAT FISHERMANS FISONAIR FISSAN FISSURA FIT FIT+VITAL FITNESS FITNESSUHR FITTYDENT FIX FIXIER FIXIERBAND FIXIERBANDAGE FIXIERBINDE FIXIERGURT FIXIERHOSEN FIXIERPFLASTER FIXIERSET FIXIERSLIP FIXIERUNGSBAND FIXIERVERSCHLUSS FIXIERVLIES FIXIES FIXISTRETCH FIXOMULL FIZZY FK FLACAR FLACHBODEN FLACHFILTER FLACHSOEL FLACHWAAGE FLAEM FLAGYL FLAMMAZINE FLAMYAR FLANAMOX FLANELLBINDE FLAP FLASCHEN FLASCHENBUERSTE FLASCHENDOSIERER FLASCHENHALTER FLASCHENMANTEL FLASCHENOEFFNER FLASCHENSAUGER FLASCHENSTAENDER FLASCHENSYSTEM FLASCHENWARMHALTER FLASH FLATUSAN FLAVEC FLAVO FLAVOID FLAVONE FLAVOSOY FLEBOSTASIN FLECADURA FLECAINID FLECHTOMED FLEET FLEISCH FLEISCHMESSER FLENIN FLEXAL FLEXASE FLEXI FLEXIBLE FLEXICARE FLEXIDERM FLEXIFLO FLEXITOL FLEXLIFE FLEXOVERSAL FLEXTEND FLEXXUM FLEXY FLIEDER FLIEG FLIEGEN FLIEGENSTOP FLIGHT FLINT FLIXOTIDE FLOCARE FLOCKENUNTERLAGEN FLOCKENWINDEL FLOH FLOHSAMEN FLOHSAMENSCHALEN FLOHSTOP FLOR FLORABIO FLORACIT FLORADIX FLORAFARM FLORAFIT FLORAPRESS FLORASOY FLORENA FLORES FLORESTA FLORICARD FLORIDA FLORIMEL FLORISAN FLORON FLORONE FLOSA FLOSBRUSH FLOSEAL FLOSEMA FLOSINE FLOSSBRUSH FLOSSY FLOTIRAN FLOTRIN FLOWREGLER FLOXAL FLUAD FLUANXOL FLUC FLUCINAR FLUCLOX FLUCLOXACILLIN FLUCOBETA FLUCOLICH FLUCONAZOL FLUCTIN FLUCTINE FLUDARA FLUDILAT FLUDROCORTISON FLUEGELHAHN FLUEGGE FLUESSIG FLUESSIGKEITSFILTER FLUESSIGSEIFE FLUG FLUGTRAUM FLUI FLUID FLUIDENTA FLUIMUCIL FLUMID FLUNARIZIN FLUNAVERT FLUNAZUL FLUNEURIN FLUNI FLUNIBETA FLUNINOC FLUNITRAZEPAM FLUOMYCIN FLUOPIN FLUOR FLUORESCEIN FLUORESZEIN FLUORETTEN FLUORID FLUORIDIN FLUORIL FLUORIT FLUORO FLUOROPOS FLUOROS FLUOROURACIL FLUORZAEPFCHEN FLUOX FLUOXE FLUOXELICH FLUOXEMERCK FLUOXETIN FLUOXGAMMA FLUPHENAZIN FLUSPI FLUSPIRILEN FLUTA FLUTAMID FLUTEXIN FLUTIDE FLUTIVATE FLUVOHEXAL FLUVOXADURA FLUVOXAMIN FLUXET FLYERS FLYING FM FOAM FOAM-NASE FOCALEX FOEHN- FOEHRER FOENICULUM FOENUM FOERDERMODUL FOERSTER FOEVYSAT FOKALEPSIN FOL FOLAPAS FOLARELL FOLBENE FOLCUR FOLGAMMA FOLI FOLICACID FOLICOMBIN FOLIGAN FOLIO FOLIODRAPE FOLIODRESS FOLISYX FOLLICULI FOLLIKULINORM FOLSAEURE FOLSAN FOLVERLAN FOMALVE FOME FOMEPIKEHL FONDRIL FOOD FOR FORADIL FORANE FORASEPT FORAZE FORENE FOREST FOREVER FORLAN FORLAX FORM FORMA FORMABELL FORMAGUM FORMASAN FORMAZELL FORMEINLAGE FORMEL FORMICA FORMICA/OXALIS FORMICAIN FORMIDIUM FORMISOTON FORMOLINE FORMSCHIENE FORMULA FORTAKEHL FORTAMIN FORTBILDUNGSVIDEO FORTE FORTECORTIN FORTICARE FORTIFRESH FORTIJUCE FORTIMEL FORTOBELL FORTOVASE FORTUM FORUM FOS FOSAMAX FOSCAN FOSCAVIR FOSFOSERINA FOSICOMB FOSINORM FOST FOTIL FRAGARIA FRAGMIN FRANGIPANI FRANGULA FRANKLIN FRANZBRANNTWEIN FRAPANTOL FRATER FRAU FRAUEN FRAUENBAD FRAUENDUSCHE FRAUENMANTEL FRAUENTEE FRAUENTHERMOMETER FRAUENTONIKUM FRAUEN-TONIKUM FRAXINUS FRAXIPARIN FRAXIPARINA FRAXIPARINE FRAXODI FREBINI FREE FREEDOM FREEFLEX FREESTYLE FREEXS FREI FREKA FREKADROP FREKAMAN FREKAMILD FREKAMIX FRELU FRENCH FRENOPECT FRENTA FRESENIUS FRESH FRESHMIX FRESUBIN FRIDOLIN FRIEDEN FRIEDERM FRIEDRICHSHALLER FRIESEN FRIGOTHERM FRIHO FRIO FRIPA FRISCH FRISCHE FRISCHER FRISIUM FRITZSTOCK FROEHLICHE FROMMS FROSCHFINGERSCHIENE FROTTEE FRUBIASE FRUBIENZYM FRUBILURGYL FRUBIZIN FRUCHT FRUCHTBARKEITSRATGEBER FRUCHTS FRUCHTSAFTBAERCHEN FRUCHTSAFTBAERLI FRUCHTY FRUCTIS FRUCTO FRUECHTE FRUECHTECOCKTAIL FRUECHTEKINDERTEE FRUECHTEKORB FRUECHTETEE FRUECHTETEES FRUECHTEWUERFEL FRUEH- FRUEHERKENNUNGSHILFE FRUEHGEBURTENTHERMOMETER FRUEHLING FRUEHLINGSBOTE FRUEHLINGSWOLKEN FRUEHLINGSZAUBER FRUEHMESNER FRUEHSTUECKSBRETT FRUEHSTUECKSKRAEUTERTEE FRUEHSTUECKSTEE FRUGELLETTEN FRUIT FRUMIKAL FRUTIVITAL FRUTIX FRUZYMTABS FRYDMAN FS FSME FUCARDIVAL FUCHS FUCICORT FUCIDIN FUCIDINE FUCITHALMIC FUCO-CYL FUCUS FUEHRUNGSDRAHT FUEHRUNGSHILFE FUEHRUNGSKANUELEN FUEHURNGSDRAHT FUELL FUELLKANUELE FUELLSORTIMENT FUELLUNG FUENFER FUER FUETTER FUETTERUNGSHILFE FUGACID FUGATEN FUGEREL FULCIN FULDAPECT FULGURAN FULL FUMADERM FUMARIA FUNCTIONAL FUNDAMENTSALZ FUNGATA FUNGIDERM FUNGIDEXAN FUNGIZID FUNGUR FUNICULUS FUNKTIONS FUNKTIONSSALZ FUNNY FURACIN FURADANTIN FURANTHRIL FURESIS FURO FUROBETA FUROGAMMA FUROMED FURORESE FUROSAL FUROSEMID FUSID FUSS FUSS- FUSSBAD FUSSBADE FUSSBADESALZ FUSSBADEWANNE FUSSBALLEN FUSSBALSAM FUSSBETT FUSSCREME FUSSDEOGEL FUSSDUSCHE FUSSFRISCH FUSSGELENK FUSSGELENKSTUETZE FUSSHEIL FUSSKNOECHELSTUETZE FUSSLOTION FUSSMANSCHETTE FUSSMASSAGE FUSSMASSAGECREME FUSSMASSAGEROLLER FUSSNAGELKNIPSER FUSSNAGELSCHERE FUSSORTHESE FUSSPERLBAD FUSSPFLEGE FUSSRASPEL FUSSREINGER FUSSREINIGER FUSSROLLER FUSSSPRUDELBAD FUSSTHERAPIEROLLER FUSSWAERMER FUTURIL FUTURO FUZEON G G.E.H.-SAN GA GABA GABAPENTIN GABAX GABE GABEL GABITRIL GABOCULT GABRILEN GABUNAT GADOVIST GAENSEBLUEMCHEN GAENSEFINGERKRAUT GAENSEGURGEL GAIA GAJOL GALACORDIN GALACTODERM GALACTOMIN GALACTOPHARM GALALLITHSTAEBCHEN GALANGA GALANTHUS GALBANUM GALEA GALEGA GALENAVOWEN GALENIT GALENIT/ GALEOPSIS GALGANT GALGANTTABLETTEN GALINSOGA GALIUM GALIVERT GALLA GALLCUSAN GALLE GALLEMOLAN GALLEN GALLENDRAINAGE GALLENJA GALLENSEKRETBEUTEL GALLENSTEINTROPFEN GALLENTEE GALLEVIN GALLINERO GALLITH GALLOBETA GALLOPAMIL GALLOROBAL GALLOSELECT GALLSEIFE GALPHIMIA GALVAPIN GAMMA GAMMACUR GAMMAGLANDIN GAMMAPLAN GAMMATEC GAMMEX GAMMON GAMONIL GAMSER GANODERMIN GANOFIT GARCINIA GARD GARDENIA GARGARISMA GARGEL GARLIC GARLICIN GARMASTAN GARTEN GASTRACID GASTRARCTIN GASTRI GASTRICHOLAN GASTRICUMEEL GASTRICUR GASTRIMINT GASTRIN GASTRIPAN GASTRISELECT GASTRITIS GASTRITOL GASTRO GASTROBIN GASTROFLATOL GASTROGRAFIN GASTROLIND GASTROLUX GASTRONERTON GASTROPEG GASTROPLANT GASTROPOLIS GASTROPROTECT GASTROSECUR GASTROSIL GASTROSTAD GASTROTRANQUIL GASTROVEGETALIN GASTROZEPIN GASTRYSAT GAULTHERIA GAVISCON GAZESTREIFEN GAZIN GAZOFIX GAZOMULL GEBAUERS GEBIRGS GEBIRGSKRAEUTERTEE GEBISS GEBISSDOSE GEBISSSCHALE GEBORGENHEIT GEBURTSOEL GEBURTSTAGSKARTE GECKO GECOSAN GEFAESS GEFRIERBEUTEL GEFRIERBEUTELADAPTER GEGEN GEHBANK GEHBOCK GEHBUEGEL GEHE GEHEIMNISSE GEHGALOSCHE GEHGESTELL GEHGESTELLTASCHE GEHGIPS GEHHILFE GEHHILFEN GEHHILFENKAPPE GEHOERGANGTUPFER GEHOERSCHUTZ GEHOERSCHUTZSTOEPSEL GEHRAD GEHROLLBANK GEHSCHUH GEHSTOCK GEHSTOLLEN GEHSTUETZE GEHSTUETZEN GEHWAGEN GEHWOL GEISSRAUTE GEKO GEL GELA GELACET GELAFEBAN GELAFUNDIN GELAFUSAL GELAMIN GELAPROBST GELASPON GELASSENHEIT GELASTYPT GELATAMP GELATINA GELATINAT GELATINE GELATINESCHWAMM GEL-ATROS GELAVIT GELBAG GELBER GELCAST GELEDABEILLE GELEE GELENK GELENKBALSAM GELENK-BALSAM GELENKE GELENKFREUND GELENKJA GELENKO GELENKOPTIMIZER GELENKOSAN GELENKS GELENK-UND GELENKVERBAND GELFERT GELICAIN GELIPERM GELIPUR GELITA-TAMPON GELKISSEN GELLYMATE GELMODEL GELO GELOBRONCHIAL GELOCAST GELODURAT GELOMEER GELOMYRTOL GELONASAL GELONIDA GELOSANA GELOSITIN GELOSTRETCH GELOVITAL GELSEMIUM GELUM GELUSIL GEMFI GEMUESE GEMUESEKAPSELN GEMUESEMESSER GEMUESESCHAELER GEMZAR GEN GENCIN GENCYDO GENESIS GENESUNGSKARTE GENGIGEL GENIAL GENIESS GENISTEIN GENIUS GENOTONORM GENOTROPIN GENT GENTA GENTAMICIN GENTAMYCIN GENTAMYTREX GENTANIT GENTEAL GENTIANA GENTLE GENTONORM GENU GENUAKTIV GENU-CYL GENUGIB GENUMEDI GENUPLUS GENUS GENUSAFE GENUTRAIN GEO GEPAN GERADEHALTEGUERTEL GERAETEHALTER GERANIE GERANIEN GERANIUM GERATHERM GERI GERICARDIAL GERIGOA GERIVIT GERLAN GERLAPIN GERLASAN GERLAVIT GERMANIUM GERMED GERMINOL GERNEBCIN GERO GERONTAMIN GERSTEN GERSTENGRAS GERSTENGRUEN GERSTENSAFTGRAS GERUCHS GERUCHSBINDER GERUCHSKILLER GESAESSKISSEN GESANA GESCHENKDOSE GESCHENKKARTON GESICHTS GESICHTSCREME GESICHTSGEL GESICHTSMASKE GESICHTSPFLEGE GESICHTSREINIGUNG GESICHTSSAUNA GESICHTSTONIKUM GESICHTSWASSER GESICHTSZELT GESIDINE GESTAGENOTROP GESTAKADIN GESTAMESTROL GESTAPOLAR GESUNDFORM GESUNDHEITS GESUNDHEITSDOKUMENTEN GESUNDHEITSDUSCHGEL GESUNDHEITSFUESSLINGE GESUNDHEITSSOCKEN GETRAENKETASCHE GETREIDE GEUM GEVILON GEWEBE GEWICHTREDUKTION GEWICHTSZUNAHME GEWINDESTANGE GEWUERZE GEWUERZNELKEN GEWUERZNELKENOEL GEZIELTE GHEE GHRH GIANDA GIBAUD GICHT GIGASEPT GIGAZYME GILCHRIST GILLETTE GILMAZ GILMED GILOFA GILOFAMED GILT GILUCOR GILURYTMAL GINCURAN GINETTEN GINGER GINGICAIN GINGILOBA GINGIUM GINGIVA GINGIVITOL GINGKO GINGOBETA GINGOPRET GINKGO GINKGOBAKEHL GINKGOFORCE GINKGORELL GINKGOSCHUCK GINKOBIL GINKODILAT GINKOKAN GINKOPUR GINSANA GINSENA GINSENG GINSTER GINTEC GINTONAL GIPSBINDE GIPSGALOSCHE GIPSLONGUETTEN GIPSY GIRHA GIRHEULIT GITTA GITTALUN GITYL GKE GL+EL GL+EM GL+ES GLA GLADEM GLADIXOL GLADS GLAENZENDER GLAMIN GLANDOCLEAN GLANDOL GLANDOMED GLANDOSANE GLANDULA GLANDULAE GLANDUSELECT GLANZ GLAS GLAS- GLASFLASCHE GLASHALTER GLASSPRITZE GLAS-TEEFLASCHE GLAUBERSALZ GLAUCO GLAUCOTHIL GLAUKO GLAUPAX GLAUTARACT GLEITGEL GLEITGELEN GLEITMATTE GLEITMITTEL GLEITSCHUTZKAPPE GLEITSOCKE GLETSCHER GLIANIMON GLIB GLIBEN GLIBENBETA GLIBENCLAMID GLIBENDOC GLIBENHEXAL GLIDE GLIDER GLIMERID GLIMIDSTADA GLIOMA GLISS GLM GLOBAL GLOBALIUM GLOBOL GLONOIN GLONOINUM GLORISEX GLOVES GLOVEX GLS GLUBORID GLUCAGEN GLUCASAN GLUCERNA GLUCO GLUCOBAY GLUCOBON GLUCOFAST GLUCOFILM GLUCOFIT GLUCOFLEX GLUCOJECT GLUCOLET GLUCOMANNAN GLUCOMEN GLUCOMETER GLUCOPHAGE GLUCOPLASMAL GLUCORECT GLUCOREMED GLUCOSAMIN GLUCOSAMINSULFAT GLUCOSE GLUCOSMART GLUCOSTERIL GLUCOSTIX GLUCOTIME GLUCOVEN GLUECKSGEFUEHLE GLUEHBIRNE GLUEHWEIN GLUEHWEINGEWUERZ GLUKO-CYL GLUKOVITAL GLURENORM GLUTAMIN GLUTAMINSAEURE GLUTARSIN GLUTATHION GLUTENZYM GLUTI GLUTISAL GLUTRIL GLYCERIN GLYCERINUM GLYCEROPHOSPHAT-NATRIUM GLYCEROSTERIL GLYCILAX GLYCIN GLYCINE GLYCOBOSAN GLYCOCELL GLYCYLPRESSIN GLYKOKOLL GLYOXAL GLYPOND GLYSAN GNAPHAGIN GNAPHALIUM GNEIS GO GODAMED GODD GOETTINGER GOFIT GOLD GOLDAMPULLEN GOLDEN GOLDENE GOLDGEIST GOLDKIND GOLDNERZ GOLDRUTE GOLDRUTEN GOLDRUTENKRAUT GOLDSAM GOLDTROPFEN GONAL GOOD GOPTEN GORE-TEX GOSSYPIUM GOT2B GOTA GOTAC GOTHA GOTHAPLAST GOX GPLUS GR GRACIA GRACIAMED GRACIASAN GRAESERKORB GRAMINOSE GRANAT GRANATAPFELSAMENOEL GRANATUM GRANDE GRANDEL GRANDELAT GRANINI GRANIT GRANOBIL GRANOCYTE GRANODENT GRANOTON GRANOZYM GRANU GRANUFINK GRANULAC GRANULOKINE GRANULOMA GRAPEFRUCHT GRAPEFRUIT GRAPEFRUITKERN GRAPEFRUITKERNEXTRAKT GRAPESEED GRAPHITES GRAPKO GRASSOLIND GRATIOLA GRAVI GRAVIOLA GRAVISTAT GRAVITEST GRECIAN GREEN GREENFIT GREENS GREIFFLASCHE GREIFHILFE GREIFLERNFLASCHE GREIFRASSEL GREIFZANGE GRETHERS GRICIN GRIECHISCHER GRIFFPOLSTER GRIFFSTANGE GRIFFVERDICKUNG GRIFFVERSTAERKER GRIFFVERSTAERKUNG GRIFOLANIN GRINDELIA GRIPPE GRIPPER GRIPPEROBAL GRIPPEX GRIPPHEEL GRIPPOCAPS GRIPPOSTAD GRIPPS GRIPSTAR GRIPSTICK GRISEO GROBSTAUBFILTER GROSHONG GROSS GROTANAT GRUEN GRUENALGEN GRUENATUR GRUENCEF GRUENE GRUENER GRUENES GRUENLICHT GRUENLIPP GRUENSPARGEL GRUENTEE GRUENWALDER GSA G-STROPHANTHINUM GTE GTO GU GUAIACUM GUAJACUM GUAJAKHARZ GUALEDUM GUANIDIN GUAR GUARAMBA GUARANA GUARANAFIT GUARDIAN GUAVE GUEDEL GUEDELTUBEN GUERTEL GUERTELTASCHE GUGGUL GUGGULU GUIBOR GUM GUMBARAL GUMBIX GUMMI GUMMIBAERCHEN GUMMIBAEREN GUMMIHANDSCHUHE GUMMILASTIKBINDE GUMMISCHLAUCH GUMMISTRUMPFANZIEHER GUNDELREBE GUNPOWDER GURGELLOESUNG GURKENKRAUTOEL GURKENMILCH GURT GURWASON GUT GUTA GUTE GUTEN GUTRON GUTTALAX GUTTAPLAST GX GXE GYM GYMNASTIK GYMNASTIKBALL GYMNASTIKBAND GYMNASTIKMATTE GYMNIC GYMNICBALL GYN GYNAECOHEEL GYNAEKO GYNAEKOLOGISCHER GYNAICOL GYNAMON GYNETICS GYN-LYS GYNO GYNOCASTUS GYNODIAN GYNOKADIN GYNO-MYKOTRAL GYRASTOP GYROFLOX GYROLUX GYRUS H H&S H-14 H2 HA HAAR HAARBUERSTE HAARENTFERNER HAARKUR HAARNA HAARSCHERE HAARSPUELUNG HAARWASCHBECKEN HAARWASCHRING HAARWASCHWANNE HAARWASSER HAARWUCHSIN HABERECHT HABIFAC HABSTAL HACI HAEMACCEL HAEMA-GASTREU HAEMATHOL HAEMATIT HAEMATO HAEMATOPAN HAEMITON HAEMO HAEMOAGIL HAEMOCCULT HAEMO-CYL HAEMOFUSIN HAEMO-GLUCOTEST HAEMO-GLUKOTEST HAEMOLANCE HAEMOPLUS HAEMOPRESSIN HAEMOPROTECT HAEMOROBAL HAEMORRHOID HAEMORRHOIDAL HAEMORRHOIDALLEIDEN HAEMOSAL HAEMOSTILETTEN HAENAL HAENGEWAAGE HAES HAFER HAFERKLEIE HAFERSTROH HAFESAN HAFT HAFTAN HAFTANFIX HAFTBINDE HAFTELAST HAGEBUTTEN HAGEBUTTENKERNOEL HAGEMED HAHN HAHNBANK HAHNBANKLINIE HAI HAIFISCH HAIFISCHOEL HAIKNORPEL HAIKNORPELPULVER HAIMA HAIPA HAIR HAIREXSTOP HAIROKA HAIROTON HAIRR HAIRWONDER HAKA HAKLE HALAMID HALBMOND HALBROLLE HALCION HALDOL HALF HALICAR HALIT HALLIG HALLO HALLOO HALOPER HALOPERIDOL HALPROTEC HALS HALSFEGER HALSGUMMI HALSKRAUSE HALSKRAWATTE HALSSCHMERZEN HALSSTUETZE HALSWOHL HALTEBAENDER HALTEBAND HALTEGRIFF HALTEGUERTEL HALTEGURT HALTER HALTERUNG HAMADERM HAMADEST HAMADIN HAMAMELIS HAMBURGER HAMDARD HAMETUM HAMOL HAND HAND- HAND/FUSSGELENKFESSEL HANDBANDAGE HANDBUERSTE HANDCREME HANDFESSEL HANDGELENKBANDAGE HANDGELENKFESSEL HANDGELENKORTHESE HANDGELENKRIEMEN HANDGELENKSORTHESE HANDGELENKSTUETZE HANDGRIFF HANDGRIFFPOLSTER HANDGYMNASTIK HANDINNENFLAECHEN HANDLAUF HANDMASSAGEROLLER HANDMILCHPUMPE HANDO HANDPFLEGE HANDPFLEGECREME HANDPUMPE HANDSAN HANDSCHLAUFE HANDSCHUHE HANDSCHUTZSCHAUM HANDSOFT HANDSPENDER HANDSPREIZER HANDSPRUEHKOPF HANDSTOCK HANDTRAINER HANDWAERMER HANDWASCHBUERSTE HANDWUNDER HANDY HANF HANFSAMEN HANOALGYN HANOCHOLAN HANOCOR HANOCUTAN HANOGALLAN HANOOXYGEN HANOTOXIN HANOVITAN HANS HANSAL HANSAMED HANSAPLAST HANSAPOR HANSEATEN HAPLOPAPPUS HAPPINESS HAPPS HAPPY HAPPYCAROTEN HARABUZ HARIBO HARLEKIN HARMONIE HARMONY HARMOSIN HARNABLEITUNGSSYSTEM HARNBLASE HARNLEITERBOUGIERUNG HARNLEITERDILATION HARNROEHRENOLIVE HARNROEHRENSPLINT HARNROEHRENVERSCHLUSS HARNSAEURETROPFEN HARNSTOFFSALBE HARNTEE HARNTREIBENDER HARO HARONGA HARONGAN HARPAGIN HARPAGO HARPAGOFORTE HARPAGOPHYTUM HARPAGOSAN HARTMANN HARUGOLD HARZ HARZOL HASCHERPUR HASSOUN HATE HATSCHI HATTRIC HAUBE HAUHECHEL HAUS HAUSAPOTHEKE HAUSCHKA HAUSER HAUSERS HAUSHALT HAUSHALTSCHERE HAUSHALTSHANDSCHUHE HAUSKRANKENPFLEGE HAUSMANN HAUSSCHUH HAUSSTAUBALLERGIEN HAUSTEE HAUT HAUTBEBEN HAUTCREME HAUTFIT HAUTFUNKTIONS HAUTFUNKTIONSBAD HAUTFUNKTIONSTABLETTEN HAUTGEIST HAUTKLEBER HAUTKLEBERENTFERNERTUECHER HAUTKLEIEBAD HAUTLOTION HAUTMESSER HAUTNAEHR HAUTOEL HAUTPFLEGE HAUTPFLEGENDE HAUTPFLEGESALBE HAUTPFLEGETEE HAUTPLUS HAUTREIN HAUTSCHERE HAUTSCHUTZ HAUTSCHUTZTUECHER HAUTSTRAFF HAUTTHERAPIE HAUT-UND HAUTZANGE HAVPUR HAVRIX HAWAIIAN HBVAXPRO HCA HCG HCT HCTAD HEAD HEADSCHE HEALON HEALTH+ HEALTHY HEART HEARTSTART HEAT HEBE HEBEKISSEN HEBEMATTE HECHT HEDELIX HEDERA HEFASOLON HEFE HEFTPFLASTER HEGRIMARIN HEI HEIDEKRAUTBLUETENTEE HEIDELBEER HEIDELBEERBLAETTER HEIDELBEERE HEIDELBEEREN HEIDELBERGER HEIDELBERGERS HEILAND HEILBUTT HEILCREME HEILERDE HEILKRAEUTER HEILKRAEUTERBAD HEILKREIDE HEILPFLANZEN HEILWAERMER HEIM HEIMKOMMEN HEIROL HEISAN HEISS/KALT HEISSE HEITRIN HEIZKISSEN HEKLA HELAGO HELARIUM HELASTIC HELFENDE HELIANTHUS HELICOBACTER HELIMATIC HELINA HELIOBAND HELIOCAST HELIOCLIP HELIOCREPP HELIODERM HELIODUR HELIOFALT HELIOFIX HELIOFLEX HELIOFRACT HELIOGLOVE HELIOGRIP HELIOLAN HELIOLAST HELIOLASTIC HELIOMED HELIOMULL HELIOPAD HELIOPLAST HELIOPOR HELIOQUICK HELIORIN HELIOS HELIOSAN HELIOSAVE HELIOSILK HELIOSLIP HELIOSOFT HELIOSPORT HELIOSTRIP HELIOTAPE HELIOTEX HELIOTRICOT HELIOTUPF HELIOVLIES HELIOZELL HELIPUR HELIXOR HELIZYME HELLEBORUS HELMEX HELO-ACID HELODERMA HELONIAS HELOPANFLAT HELPIC HELPP HELSOVAL HEM HEMO HEMOCARE HEMOCOL HEMOCOLLAGENE HEMODORM HEMOHES HEMOMED HENKELL HENNA HENNAPLUS HENRI HENRY HENTSCHEL HENZE HEPA HEPABESCH HEPABOLAN HEPAFIX HEPAGALLIN HEPAGRISEVIT HEPAR HEPARANOX HEPARCYN HEPARIN HEPAR-MAGNESIUM HEPAROBAL HEPARON HEPARSEDO HEPARSTAD HEPATHIN HEPATHOXIN HEPATHROMB HEPATHROMBIN HEPATI HEPATICUM HEPATIK HEPATIMON HEPATORELL HEPATOS HEPA-VIBOLEX HEPAWELL HEPEEL HEPLANT HEPOTHESAN HEPPINGER HEPPNERS HEPSERA HER HERALVENT HERBA HERBACEROL HERBACIN HERBADERM HERBAL HERBALES HERBALIFE HERBAMEDIN HERBANEST HERBASEKTOS HERBATHERM HERBIN HERBST HERBSTWALD HERCEPTIN HERICIDIN HERICIUM HERKOS HERMES HERNIARIA HERNIENNETZ HERPES HERPETAD HERPHONAL HERRENKAMM HERRENSCHERE HERRENSTOCK HERRENVORLAGE HERRICK HERSFELDER HERZ HERZFLUID HERZGESPANN HERZKRAFT HERZLICHEN HERZLIEB HERZMITTEL HERZPOWER HERZPUNKT HERZSPRUNG HERZTONIKUM HERZTROPFEN HERZWERT HESTIA HETTERICHS HETTRAL HEU HEUBLUMEN HEUBLUMENKISSEN HEUMANN HEUSCHNUPFEN HEUSCHNUPFENMITTEL HEVERT HEVERTIGON HEVERTNIER HEVERTO HEVERTOGALL HEVERTOGYN HEVERTOPLEX HEVERTOTOX HEVERTOVAL HEVERTOZYM HEWA-CYL HEWALLERGIA HEWEANGIN HEWEASTHMON HEWEBERBEROL HEWEBLAST HEWECHOL HEWECOLIT HEWECOR HEWECYST HEWEDERM HEWEDOLOR HEWEDORM HEWEFORMICA HEWEGASTRON HEWEGINKGO HEWEKLIMAN HEWEKZEM HEWELYMPHON HEWENASAL HEWENEPHRON HEWENEURAL HEWEOEDEM HEWEPHOS HEWEPSYCHON HEWERHEUM HEWESABAL HEWESCILL HEWESELEN HEWESKLERAN HEWESOOR HEWESPLENOM HEWESPONDYL HEWETHYREON HEWETON HEWETRAUMEN HEWEURAT HEWEVEN HEXABRIX HEXAL HEXAMON HEXAQUART HEXAVAC HEXENSTAEBCHEN HEXENTURM HEXIT HEXOBION HEXORAL HEXORALETTEN HF HI HIBISCUSBLUETEN HIBISCUSTEE HIBISKUSTEE HIBTITER HICKMANN HICO HIDROFUGAL HIDROSIS HIGDIL HIGH HIGHLAND HIGHSPEED HILARY HILDEGARD HILFE HILLERS HIMALAJA HIMALAYA HIMBEERBLAETTER HIMBEERE HIMBEEREN HIMED HIMMLISCHER HINDUSAN HINGFONG HINOKI HIPP HIPPO HIPPOCAMPUS HIPPOLAC HIPPOPHAE HIPPOQUICK HIRNSTAMM HIRSAN HIRSCHTALG HIRSCHTALGCREME HIRSCHZUNGEN HIRSE HIRSEKISSEN HIRSESCHALEN HIRTENTAESCHEL HIRTENTAESCHELKRAUT HIRUDO HIRUDOID HISFEDIN HISTAMIN HISTAMINUM HISTINESS HISTOACRYL HISTOFREEZER HIVID HKN HME HN HO HOANG HOANGS HOBELKLINGEN HOCHLEISTUNG HOCHRAND HODEN HODENPROTHESE HODENROLLE HOECUTIN HOEGA HOEGADERM HOEGADERMAN HOEGAFIXAN HOEGASAN HOEGASEPTAN HOEHENMESSER HOEHENSONNENBRILLE HOEHENSONNENBRILLEN HOELLENSTEIN HOERGESCHAEDIGTE HOERSCHLAUCH HOERVERSTAERKER HOESCHEN HOEVENOL HOFIBU HOGGAR HOLFUNGIN HOLIDAY HOLLAENDISCH HOLLE HOLLISTER HOLLMO HOLLYBED HOLOXAN HOLUNDER HOLUNDERBEER HOLUNDERBLUETEN HOLUNDERTEE HOLZAPFELESSIG HOLZHACKER HOLZLEHNERS HOLZMUNDSPATEL HOLZSCHUTZMITTEL HOLZWATTETRAEGER HOMATROPIN HOME HOMEDA HOMOBION HOMOCENT HOMOCYSTEIN HOMOEOPATH. HOMOEOPATHIE HOMOEOPATHISCHE HOMVIOCORIN HOMVIORA HOMVIOTENSIN HONEY HONEYBUSH HONIG HONIGBAERCHEN HONIGBLUETE HONIGBUSCHTEE HONIG-SHAMPOO HONIGWABE HONIGWACHS HONVAN HOODIA HOP HOPE HOPFEN HOPFENZAPFEN HORIZONT HORIZONTALE HORIZONTE HORMA HORMEEL HORMOCENTA HORMOFEM HORNERZ/ HORNHAUT HORNHAUTBALSAM HORNHAUTHOBEL HORNHAUTRASPEL HORNHAUTSCHWAMM HORNHAUT-UND HORNY HORPHAGEN HORVILAN HOSENMANSCHETTE HOSENTRAEGERGURT HOSPIDERMIN HOSPISEPT HOSPITEX HOSTESS HOT HOTLIKE HOWARD HOX HOYER HOZ H-PAK HPE HPH HPMC HR HRT HS HSA HSG HUBERNADEL HUEFTSCHUTZ HUEHNERAUGEN HUEHNERAUGENMITTEL HUFLATTICH HUGGIES HUGO HUMA HUMALOG HUMAN HUMANA HUMANUS HUMAPEN HUMATIN HUMATROPE HUMEDIA HUMID HUMINSULIN HUMMEL HUMULIN HUMULUS HUNJADI HUNTERIA HUS HUSTAGIL HUSTEEL HUSTELINCHEN HUSTEN HUSTENBONBON HUSTENSTILLER HUSTENTABS HUSTENTROPFEN HUSTI HUSTIES HUT HUTBERG HVB HWS HY HYA HYALART HYALGIN HYALOFEMME HYALOFILL HYALOGRAN HYALUBRIX HYALURON HYALURONSAEURE HYANIT HYBEN HYCAMTIN HYDERGIN HYDERGINE HYDIPHEN HYDRABIS HYDRACOLOR HYDRAFOAM HYDRAPLEX HYDRASTIS HYDREA HYDRIN HYDRO HYDROBAG HYDROCHINON HYDROCOLL HYDROCORTISON HYDROCOTYLE HYDROCUTAN HYDRODERM HYDRODEXAN HYDROFILM HYDROG HYDROGALEN HYDROL HYDROLIFT HYDROMED HYDROMEDIN HYDROPEX HYDROPHILES HYDROPIPER HYDROPRESS HYDROSONIC HYDROSORB HYDROTALCIT HYDROTRIX HYDROVITAL HYGENA HYGIENE HYGIENEBEUTEL HYGIENESCHUTZHOSEN HYGIENISCHE HYGROBABY HYGROBAC HYGROBOY HYGROLIFE HYGROTON HYKUSAN HYLA HYLAFORM HYLAK HYLAN HYLASE HYLO HYLOSAN HYMNOX HYOSCYAMUS HYOSCYAMUS/VALERIANA HYPAFIX HYPAL HYPER HYPERCIRCIN HYPERCORAN HYPERESA HYPERFLEX HYPERFORAT HYPERGEL HYPERGUM HYPERICAPS HYPERICUM HYPERIDYST HYPERIMERCK HYPEROBAL HYPERPROST HYPERPUR HYPERVENTILATIONSMASKE HYPHEN HYPNOMIDATE HYPNOREX HYPO HYPOCHLORIT HYPODERM HYPODERMISCHE HYPOGEEN HYPOLASTIC HYPOMARTIN HYPOPHAN HYPOPHYSIS HYPOPHYSIS/STANNUM HYPOTHALAMUS HYPOTON HYPOTONIE HYPREN HYRIDIA HYRIN HYSAN HYSSOPUS HYSTE HYTRIN HYZUM IBERIS IBEROGAST IBU IBUBETA IBUDOLOR IBUFLAM IBUHEXAL IBUMERCK IBUPHLOGONT IBUPROF IBUPROFEN IBUTAD IBUTOP ICG ICHTHO ICHTHOCORTIN ICHTHODERM ICHTHOLAN ICHTHOSEPTAL ICHTHOSIN ICHTHRALETTEN ICHTHYOL ICHTHYOLUM ICHTYOSOFT ICKERSCHER ICO ICOMED ICON ICOPED ICORAL ICOSAN ID IDEAL IDEALAST IDEALBINDE IDEALFIX IDEALFLEX IDEALHAFT IDEALPLAST IDENA IDENALAST IDEOS IDIM IDOM IDRIL IFO IGELBALL IGEVAC IGNATIA IHRE IHRLICH IKUPA ILA ILEO ILEOMATE ILEUM ILGON ILIO ILJA ILLINOIS ILLUM ILO ILOMEDIN ILON ILRIDO ILV IM IMAGELIA IMAGOPAQUE IMAP IMAZOL IMBELION-GASTREU IMBUN IME IMEC IMEDEEN IMERON IMESON IMEX IMIDIN IMIGRAN IMIPRAMIN IMKER IMMERFIT IMMO IMMORTELLE IMMUCYST IMMUDYNAL IMMUN IMMUNE IMMUNIZEN IMMUNJA IMMUNO IMMUNOSELECT IMMUNOTROP IMMUNPOWER IMMUNWELL IMODIUM IMOFLORA IMOVANE IMPACT IMPATIENS IMPERATORIA IMPFLANZETTE IMPLANON IMPLANT IMPLANTOFIX IMPORTAL IMPOTENZ IMPRAEGNOL IMPRESAN IMPRESSO IMPROMEN IMPULS IMPULSE IMTV IMU IMUCAPS IMUKIN IMUREK IMUREL IN INADINE INBEDS INCARE INCIDES INCIDIN INCLUDAL INCO INCONTURINA INCOPULS INDA INDAPAMID INDERAL INDERM INDERMIL INDIGO INDIKATORPAPIER INDIRAMIN INDISCHER INDISCHES INDIVINA INDO INDOCOLIR INDOFOLIA INDOL INDOLEC INDOMET INDOMETACIN INDUCTOS INDUO INDURATHOL INDURATIONS INEGY INFA INFANRIX INFANT INFASID INFATRINI INFECTOBICILLIN INFECTOCEF INFECTOCILLIN INFECTOCLONT INFECTOCORTIKRUPP INFECTODIARRSTOP INFECTOFLU INFECTOFOS INFECTOKRUPP INFECTOMOX INFECTOMYCIN INFECTOPEDICUL INFECTOPYODERM INFECTOROXIT INFECTOSOOR INFECTOSTAPH INFECTOTRIMET INFECTOVAC INFEKT INFEKTAL INFEKTIONSSCHUTZ INFESOL INFI INFIDYSTON INFIFER INFIGRIPP INFIHEPAN INFIKAUSAL INFIMINZ INFIOSSAN INFIPECT INFIPROCT INFISPARTIN INFITRAUMEX INFLAM INFLANEFRAN INFLANEGENT INFLU INFLUDO INFLUENCINUM INFLUEX INFLUSPLIT INFLUTRUW INFLUVAC INFLUVIT INFORM INFRA INFRAROT INFRAROTLAMPE INFRAROTLICHTLAMPE INFRAROTSTRAHLER INFU INFUFIL INFUKOLL INFUSA INFUSION INFUSIONS INFUSIONSBESTECK INFUSIONSGERAET INFUSIONSLEITUNG INFUSIONSNADEL INFUSIONSREGLER INFUSIONSSCHIENE INFUSIONSSET INFUSIONSSTAENDER INFUSIONSSTATIV INFUSIONSVERLAENGERUNG INFUSIONSZUBEHOER INFUSIONSZULEITUNG INFUSIOSNZUBEHOER INGRABAN INGRUBAR INGWER INHALATIONSBAD INHALATIONSGERAET INHALATIONSMASKE INHALATIONSSAUGER INHALATIONSTHERAPIE INHALATOR INHALER INHALIER INHALIERGERAET INHALIERHILFE INIMUR INITIAL INJECT INJECTIO INJECTOMAT INJECTOR INJEEL INJEKT INJEKTIONS INJEKTIONSKISSEN INJEKTIONSPFLASTER INJEX INKONTINA INKONTINENZ INKONTINENZHOSE INKONTINENZKNOEPFER INNENKANUELE INNEOV INNO INNOHEP INNOVADOL INNOVADORM INNOVAFOLAT INNOVITAL INNOVO INOMAX INOSITOL INOVATIN INRATIO INSECTAN INSEKTEN INSEKTENABWEHR INSEKTENSCHUTZ INSEKTENSTICH INSEKTENSTICK INSEKTENSTOP INSEKTIZID INSEL INSEMINATION INSIDON INSPIRAL INSPIROL INSTANT INSTANTCATH INSTAPURE INSTRU INSTRUMENT INSTRUMENTEN INSUFFLATIONSBRILLE INSULIN INSULINPUMPE INSUMAN INTACT INTAL INTEGRAL INTEGRALE INTEGRILIN INTEGRITY INTELLECTUM INTELLIGEN INTENSIV INTENSIVE INTERCOSTAL-GASTREU INTERDENTAL INTERDENTALBUERSTE INTERDENTALBUERSTEN INTERDENTALHALTER INTERFACE INTERFLOSS INTERGLIDE INTERLATEX INTERMED INTERMUTI INTERNAL INTERNATIONALES INTESTAMIN INTESTOFIX INTEX INTIM INTRA INTRADENT INTRADERMI INTRAFEMORAL INTRAFUSIN INTRALIPID INTRALONG INTRAMIN INTRAPORT INTRAPUR INTRASIL INTRASTICK INTRAVENT INTROCAN INTROCATH INTRODUCER INTRONA INU INULA INULAC INULIN INVANZ INVIRASE INWELT INZELLOVAL INZISIONSSCHERE INZOLEN IOCARE IODOSORB IONAIR IONISIERER IONTOPHORESEGERAET IOPADOL IOPAMIDOL IOPIDINE IP IPALAT IPECACUANHA IPER IPPB I-PROX IPV IRENAT IRIDIUM IRIS IRIS-CYL IRISWURZEL IRO-ELXIER IRRIGATIONSSET IRRIGATIONSSTAENDER IRRIGATOR IRRIMATIC IRS IRTAN IRUXOL IRYFIX IRYFLEX IS ISABELLE ISAPAK ISARTALER ISCADOR ISCHIA ISCHIAN ISCHIAS-GASTREU ISCOVER ISCUCIN ISDN ISEN ISEPHCA ISICOM ISIS ISITOIL ISMANTON ISMN ISMO ISO ISOBA ISOCILLIN ISODERM ISOFLAVONE ISOFLAVONOIDE ISOFLURAN ISOFRESH ISOGINKGO ISOGLAUCON ISOGUTT ISOKET ISOLIER ISOMOL ISOMON ISOMONIT ISOPRINOSINE ISOPROPANOL ISOPTIN ISOPTINE ISOPTO ISOPUR ISOSOURCE ISOSTAR ISOSTENASE ISOTONE ISOTONIC ISOTONISCHE ISOTRET ISOTRETINOIN ISOTREX ISOTREXIN ISOVIST ISOZID ISPENORAL ISSHO ITIRES ITRACOL ITROP IU IUI IUP IV IVAC IVEL IVIP IXENSE IXOTEN JABORANDI JACOBUS JACUTIN JAEGERMAGEN JAICO JAIKIN JALAPA JALOSKIN JAMAICA JAMINZ JAMSHIDI JANOSCH JANOSIN JAP JAPAN JAPANISCHE JAPANISCHER JAPANISCHES JAPOMINOEL JARDIN JARSIN JASIMENTH JASMIN JASMINBLUETEN JASPIS JATOBA JATROPHA JATROSOM JATROX JAVALEAN JEDES JEDIPIN JEHOSAN JEJUNOKATHETER JEJUNUM JELCO JELLIN JELLIPROCT JELLISOFT JELONET JENABROXOL JENACARD JENACILLIN JENAFENAC JENAPIROX JENAPROFEN JENAPURINOL JENASPIRON JENATENOL JENOXIFEN JEPROLOL JET JETCAN JEUNESSE JEVITY JH JHP JIAO JILL JINDA JINGLE JINHUA JO JOBADERM JOBALAN JOBST JOBUSAN JOCAPSAN JOD JODETTEN JODGAMMA JODID JODOBAC JODOFORM JODOFORMAGAZE JODOFORMMULL JODOFORMSTREIFEN JODOTAMP JODQUELL JODTHYROX JODTINKTUR JODUM JOGGIFLEX JOGHURT JOGUN JOHANNISKRAUT JOHANNISKRAUTTEE JOHANNISOEL JOHNSONS JOJOBA JOKRE-GINSAN JOMAX JONEN JONHY JONOSTERIL JORDAN JOSTRAL JOVAN JOWAMI JOWIDARMIN J-PAK JSO JSONETTIN JSOSKLERAN JSOSTOMA JUANOLA JUBILAEUMS JUBIN JUBRONCHAN JUCALCETTEN JUCAPT JUCOR JUCURBA JUCYSTAN JUDONT JUDORM JUENGER JUFLAVON JUFORMIN JUFURIX JUGLANS JUGRIPPAN JUKUNDA JULIETTE JULPHAR JUMBOFLASCHE JUNFOS JUNGEBAD JUNGFRAU JUNIK JUNIOR JUNIORSAFE JUNIPERUS JUNIPERUS/BERBERIS JUNISANA JUNISSION JUNIZAC JURA JURACOR JURACTIV JURASABAL JURASINTH JURATOX JUST JUSTAR JUSTICIA JUTABIS JUTABLOC JUTACLIN JUTACOR JUTADILAT JUTADOL JUTAFENAC JUTAGILIN JUTALAR JUTALEX JUTAMOX JUTANORM JUTAPRESS JUTAXAN JUTE JUTHIAC JUTUSSIN JUV JUVE JUVEL JUVENTAL JUVITON JUWEL K K.H.3 K1 K2R KABAN KABANIMAT KABIVEN KACINOKATT KADEFUNGIN KADEMANN KAELTE KAELTEKISSEN KAELTEKOMPRESSE KAELTESPRAY KAEPTNS KAESEHOBEL KAESELAB KAESESCHNEIDE KAI KAIREM KAISER KAKAO KAKTUSFEIGEN KAL KALANTOL KALAX KALIBRATOR KALINOR KALITRANS KALIUM KALIUM/TEUCRIUM KALIUMCHLORID KALIUMCITRAT KALIUMIODID KALIUMJODID KALIUMLACTAT KALIUMPERMANGANAT KALKSAFT KALKURENAL KALLI KALMA KALMIA KALORIEN KALORIFIT KALOVOWEN KAL-SA-KA KALT-HEISS KALTINSON KALTOSTAT KALT-SOFORT KALT-WARM KALTWETTERBAD KALYMIN KALZIUM KAMERABEZUG KAMERAKABEL KAMILLAN KAMILLE KAMILLEN KAMILLENBLUETEN KAMILLIN KAMILLODERM KAMILLOPUR KAMILLOSAN KAMILLOZON KAMINFEUER KAMISTAD KAMM KAMM. KAMPFER KAMPHER KAN KANA KANAMYCIN KANAMYTREX KANAVIT KANGAROO KANISTERDOSIERER KANISTERHAHN KANISTERPUMPE KANJON KANNE KANUELE KANUELEN KANUELENABWURFBEHAELTER KANUELENEIMER KANUELENENTSORGUNGSBOX KANUELENFIXIERPFLASTER KANUELENFIXIERUNG KANUELENHALTEBAND KANUELENPFLASTER KANUELENREINIGUNGSBUERSTE KANUELENREINIGUNGSPULVER KANUELENREINIGUNGSSET KANUELENREINIGUNSBUERSTE KANUELENTRAGEBAND KANUKA KAOPROMPT KAPHA KAPPE KAPPEN KAPPENPESSAR KAPPUS KAPS KAPSELN KARBONELEKTRODEN KARDAMOM KARDIACA KARGO KARIBIKTRAUM KARIL KARIM KARISON KARIT KARKADE KARLSBADER KARNEOL KAROTEINT KAROTIN KAROTTE KAROTTEN KARPALTUNNEL KARTOFFEL KARTOFFELSCHAELER KARTOFFELSUPPE KARTUSCHENCONTAINER KARVEA KARVEZIDE KASSITERIT KASTACOMP KATADOLON KATALYSATOREN KATALYT KATAPULTSITZ KATARRH KATASPIR KATHETER KATHETERISIERUNGSSET KATIMUN KATMAI KATOPTRIT KATTINJEKT KATTWICOR KATTWIDERM KATTWIGA KATTWIGAST KATTWIGRIPP KATTWILACT KATZENFELL KAUDROPS KAUEXOL KAUFMANNS KAULETTE KAVA KAVERI KAVITHAM KAWA KAWARA KCL KDA KECIFLOX KEEPIN KEHLKOPF KEILKISSEN KEILPOLSTER KEIMAX KELOCOTE KELOFIBRASE KELP KELTEN KELTICAN KEMPTENER KEN-ADAPTER. KENALOG KENDURAL KEPHALODORON KEPINOL KEPPRA KEPTAN KERA KERAFOAM KERALOCK KERAMIK KERAMIKFEILE KERAMIKNAGELFEILE KERAMIKRASPEL KERAMIKTELLER KERAPIL KERASAL KERATO KERAWASH KERLIX KERLONE KERMA KERNZL KERULAC KERUTABS KESSAR KESSLERS KET KETA KETAMIN KETANEST KETEK KETO KETOCAL KETOCONAZOL KETOF KETOFEX KETOPROFEN KETOSTERIL KETOSTIX KETOTIFEN KETOZOLIN KETUR-TEST KEUCHHUSTEN KEUSCHLAMM KEVATRIL KEYMER KFO KFZ-VERBANDKASTEN KFZ-VERBANDKISSEN KFZ-VERBANDTASCHE KHELLINUM KIARA KIC KID KIDNEYBOHNEN KIDS KIDSGUARD KIEFERNADEL KIEFERNNADEL KIEFEROSTITIS KIELSELERDE KIESELERDE KIESELSAEURE KIESELSAURE KIESELSTEINE KIESERIT KIESEWALTER KIHLS KILLAVON KIMUN KINDER KINDERBAD KINDERBAERCHEN KINDERBECHER KINDERFINGERSCHIENE KINDERKOMPRESSE KINDERKRUECKE KINDERPFLASTER KINDERPFLEGE KINDERPUNKT KINDERSCHERE KINDERSOHLENWAERMER KINDERTHERMOMETER KINDERTRAEUME KINDERUNTERARMSTUETZE KINDERVITAMINE KINDERWAAGE KINDERWAERMFLASCHE KINDERZAHNBUERSTE KINERASE KINERIS KINLONG KINNBINDE KINOLYMPHAT KINZALKOMB KINZALMONO KIPPHEBELVERSCHLUSS KIRA KIRCHHOF KIRIM KIRSCH KIRSCHE KIRSCHKERN KIRSCHKERNKISSEN KIRSCHKERNSAECKCHEN KIRSCHSTEIN KIRSCHSTEINKISSEN KIRSCHSTEINSACK KIRSCHZAUBER KISSENBEZUG KISSINGER KIT KITTEL KIWI KIZI KIZIOEL KK KLACID KLAMATH KLAMMERN KLAPP KLAPPGRIFF KLAPPSITZ KLAPPTEILE KLARER KLARICID KLARSICHT KLASSISCHE KLEAN KLEBE KLEBEBAND KLEBEBINDE KLEBEELEKTRODE KLEBEETIKETTEN KLEBESENSOR KLEBESPRAY KLEBI KLEBSIELLA KLEBSTOFF KLEENEX KLEIDERSCHUTZ KLEIE KLEINBLUETIGES KLEINE KLEINER KLEINES KLEMME KLETTBAND KLETTENSAMENOEL KLETTENWURZEL KLETTFERSENRIEMEN KLETTHALTEBAND KLETTORELL KLETTOSTAR KLETTVERSCHLUSS KLIFEM KLIMACTIV KLIMADYNON KLIMAGUT KLIMAK KLIMAKTERIUM KLIMAKTHEEL KLIMAKTIV KLIMAKTOPLANT KLIMAKTOSIN KLIMASORIN KLIMAVIT KLIMAX KLIMO-GERAL KLIMONORM KLINIDERM KLINIGRIP KLINION KLINOMYCIN KLINOREN KLINOXID KLINT KLIOGEST KLISMACORT KLISTIERROHR KLISTIERSPRITZE KLOCK KLOSETTSTUHL KLOSTER KLOSTERFRAU KLOSTERHOF KLYSMA KLYSO KMI KNAUTIA KNEIPP KNIE KNIEBALSAM KNIEBANDAGE KNIEGELENKBANDAGE KNIEKAPPE KNIEORTHESE KNIEROLLE KNIESCHONER KNIESTRUMPF KNIESTUETZE KNIEWAERMER KNOBINON KNOBLAUCH KNOBLAUCHOEL KNOBLIN KNOBOLIN KNOCHENMARK KNOCHENWACHS KNOECHEL KNOECHELBANDAGE KNOECHELKREUZBAND KNOEPFCHEN KNOEPFHILFE KNOPF KNOPFKANUELE KNOPFLOCHSCHIENE KNOPFSONDE KNOPFVERLAENGERUNG KNORPELFIT KNUFINKE KNUSPER KOCHBUCH KOCHMESSER KOCHSALZLOESUNG KODAN KODIPHARM KOEHLERS KOEHNLECHNERS KOELLN KOELLNFLOCKEN KOELLNS KOELNISCH KOELNISCHE KOELSCHE KOERNER KOERNERKISSEN KOERPER KOERPERFETT KOERPERFETTANALYSEGERAET KOERPERFETTMONITOR KOERPERFETTWAAGE KOERPERLOTION KOERPEROEL KOERPERPFLEGEOEL KOERPERTEMPERATUR KOERPERWAERMER KOHAESIVE KOHL KOHLE KOHLENHYDRAT KOHLENSAEUREBAD KOHLSUPPE KOHLSUPPEN KOHRSOLIN KOKOS KOKOSNUSS KOKOVANILLE KOLIBRI KOLIKOJECT KOLIKTROPFEN KOLLAGEN KOLLAGENREAGENS KOLLAPS-GASTREU KOLLATERAL KOLOSTOMIEBEUTEL KOLOSTRUM KOMBI KOMBINATIONSBESTECK KOMBINATIONSNADEL KOMBISCHERE KOMBISTUETZGRIFF KOMBUCHA KOMEDONENQUETSCHER KOMFORT KOMPAKT KOMPENSAN KOMPLETT KOMPLEXMITTEL KOMPOSITION KOMPRESSE KOMPRESSEN KOMPRESSENSTOFF KOMPRESS-HUETCHEN KOMPRESSIONS KOMPRESSOR KOMPREX KON KONAKION KONDOM KONDOME KONDOMURINAL KONFETTI KONJAC KONJACMEHL KONJAKMEHL KONJUNKTIVAL KONNEKTIONS KONNEKTOR KONNEKTORSCHLEUSE KONSTITUTIN KONSTOSIN KONSUL KONTAGRIPP KONTAKTGEL KONTAKTLINSE KONTAMED KONTAMEDCHEN KONTRASTBRILLE KONTRASTMITTELBESTECK KONZENTRATIONSOEL KOPF KOPFANSCHLAG KOPFHAUBE KOPFHOERNCHEN KOPFKISSEN KOPFSCHMERZMITTEL KOPFSCHNEIDER KOPFSCHNELLVERBAND KOPFUMFANGMESSBAND KOPFWASCHBECKEN KOPFWASCHMULDE KOPFWASCHVORRICHTUNG KOPFWASCHWANNE KORACAL KOREA KOREANISCHER KORIANDER KORIANDERBLATT KORIANDERSAMEN KORNZANGE KORO KORODIN KOROKOR KOROLIND KOROSTATIN KORSOLEX KORTIKOID KOSMETIK KOSMETIKPINZETTE KOSMOLOGIE KOSMOSAN KOSO KOSTBARE KOUSA KP KRAEUTER KRAEUTERBAEDER KRAEUTERBLAETTER KRAEUTERDECKE KRAEUTERDUSCHE KRAEUTERGEL KRAEUTERKISSEN KRAEUTERKORB KRAEUTERLAX KRAEUTERMINIS KRAEUTERMISCHUNG KRAEUTERSIRUP KRAEUTERTEE KRAEUTERWEIN KRAFTMESSER KRAFTRADVERBANDKASTEN KRALLENDORN KRANKEN KRANKENAUFRICHTER KRANKENHEMD KRANKENHOSE KRANKENRING KRANKENSTOCK KRANKENSTUHL KRANKENTASSE KRANKENTRAGE KRANKENTRANSPORTSTUHL KRANKENUNTERLAGE KRANKHEITEN KRAPF KRAUSE KRAUSEMINZWASSER KREATIN KREBS KREISLAUF KREISZEIGERWAAGE KREON KREOSOTUM KREPPAPIERBINDE KREPPBINDE KRESTO KRESTOPOL KREUZBEIN KREUZGELENKBANDAGE KREUZKUEMMEL KREUZMOOR KREWI KRIHASOL KRISTALLE KRISTALLSALZ KRISTALLTHERAPIE KRISTALON KROPHAN KRUECKE KRUECKEN KRUECKENHALTER KRUECKENHALTERUNG KRUECKENKAPS KRUECKENKAPSEL KRUECKENTRAEGER KRUEGEROL KRUEKENKAPSELN KRUELLGAZETUPFER KRYO KRYOPIN KRYOTHERM KRYPTOCUR KS KSM K-SPRAY KUDDLER KUDZU KUECHENBRETT KUECHENWAAGE KUEHL KUEHLAKKU KUEHLBANDAGE KUEHLENDES KUEHLES KUEHLGEL KUEHLPFLASTER KUEHLSPRAY KUEHLTASCHE KUEHLTIER KUEHR KUEMMEL KUENSTLICHE KUENSTLICHER KUERAVIT KUERBIS KUERBISKERN KUERBISKERNE KUERBISKERNOEL KUERBISSAMEN KUKIDENT KUKIS KUKUINUSS KULAN KULMINOL KUMSAN-GINSENG KUNDENVORTRAGS KUPFER KUPPLUNG KUPPLUNGSGEWINDE KUPPLUNGSSTUECK KUR KURMOLKE KURZZUG KUSCHELTRAUM KWAI KWIZDA KYRIAC KYRIAL KYTRIL KYTTA L L.P.C. LA LABELLO LABIO LABIOSAN LABOCANE LABOMAT LAC LACALUT LACHEMISTOL LACHESIS LACHNANTHES LACHSOEL LACKMUSPAPIER LACOERDIN LACOPHTAL LACORWEN LACRI LACRIGEL LACRIMAL LACRISIC LACTACYD LACTAID LACTASE LACTEL LACTEOL LACTICOL LACTISAN LACTISOL LACTIVAGIN LACTO LACTOBACILLUS LACTOBACT LACTO-CUM LACTOCUR LACTOFERMEN LACTONA LACTOPURUM LACTOREGEN LACTOVITAL LACTRASE LACTUCA LACTUFLOR LACTULOSE LACTUS LACTUVERLAN LACVITAL LADEGERAET LADIVAL LADONNA LADY LADYCAPS LADYGRAN LADYS LADYSOFT LAENGENMESSER LAENGSHOBEL LAERCHE LAERDAL LAETZCHEN LAEUFER LAEUSE LAEVILAC LAEVUL LAFAMME LAFOL LAGERUNGSKEIL LAGERUNGSKISSEN LAGERUNGSKOPFKISSEN LAGERUNGSROLLE LAGERUNGSROLLSTUHL LAGERUNGSSCHIENE LAGOSA LAGOSAL LAIF LAIS LAIT LAKEN LAKI LAKOTA LAKRIMENT LAKRITZ LAKTASE LAKTOSE L-ALANIN LALUK LAMEER LAMICTAL LAMINA LAMIOFLUR LAMISIL LAMIUM LAMMFELL LAMOTTE LAMRA LAMUNA LANG LANGBEINHOSE LANGZEIT LANGZUG LANICOR LANITOP LANO-E LANOLIN LANOMED LANOSAN LANSINOH LANSOX LANTAREL LANTUS LANYL LANZETTEN LANZOR LAPACHO LAPACHORINDE LAPACHORINDENTEE LAPACHOTEE LAPAVITAL LAPIS LARGAL L-ARGININ L-ARGININ/L-ORNITHIN/ L-ARGININE L-ARGININ-HYDROCHLORID L-ARGININPYROGLUTAMAT LARIAM LARIBELLE LARIFIKEHL LARINGO LARISOD LARY LARYLIN LARYNGEKTOMIEKANUELE LARYNGOFIX LARYNGOMEDIN LARYNGOSKOP LARYNGSAN LARYNX LARYNX/APIS LASAR LASEPTON LASER LASERVIS LASIX LASONIL LASSEL LAST LASTOBIND LASTOCOMP LASTODUR LASTOFA LASTOGRIP LASTOHAFT LASTOTEL LATENSIN LATEX LATEXHANDSCHUHE LATHYRUS LATICORT LATRIL LATRODECTUS LATSCHENKIEFER LATSCHENKIEFERNOEL LATSCHENKIEFERNSALBE LAU LAUBEEL LAUBENDERS LAUCHSTAEDTER LAUFWUNDER LAUROCERASUS LAVA LAVANDIN LAVANDULA LAVANID LAVATHERM LAVENDEL LAVENDELBEUTEL LAVENDELBLUETEN LAVERA LAVERE LAVOL LAWEFLUOR LAXAGETTEN LAXANIN LAXANS LAXBENE LAXOBERAL LAXOFALK LAXOPOL LAXYSAT LAYENBERGER LBT LC L-CARN L-CARNIPURE L-CARNITIN L-CARNITIN+LACHSOEL L-CARNITIN+L-PHENYLALANIN L-CARNITINE L-CARNOSIN L-CITRULLIN L-CYSTEIN L-CYSTIN L-CYSTINE LEA LEAN LEARNIMMUN LEATON LEBENSAKTIVE LEBENSBAUM LEBENSELEXIER LEBENSENERGIE LEBENSKRAFT LEBENSMITTEL LEBENSMITTELUNVERTRAEGLICH LEBENSTONIKUM LEBENSTROPFEN LEBENSWERT LEBER LEBERSCHUTZ LEBERTRAN LEBEWOHL LEBIC LEBIXO LEBKUCHEN LECICARBON LECITAGIL LECITHIN LECITHIN+VITAMIN LECITHINUM LECITONE LEDER LEDERDAEUMLING LEDERFINGERLING LEDERFOLAT LEDERLIND LEDERLON LEDERMIX LEDUM LEFAX LEFAXIN LEFERDIVIN LEG LEGA LEGALON LEGANA LEGAPAS LEGFIX LEGIUS LEGUMINOSA LEIBBINDE LEIBEISBEUTEL LEIBGURT LEINA LEINACRYL LEINAPLAST LEINETHALER LEINOEL LEINSAAT LEINSAMEN LEINSAMENOEL LEIODERM LEIOS LEISTENSCHUTZ LEISTUNGS LEMISON LEMNA LEMOCIN LEMON LEMONGRAS LEMONGRASOEL LEMONGRASS LEMONGRASTEE LENDENBANDAGE LENDENKISSEN LENDORM LENDORMIN LENICET LENKELAST LENKIDEAL LENKOSAN LENOXIN LENS LENSAN LENSCARE LENTAYA LENTINULIN LENTO LEO LEONURUS LEPONEX LEPTANDRA LEPTILAN LERNBECHER LERNEN LERNTASSE LEROBAL LEROY LESCOL LESEBRILLE LESEHILFE LESELUPE LESESTAB LESPEDEZA LESS LEU LEUCHTLUPE LEUCOVORIN LEUKASE LEUKERAN LEUKICHTAN LEUKOBOY LEUKOCLIP LEUKODERM LEUKOFIX LEUKOFLEX LEUKOMINERASE LEUKONA LEUKOPLAST LEUKOPOR LEUKOSILK LEUKOSPRAY LEUKOSTRIP LEUKOTAPE LEUPIN LEUSTATIN LEVAMED LEVELPLUS LEVEMIR LEVICO LEVISTICUM LEVITRA LEVIUM LEVO LEVOBETA LEVOCARB LEVOCOMP LEVODOP LEVODOPA LEVODOPA/ LEVOGYNON LEVOMEPROMAZIN LEVOPAR LEVOPHTA LEVOPRONT LEVOVIST LEXIKON LEXOBENE LEXOSTAD LEXOTANIL LEYHS LGG L-GLUTAMIN L-GLUTAMINE L-GLUTATHION LH LHI L-HISTIDIN L-HISTIDINE LI LIAN LIASAN LIBERNAL LIBERO LIBERTIN LIBERTY LIBIDO LIBIONAN LIBOVITAL LIBRESSE LIBRIUM LICAIN LICHT LICHTBLICK LICHTDUSCHE LICHTPUNKTNEUN LICHTTHERAPIEGERAET LICHTWECKER LID LIDESTHESIN LIDO LIDOCAIN LIDOCAINGEL LIDOCARD LIDOJECT LIEBESTRAUM LIEBLINGS LIED LIEGENABDECKUNG LIEGENAUFLAGEN LIEGENPAPIER LIEN LIEN/ LIERAC LIFE LIFELINE LIFEPORT LIFEQ LIFESCAN LIFESTYLES LIFEVITAL LIFEWAY LIFOSAN LIFT LIFTING LIGACAST LIGAFLEX LIGAMENTUM LIGASANO LIGHT LIGNE LI-IL LIKUDEN LILIOR LILIUM LILLY LIMBA LIMETTE LIMONE LIMPTAR LINA LINALOE LINALOEHOLZ LINDEN LINDENBLUETEN LINDENBLUETENTEE LINDESA LINDIGOA LINDOFLUID LINDOS LINDOXYL LINDT LING LINGUA LINIMENTUM LINIPLANT LINKS LINOLA LINOLADIOL LINOSAN LINT LINUGRAN LINUSIT LIORESAL LIP LIPA LIPAMIN LIPANTHYL LIPAZYM LIPEI LIPIDAVIT LIPIDIL LIPIFIL LIPIODOL LIPIPOR LIPISCOR LIPO LIPOBIOTIN LIPOCOL LIPODERM LIPODUR LIPOFACTOR LIPOFUNDIN LIPO-MERZ LIPONSAEURE LIPOPHARM LIPOPHILE LIPORAL LIPOSERIN LIPOSIC LIPOSOME LIPOSOMEN LIPOSORB LIPOSTABIL LIPOTALON LIPOTRANS LIPOTROP LIPOVENOES LIPOVITAN LIPOX LIPOZONE LIPP LIPPENBALSAM LIQUA LIQUEMIN LIQUIBAG LIQUICK LIQUID LIQUIDEPUR LIQUIDERMA LIQUIDORM LIQUIFILM LIQUIFLO LIQUIGEL LIQUIGEN LIQUINOVA LIQUIRIT LIQUISTOP LIQUOR LISERDOL LISI LISIBETA LISIDOC LISIGAMMA LISIHEXAL LISILICH LISINO LISINOPRIL LISKANTIN LISODURA L-ISOLEUCIN LISTERINE LISTERIOSE LISTERSCHERE LITAI LITAK LITALIR LITHIAS-CYL LITHIOFOR LITHIUM LITHIUMEEL LITHOFALK LITHOSPERMUM LITHOTHAMNIUM LITHUREX LITSEA LITTLE LIVIELLA LIVOCAB LIXIN LKS L-LEUCIN L-LEUCIN/L-ISOLEUCIN/ L-LYSIN L-LYSINE L-LYSINHYDROCHLORID LM L-METHIONIN L-METHIONINE LM-POTENZ LM-POTENZEN LOBELIA LOBETA LOBIVON LOBUS LOBYLY LOCABIOSOL LOCABIOTAL LOCACORTEN LOCASALEN LOCEMOTION LOCERIA LOCERYL LOCOL LOEFFEL LOEFLUND LOESCALCON LOESFERRON LOESMAG LOESNESIUM LOESUNGSMITTEL LOEWE LOEWENZAHN LOEWENZAHNBLAETTER LOEWENZAHNTEE LOFARMA LOFRIC LOFTAN LOGIMAT LOGIMAX LOHMANN LOKALISON LOLIUM LOLLI LOMABRONCHIN LOMACHOLAN LOMAHERPAN LOMAHYPERICUM LOMAL LOMAR LOMAREN LOMARHEUMIN LOMATOL LOMATUELL LOMBACROSS LOMBAFIX LOMBAX LOMEXIN LOMIR LOMUPREN LOMUPREN/OPTICROM LONARID LONDON LONG LONGASTERIL LONGELAST LONGLIFE LONGTUSSIN LONGUETTE LONITEN LONOLOX LONOTEN LOOFAH LOOK LOOM LOONEY LOP LOPA LOPALIND LOPEDIUM LOPEPHAM LOPERA LOPERAMID LOPERHOE LOPHAKOMP LOPIRIN LOPRESOR LOPRESSOR LORA LORADERM LORAFEM LORAGALEN LORAGAMMA LORALERG LORANO LORATADIN LORATADURA LORATAGAMMA LORAVIS LORAZEPAM LORBEERESSENZ LORBEEROEL LORDOLOC LORDOSE LORENZOS LORETAM LOREX LORINDEN LORMETAZEPAM L-ORNITHIN L-ORNITHIN/L-ARGININ L-ORNITHIN/L-PHENYLALANIN L-ORNITHIN/L-TRYPTOPHAN L-ORNITHIN/L-TYROSIN LOROSAN LORZAAR LOS LOSALT LOSAPAN LOSCON LOSEC LOTA LOTIO LOTION LOTRICOMB LOTRIDERM LOVA LOVABETA LOVADURA LOVAGAMMA LOVAHEXAL LOVASTATIN LOVE LOVELLE LOVERS LOVETONIC LOW LOXIN LPC LPCELL L-PHENYLALANIN L-PHENYLALANINE LPI L-PROLIN L-PROLINE LS L-SERIN L-SERINE LS-VERBINDER LT L-TAURIN L-THREONIN L-THYROSIN L-THYROX L-THYROXIN L-TYROSIN L-TYROSINE LUBEXXX LUBRICANT LUBRIKANO LUBRIN LUBROVIT LUCCA LUDIOMIL LUECK LUENODOLOR LUENOLAX LUER-LOCK LUESINUM LUFFA LUFFACUR LUFFANEST LUFFASAN LUFFEEL LUFTBEFEUCHTER LUFTDUSCHE LUFTENTFEUCHTER LUFTFILTER LUFTIKUS LUFTKISSEN LUFTPUMPE LUFTREINIGER LUFTRING LUFTSPRUDELBAD LUFTSPRUDELBAEDER LUISA LUIVAC LUMA LUMBAGO LUMBAMED LUMBINON LUMBO LUMBOAKTIV LUMBOLOC LUMBOTRAIN LUMIGAN LUMINAL LUMINALETTEN LUMIREM LUMISON LUMITEST LUNAI LUNALIND LUNDERQUIST LUNGENKRAUT LUO LUPE LUPENHUELSE LUPHENIL LUPULINUM LUPULUS LUTAX LUTEASAN LUTEIN LUTRELEF LUUF LUVASED LUVERIS LUVOS LUX LUXEYE L-VALIN L-VALINE LYC LYCO LYCOAKTIN LYCOPENE LYCOPENOMIN LYCOPIN LYCOPODIUM LYCOPUS LYCOVEN LYCOVOWEN LYGAL LYMGYM LYMPHADEN LYMPHADENOMTROPFEN LYMPHATIK LYMPHDIARAL LYMPHO LYMPHOCAUSAL LYMPHOGLOBULIN LYMPHOMYOSOT LYMPHOROBAL LYMPHOZIL LYMPHSET LYMPHTROPFEN LYN LYOGEN LYOMOUSSE LYORODIN LYOSTYPT LYOVAC LYRA LYRICA LYSETOL LYSIMACHIA LYSIN LYSINE LYSMINA LYSODREN LYSOFORM LYSOFORMIN LYSSINUM LYSTHENON M M6 MA MAALOX MAALOXAN MABTHERA MACA MACABOL MACADAMIA MACADO MACALVIT MACAPUR MACASEL MACELA MACH MACHOLDT MACIS MACKS MACOEL MACOFLEX MACOPERF MACRODEX MACROSOL MADAME MADAR MADOPAR MAEDESUESSTEE MAENNER MAENNERMITTEL MAENNERTEE MAERCHENWALDTEE MAFLURELL MAFRUVIT MAGALDRAT MAGASTRON MAGEN MAGEN-DARM-ENTOXIN MAGEN-DARMTEE MAGEN-DARM-TEE MAGEN-DARMTROPFEN MAGENGOLD MAGENKATHETER MAGEN-LEBER-GALLE MAGENSAFT MAGENSCHLAUCH MAGENSONDE MAGENSONDEN MAGENSPUELSET MAGERMILCHPULVER MAGIC MAGISCHE MAGIUM MAGMED MAGNASPART MAGNEFIT MAGNEROT MAGNESIOCARD MAGNESIT MAGNESIT/ MAGNESIUM MAGNESIUMOROTAT MAGNESOPAN MAGNESOROT MAGNET MAGNETE MAGNETFELD MAGNETFELDGERAET MAGNETFELDTHERAPIE MAGNETFELDTHERAPIEGERAET MAGNETRANS MAGNETSCHLUESSEL MAGNETSONDE MAGNETTHERAPIE MAGNETTHERAPIEKOFFER MAGNEVEN MAGNEVIST MAGNEVIT MAGNO MAGNOFLEX MAGNOLIA MAGNOLIEN MAGNOLIENBLAETTER MAGNORELL MAGNOTHERM MAGNUM MAGSAN MAGWELL MAHLZEITENERSATZ MAHSAN MAIELAST MAIER MAIFIX MAIGLOECKCHEN MAIMED MAINASAL MAINAT MAINETZ MAINZER MAIPORE MAIROSEN MAISBARTHAARE MAISKEIM MAITAKE MAJOCARMIN MAJOLA MAJORAN MAJORANA MAKATUSSIN MAKI MAKOL MALACHIT MALANDRINUM MALARONE MALBUCH MALEXIN MALIASIN MALIBU MALINERT MALIPURAN MALLEBRIN MALLEO MALLEOLOC MALLEOSAFE MALLEOTRAIN MALMENOS MALTESER MALTOCAL MALTODEXTRIN MALTON MALTRON MALTYL MALUDENT MALVA MALVASEN MALVEN MALVENBLAETTER MAM MAMASPORTIVE MAMBA MAMILAN MAMIVAC MAMMA MAMMUT MAN MANAGER MANCINELLA MANDA MANDARIN MANDARINE MANDARINEN MANDEL MANDELABSAUGER MANDELO MANDELOEL MANDIBULA MANDOFEN MANDRAGORA MANDRIN MANDRINS MANEX MANGAN MANGANUM MANGO MANICURE MANIKUERE MANINIL MANIPUR MANIQUICK MANISOFT MANNIT MANNITOL MANNO MANS MANSCHETTE MANU MANUCEDIN MANUDENT MANUFIX MANUGIB MANUKA MANULOC MANUMED MANUPLAST MANUSOFT MANUTRAIN MANUVAC MANYL MANYPER MAOTIL MAPA MAPOX MAPROLU MAPROTILIN MAPURIT MAR MARAMENT MARANON MARASKA MARAX MARCOUMAR MARCUMAR MARCUPHEN MARDUK MAREEN MAR-FLOW MARIA MARIDERM MARIE MARIEN MARIENBADER MARIENDISTEL MARIENDISTELFRUECHTE MARIGOLD MARILON MARILYN MARINALL MARINKULIN MARINKU-PIL MARK MARKALAKT MARKERT MARKGEWINNUNGSSYSTEM MARKOFRUCT MARLEN MARLENE MARLEX MARLIN MARLO MARLY MARMOR MARNYS MAROLDERM MARPOMA MARRUBIUM MARSHALL MARTICOR MARTISED MARTIVEN MARUM MARVELON MASIMO MASKAM MASKE MASS MASSAGE MASSAGEBALL MASSAGECREME MASSAGEGERAET MASSAGEOEL MASSAGEROLLBAND MASSAGEROLLE MASSAGEROLLER MASSAGESALBE MASSAGESCHWAMM MASSAI MASSBRETT MASTER MASTERVENT MASTIX MASTODYNON MASTOIDITIS MASTOPATHIA MASTU MATAI MATE MATER MATETEE MATIGA MATMILLE MATO MATRATZE MATRATZEN MATRICELL MATRICUR MATRIGEN MATRIXX MAUMASIL MAURITIUS MAUSERS MAVALA MAVENA MAVID MAWOSON MAX MAXALT MAXEPA MAXI MAXILENE MAXILLA MAXIM MAXIPIME MAXIS MAXITROL MAXIVITA MAYA MAYBE MAYOM MAZOLA MB-LOOPS MC MCGUIRE MCP MCT MD MDS ME MEA MEALUS MEASURE MEAVERIN MEBEMERCK MECAIN MECANO MECLOSORB MECOMAR MED MEDA MEDACTIN MEDAZEPAM MEDCARD MEDECO MEDELA MEDERMA MEDETT MEDEX MEDGEL MEDI MEDIA MEDIABET MEDIBAND MEDIBOX MEDIC MEDICA MEDICAL MEDICAN MEDICASE MEDI-CATH MEDICELL MEDICHEM MEDICMATES MEDICOFOLIN MEDICOM MEDICOMFORT MEDICOMP MEDICON MEDICOOL MEDICORP MEDICURA MEDICUS MEDICUT MEDIDERM MEDIDISC MEDIFANT MEDIFIX MEDIFLEX MEDIFLO MEDIFLON MEDIFLUID MEDIFOME MEDIGEL MEDIGLOBAL MEDIHAFT MEDIKAMENT MEDIKAMENTEN MEDIKAMENTENDOSIERER MEDIKAMENTENFLASCHE MEDIKAMENTENSPENDER MEDIKAMENTENVERNEBLER MEDIKURBINDE MEDILET MEDILIKE MEDILINE MEDIMA MEDIMAG MEDIMASK MEDIMOLL MEDIN MEDINETTE MEDIOBT MEDIOLAX MEDIPANTHOL MEDIPATCH MEDIPLAST MEDIPOLAN MEDIPOR MEDIPORE MEDIQUE MEDIRIP MEDIRLL MEDIS MEDISANA MEDISCHAUM MEDISENSE MEDISET MEDISILK MEDISIT MEDISIZE MEDI-SLIP MEDISPO MEDISPRAY MEDITATION MEDITATIONS MEDITIP MEDITONSIN MEDITROL MEDIVARIO MEDIVELLE MEDIVEN MEDIVITAL MEDIVITAN MEDIWARE MEDIWOOD MEDIZIN MEDIZINAL MEDIZINBECHER MEDIZINBECHERDECKEL MEDIZINISCHE MEDIZINISCHER MEDIZINISCHES MEDLANCE MEDOBALM MEDOBIOTIN MEDOC MEDOMIX MEDORRHIN MEDORRHINUM MEDOS MEDPHANO MEDRATE MEDRELIF MEDUCRIN MEDULLA MEDUSTAR MEDYN MEER MEERES MEERESALGEN MEERESFRUECHTE MEERRETTICH MEERSALZ MEERWERT MEFILM MEFIX MEFOXITIN MEGA MEGACILLIN MEGAGLIDE MEGALAC MEGAMAX MEGAMIN MEGAPLAST MEGASCORBIN MEGASLIM MEGAVIT MEGAZYM MEGESTAT MEGGEZONES MEGLUCON MEGROMAN MEGROSKIN MEHRFACHAUFHAENGER MEIN MEISHAN MEL MELA MELABON MELADININE MELAGATRAN MELAGOLD MELALEUKA MELANEX MELANGE MELAROM MELASED MELASSE MELASSEKAPSELN MELATONIN MELAVITAL MELBROSIA MELEUDERM MELEUSKIN MELFALAN MELGISORB MELI MELIFLOR MELILOTUS MELISSA MELISSA/PHOSPHORUS MELISSA/SEPIA MELISSE MELISSEN MELISSENBLAETTERTEE MELISSENGEIST MELISSENHYDROLAT MELITRAST MELKA MELKFETT MELLERETTEN MELLERIL MELMENSIA MELNEURIN MELODIE MELOLIN MELONE MELOPAT MELOS MELOSAN MELPEROMERCK MELPERON MELPROMEN MELPROTECT MELROSUM MELVAL MEMBRAIN MEMBRANA MEMBRANOSOME MEMOPLAST MEMOROBAL MEMORY MEMOS MENALIND MENCEVAX MENG MENI MENIBOX MENICARE MENICON MENINGEOMA MENINGITEC MENINGOKOKKEN MENISCAL MENISCUS MENISKUS MENJUGATE MENO MENO-CYL MENODORON MENOFLAVON MENOGON MENOPAUSAN MENOPAUSE MENOPUR MENOREST MENOVITAL MENS MENSOTON MENSSANA MENTACUR MENTADENT MENTAL MENTALDIAET MENTALES MENTHA MENTHACINA MENTHOL MENTHOLON MENTHONEURIN MENTINIS MENTOR MENTOS MENYANTHES MEPHA MEPHITIS MEPIFORM MEPIHEXAL MEPILEX MEPITEL MEPIVACAIN MEPIVASTESIN MEPORE MEPROLOL MEPROTEC MEPROXAM MEPTID MERCILON MERCUCHROM MERCURIALIS MERCURIUS MERCUVAL MEREPRINE MERESA MERETE MERFLUAN MERGENTHEIMER MERICOMB MERIDIANKOMPLEX MERIDOL MERIGEST MERIMONO MERITENE MEROCEL MEROLA MERONEM MERTINA MERZ MESALT MESCORIT MESENCEPHALON MESENCHYM MESENCHYM/ MESNA MESOFT MESORB MESPAFIN MESSBECHER MESSER MESSKAPPEN MESSKATHETER MESSLEISTE MESSSTAB MESSZYLINDER MESTINON MESTOPORE MET META METABIAREX METABIOSULF METACARPALSCHIENE METACORONAT METAGINKGO METAHARONGA METAHEPAT METAHEPTACHOL METAKAVERON METALCAPTASE METALLADAPTER METALLDILATATOR METALLINE METALYSE METAMAGNESIUM METAMAGNESOL METAMARIANUM METAMIZOL METAMUCIL METAOSSYLEN METAPLEXAN METARUBINI METASILICEA METASOLIDAGO METASYMPHYLEN METAVENTRIN METAVIRULENT METEC METEOREISEN METEOSAN METEOZYM METEX METFODOC METFOGAMMA METFOR METFORM METFORMIN METHERGIN METHIO METHIONIN METHIOTRANS METHIZOL METHOCEL METHOTREXAT METHUSAN METHYLDOPA METHYLENBLAU METHYLERGOBREVIN METHYLERGOMETRIN METHYLPREDNISOLON METIFEX METIZOK METO METOBETA METOCLOPRAMID METODOC METODURA METOHEXAL METOK METOMERCK METOPROGAMMA METOPROLOL METOSTAD METOTREXATO METOWIEB METRO METRONID METRONIDAZOL METRONIMERCK METRONOUR METRONT METYCORTIN METYPRED METYSOLON METZ MEURASAN MEVACOR MEVALOTIN MEVINACOR MEXITIL MEZEREUM MEZYM MG MGR MIABELL MIACALCIC MIANEURIN MIANSERIN MIBA MIBURELL MIC MICANOL MICARDIS MICHAELS MICHALON MIC-KEY MICOBETA MICONAZOL MICOTAR MICRAL MICRO MICROALBUSTIX MICROFLORANA MICROFOAM MICROGYNON MICROJECT MICROKLIST MICROLIFE MICROLUT MICROMASSAGE MICROMAX MICROMIX MICROPAQUE MICROPORE MICROPROZESSOR MICROSAN MICROSONNE MICROTRAST MICTONORM MIDAZOLAM MIDRO MIFLONIDE MIGOMED MIGRA MIGRABACT MIGRAE MIGRAEFLUX MIGRAENE MIGRAENEBAND MIGRAENEMASKE MIGRAENERTON MIGRAENESTIFT MIGRAENIN MIGRAESOL MIGRAETAN MIGRALAVE MIGRASTICK MIKANIL MIKRO MIKROALBUMIN MIKROBAC MIKROEMSAN MIKROMOORAN MIKROS MIKROSTAPE MIKROSTICK MIKROWELLEN MIKRUVID MIKTIPLON MIKTOSYX MILASAN MILAX MILBENSPERRE MILCHAUFFAENGER MILCHAUFFANGSCHALE MILCHFLASCHE MILCHFLASCHE. MILCHFLASCHENVERSCHLUSS MILCHPUMPE MILCHSAUGER MILCHZAHN MILCHZAHNDOSE MILD MILDE MILGAMMA MILKA MILKUDERM MILLEFOLIUM MILNEURON MILTEX MILUMIL MILUPA MILUPINO MILURIT MILUVIT MIMAR MIMOSE MIMOSEN MINAKNE MINALKA MINASAN MINCARTIL MIND MINERAL MINERALDEO MINERALDRINK MINERALERDE MINERALIEN MINERALSCHLAMM MINERASOL MINERELL MINI MINIASAL MINIDROP MINILET MINIPRES MINIPRESS MINIRIN MINISISTON MINISLIDE MINITRANS MINITUBEN MINIUM MINKA MINO MINOCLIR MINOCYCLIN MINOPLUS MINPROG MINPROSTIN MINT MINULET MINUS MINX MINZ MINZE MINZOEL MIOCHOL MIRA MIRACLE MIRACOLD MIRADENT MIRADONT MIRAFLOSS MIRAFLOW MIRAFLUOR MIRAFLUORID MIRAGEL MIRAJECT MIRANOVA MIRAPEXIN MIRASOFT MIRCOS MIRENA MIRFAT MIRFUDORM MIRFULAN MIRFUSOT MIRO MIROTON MIROYAL MIRRANGE MIRRATEEN MIRRICA MIRTA MIRTALICH MIRTAZAPIN MIRTAZELON MIRTAZZA MISOLA MISS MISTABRONCO MISTEL MISTELKRAUT MIT MITCHELLA MITCHELLANDO MITESSERENTFERNER MITO MITOMYCIN MITOSYL MITOVITAL MITOXANTRON MITTELOHRPROTHESE MITTELSTRAHL MIVACRON MIVITASE MIXMAL MIXTARD MIXTURA MIZOLLEN MKS M-LASTIC MOBEC MOBIC MOBIFORTON MOBILAT MOBILE MOBILOC+GEL MOBISTOM MOBLOC MOCLIX MOCLOBEMID MOCLOBETA MOCLODURA MOCLONORM MODELL MODERMA MODERN MODIFAST MODIFIZIERTE MODIFIZIERTES MODIP MODUCREN MODUCRIN MODULEN MODURETIK MOENCH MOENCHFLORIS MOENCHS MOENCHSPFEFFER MOENCHVITACARE MOERSER MOEWE MOFESAL MOGADAN MOGADON MOHR MOISTURIZER MOISTURIZING MOJO MOLA MOLEVAC MOLICARE MOLIFORM MOLIMED MOLINEA MOLINIA MOLIPANTS MOLKE MOLKE+APFELESSIG+VIT.C MOLKEBAD MOLKE-TRINKKUR MOLKFIT MOLKUR MOLLELAST MOLL-ZELL MOLOSAN MOLSI MOLSIBETA MOLSIDOMIN MOLSIHEXAL MOLSIKET MOLTEX MOLTON MOLTONUNTERLAGEN MOLYBDAEN MOLYBDAENHEFE MOLYBDAENUM MOMORDICA MOMORSYX MONAPAX MOND MONDANA MONDAY MONDOMED MONI MONIT MONO MONOBETA MONOCLAIR MONOCLIX MONOFILAMENT MONOFLAM MONOFLO MONOGEN MONOI MONOJECT MONOJECTOR MONOLET MONOLONG MONOMYCIN MONONUCLEOSE MONOPUR MONOSIGMA MONOSTAR MONOSTENASE MONOSTEP MONOVAC MONTAL MONTANA MONTESOL MONTGOMERY MONURIL MOOR MOORKOMPRESSE MOORLAUGE MOORLIFE MOORPASTE MOORSHAMPOO MOORTRINKKUR MOOSGUMMIGRIFF MORADORM MORBILLI MORBILLINUM MORGENTAU MORONAL MORPHEUS MORRIS MOSCHUS MOSCHUSROSE MOSEGOR MOSER MOSI MOSIGUARD MOSKITO MOSKITONETZ MOSKOVIA MOSQUITO MOTENS MOTILIUM MOTIVONE MOTRIL MOTTENSTOP MOUNTAIN MOUSSELINE MOUSTI MOVA MOVALIS MOVEEN MOVERGAN MOVICARD MOVICOL MOVIDA MOWIBERON MOWINEURON MOWIVIT MOXA MOXAROLLE MOXOBETA MOXOCARD MOXODURA MOXOGAMMA MOXONIDIN MOZARTKUGELN MP MPA MPO2 MRI MRSA MSM MTR MTX MUBITEX MUC MUCADERMA MUCADONT MUCALGIN MUCAMA MUCAN MUCAPUR MUCASEPT MUCASOL MUCEDOKEHL MUCEX MUCIVITAL MUCO MUCOANGIN MUCOCIT MUCOCLEAR MUCO-CYL MUCOFALK MUCOKEHL MUCOPHLOGAT MUCOPRONT MUCOR MUCOSA MUCOSOLVAN MUCOTABLIN MUCOZINK MUCOZYM MUCRET MUCUNA MUCUS MUECKEN MUECKENDEO MUECKENSCHRECK MUECKENSTOP MUECKENTUCH MUELLER MUENCHEN MUENCHNER MUESLI MUIRA MUKOPRE MULGATOL MULIMEN MULL MULLBINDEN MULLELAST MULLIX MULLKOMPRESSEN MULLRO MULLTUPFER MULLWATTEROLLEN MULLWATTETAMPONS MULLZUSCHNITTE MULMICOR MULPA MULTA MULTAFIX MULTAN MULTANETTEN MULTATOP MULTI MULTIBIONTA MULTIBRONCH MULTICINA MULTIDEX MULTIDRESS MULTIFIT MULTIFLUORID MULTIFUNKTIONS MULTIFUSE MULTIGURT MULTIHANCE MULTILAYER MULTILIND MULTILOAD MULTIPLASAN MULTIPLEX MULTIROYAL MULTISONIC MULTISTIM MULTISTIX MULTITALEEN MULTITEILER MULTITIMER MULTIVITAL MULTIVITAMIN MULTIVITAMINE MULTIVITAMINTEST MULTIVITOL MULTOJOD MULTOSIN MULTUM MUMIJO MUMPS MUND- MUNDBALSAM MUNDDUSCHE MUNDIL MUNDIPUR MUNDISAL MUNDKEIL MUNDKREISEL MUNDMASKE MUNDPFLEGESET MUNDPFLEGESTAEBCHEN MUNDRA MUNDSCHUTZ MUNDSCHUTZTUECHER MUNDSPATEL MUNDSPERRE MUNDSPIEGEL MUNDWASSER MUNDWASSERTABLETTEN MUNITREN MUNLEIT MUNOBAL MUREX MURIATICUM MURISAN MURMELIN MURMELTIER MURMELTIERBALSAM MURMELTIERFETT MURMELTIEROEL MURNAUERS MUSAPAM MUSARIL MUSCARSAN MUSCHEL MUSCHELKONZENTRAT MUSCHELOELFIT MUSCHELVIT MUSCLE MUSCULI MUSCULUS MUSIC MUSIKER MUSIKTHERAPEUT.KISSEN MUSK MUSKATELLER MUSKATNUESSE MUSKATNUSS MUSKATNUSSOEL MUSKEL MUSKELAT MUSKELFIT MUSKELSTIMULATOR MUSKELWAERMER MUTABELLA MUTAFLOR MUTAGRIP MUTELLON MUTTER MUTTER-KIND MUTTERKRAUT MUTTERRING MUTTERROHR MUVITAKS MWL MY MYACYNE MYAMBUTOL MYCATOX MYCELIS MYCOBUTIN MYCOFUG MYCOSPOR MYDOCALM MYDRIATICUM MYDRUM MYFORTIC MYFUNGAR MYGALE MYJECTOR MYKO MYKODERM MYKOFUNGIN MYKOHAUG MYKONTRAL MYKOPROCT MYKORED MYKOSERT MYKOTIN MYKUNDEX MYLEPSINUM MYLERAN MYOCARDIUM MYOCHOLINE MYOGEL MYOGELOTICUM MYOGIT MYOLASTAN MYOM MYOMA MYONASAN MYOPULS MYOSON MYOSOTIS MYOSPASMAL MYRICA MYRISTICA MYRRHA MYRRHEN MYRRHINIL MYRRHIS MYRTE MYRTEN MYRTENWASSER MYRTILLOCACTUS MYRTILLUS MYRTUS MYSKIN MYSTECLIN MYTHO MYTHOL MYXAL MYXOFAT MYZOTECT N NABELBINDE NABELBINDE. NABELBRUCHBAND NABELKLEMME NABELKLEMMEN NABELKOMPRESSEN NABELSCHNURBAND. NABIFIX NAC NACH NACHRUESTESET NACHRUESTSATZ NACHT NACHTKERZE NACHTKERZEN NACHTKERZEN/SCHWARZKUEMMEL NACHTKERZENOEL NACHTRUHE NACHTSCHNULLER NACHTTISCH NACHTTOEPFCHEN NACHTTOPF NACKEN NACKEN- NACKENARMKISSEN NACKENFIX NACKENHOERNCHEN NACKENKISSEN NACKENKOMPRESSE NACKENMASSAGE NACKENPOLSTER NACKENROLLE NACKENSCHUTZKOMPRESSE NACKENWAERMER NACLENS NACOM NAD NADELADAPTER NADELN NADELREIZMATTE NADELSCHUTZHUELSE NADH NAEHRSONDE NAFRIL NAFTI NAFTILONG NAGEL NAGELBUERSTE NAGELFEILE NAGELFEILPAPIER NAGELHAEUTCHEN NAGELHAUTENTFERNER NAGELHAUTMESSER NAGELHAUTSCHIEBER NAGELKLIPPER NAGELKNIPSER NAGELKUR NAGELLACK NAGELMYKOSE NAGELPFLEGESET NAGELPFLEGESTIFT NAGELREINIGER NAGELREVITALISIERUNGS NAGELSCHERE NAGELSPANGE NAGELZANGE NAHRUNGSERGAENZUNGSMITTEL NAHTMATERIAL NAIL NAIS NAJA NALADOR NALIDIN NALIN NALOSELECT NALOXON NAM NAMENSBAENDCHEN NAMENSSCHILD NANAMINZE NANDO NANO NAOMI NAPHAZOLIN NAPHTHALINUM NAPHTHOCHINON NAPROCUTAN NAPROXEN NAPROXIWIEB NARAMIG NARANOCOR NARANOCUT NARANOFEM NARANOPECT NARANOSELEN NARANOTOX NARAYANA NARBEN NARBENPFLEGEOEL NARCANTI NARCARICIN NARCISSUS NARDE NARDEN NARDENOEL NAROPIN NARZISSE NARZISSEN NASACORT NASAL NASALKANUELEN NASAN NASEN NASEN/OHRSPUELER NASENBALSAM NASENBRILLE NASENDUSCHE NASENGEL NASENKLEMMEN NASENOLIVE NASENPFLASTER NASENSAUGER NASENSCHIENE NASENSEKRETABSAUGER NASENSEKRETSAUGER NASENSONDE NASENSPRAY NASENSPUELER NASENSPUELKAENNCHEN NASENSPUELSET NASENTAMPON NASENTROPFEN NASENVERBAND NASIC NASICUR NASIVENT NASIVIN NASONEX NASOPHARYNGEALTUBUS NASS NASTURTIUM NASULIND NATEA NATHALIA NATIL NATREEN NATRILIX NATRIUM NATRIUMCHLORID NATRIUMCITRAT NATRIUMGLYCEROPHOSPHAT NATRIUMSULFAT NATU NATUCOR NATUDOLOR NATUERLICHE NATUERLICHES NATUFEM NATUIMMUN NATULAN NATULIND NATUPROSTA NATUR NATURA NATURAFIT NATURAL NATURBLUETEN NATURCREME NATURELLE NATURES NATURESS NATURHEILMITTEL NATURHEILVERFAHREN NATURINA NATURKOSMETIK NATURMOOR NATURSCHWAMM NATURSEIDE NATURVITAL NATUVIT NAUDICELLE NAUDIVETE NAUDIVITE NAUSYN NAVELBINE NAVOBAN NAVOL NAWA NAWACAST NAWATAPE NAWATRIPLAST NEBACETIN NEBILET NEBULIZER NEBUTUR NECK NECKY NEDA NEDOLON NEEM NEEMBAUMOEL NEEMOL NEERA NEFRO NEFROCARNIT NEISVAC NELKE NELKENBLAETTER NELKENBLUETENOEL NELKENKNOSPE NELKENOEL NELSON NEMA NEMACYNAR NEMAFAM NEMAGRAN NEMAPLEX NEMASABAL NEMASED NEMEXIN NENE NENEDENT NEO NEOBAC NEOBLASENKATHETER NEOBONSEN NEOCAN NEOCARBO NEOCATE NEODENT NEODISHER NEOFLUOR NEOFOLIN NEOFORM NEOGAMA NEOGYNON NEOGYNONA NEOLIN NEOLUS NEOMED NEONATEN NEOPOL NEOPRENE NEOPRETEX NEOPYRIN NEORECORMON NEOSINO NEOSTIG NEOSTIGMIN NEOSTRATA NEOSYNEPHRIN NEOTIGASON NEOTRI NEOVIN NEPHEA NEPHRACET NEPHRAL NEPHRIMOL NEPHRISOL NEPHRISYX NEPHRO NEPHROBAL NEPHROFIX NEPHROLIT NEPHROLITH NEPHROLITHOL NEPHROMARTIN NEPHRONORM NEPHROPOM NEPHROSELECT NEPHROSTERIL NEPHROSTOMIE NEPHROTECT NEPHROTHIA NEPHROTRANS NEPHRUBIN NEPHUR NEPRESOL NEPRESSOL NEPRO NEPROTEC NERAL NER-FLUID NERIBAS NERIL NERISONA NERISONE NEROLI NERVALENT NERVEI NERVEN NERVENJA NERVENKAPSELN NERVENPFLEGE NERVENRUH NERVENSTIMULATOR NERVENTEE NERVENTONIKUM NERVI NERVINFANT NERVISORIN NERVO NERVOBAL NERVOBALDON NERVOHEEL NERVOJECT NERVOREGIN NERVOSANA NERVOSPUR NERVOSTABIL NERVPIN NERVUS NERVUTON NERWOHL NERZOEL NERZOLANE NES NESSELBEUTEL NESTARGEL NESTLE NESTMANN NESTMANNN NESTMANNS NETTERUMANI NETTI NETTIDERMA NETTIDIATH NETTIGALL NETTIGYN NETTINERV NETZ NETZGERAET NETZHOSEN NETZSCHLAUCHVERBAND NETZVERBAND NETZWAESCHEBEUTEL NEUE NEUENAHRER NEUKOENIGSFOERDER NEUMOND NEUPOGEN NEURALGICUM NEURALGIE NEURALGIETABLETTEN NEURALGIETROPFEN NEURALGIN NEURALGO NEURANIDAL NEURAPAS NEURASYX NEU-REGEN NEUREXAN NEURIBOSAN NEURI-CYL NEURIUM NEURO NEUROBION NEUROBLOC NEUROCIL NEUROCOMP NEURODERMITIS NEURODYN NEUROFIBROMA NEUROLYTRIL NEURONTIN NEUROPAD NEUROPEN NEUROPLANT NEUROSAN NEUROSELECT NEUROSPORAL NEUROSTICK NEUROTRAT NEUROTROPAN NEUROVEGETALIN NEUROVIT NEUROXIN NEUSELTERS NEUTRAL NEUTRALELEKTRODEN NEUTRALPFLEGE NEUTRO NEUTROGENA NEVERILL NEW NEX NEXA NEXCARE NEXIUM NEXTEMP NEY NEYARTHROS NEYARTHROSOME NEYBRONCHIN NEYCALM NEYCHONDRIN NEYCORENAR NEYDENT NEYDESIB NEYDIGEST NEYDIL NEYDIN NEYDOP NEYFAEXAN NEYFAM NEYFEGAN NEYFERMIN NEYGASTRIN NEYGERONT NEYGLUC NEYHAEMIN NEYIMMUN NEYLIEN NEYLING NEYMAN NEYNEPHRIN NEYNORMIN NEYOPHTIN NEYOPHTON NEYPARADENT NEYPSORIN NEYPULPIN NEYRAPID NEYRHYTHMIN NEYSANGUIN NEYSEXAN NEYSKIN NEYSOL NEYSPLEN NEYSUN NEYTHEL NEYTHYMUN NEYTROPH NEYTUMORIN NG NHC NHP NI NIACIN NIAOULI NIATEC NIAULI NICCOLUM NICE NICERGOBETA NICERGOLIN NICERIUM NICHT NICHTRAUCHEN NICKEL NICKI NICOBION NICOBREVIN NICODAN NICOLIP NICORETTE NICOTIANA NICOTINAMID NICOTINELL NICOTINSAEUREAMID NICOTINUM NIEM NIEMARISHTA NIEMBAUM NIEMOLIND NIERAL NIERANO NIEREN NIERENERKRANKUNGEN NIERENFISTELKATHETER NIERENFISTELUEBERLEITUNG NIERENPFLEGE NIERENSCHALE NIERENSCHUTZBINDE NIERENTONIKUM NIERENTROPFEN NIERENWAERMELEIBBINDE NIERMISON NIERON NIF NIFATENOL NIFE NIFECLAIR NIFECOR NIFEDIPAT NIFEDIPIN NIFEHEXAL NIFELAT NIFICAL NIFRI NIFSIGMA NIFTEN NIFURANTIN NIFURETTEN NIGELLA NIGERSAN NIGHT NIKA NIKO NIKOFRENON NIKOLAUS NIKOTIN NILODOR NIMBEX NIMM NIMODIPIN NIMOGALL NIMOPECT NIMOSAN NIMOTOP NINETTE NING-HONG NIPENT NIPOLEPT NIPPEL NIPRUSS NIQUITIN NIRASON NISITA NISSEN NISSENKAMM NISSKA NISYLEN NIT NITRAMYL NITRANGIN NITRATEX NITRAZEPAM NITRAZINGELBPAPIER NITRE NITREGAMMA NITREN NITREND NITRENDEPAT NITRENDI NITRENDIDOC NITRENDIMERCK NITRENDIPIN NITRENSAL NITREPRESS NITRICUM NITRIDERM NITRIL NITRO NITRODERM NITROFURANTOIN NITROKOR NITROLINGUAL NITROSORBON NITROXOLIN NIVADIL NIVEA NIZAX NIZORAL NO NOBA NOBAALGIN NOBABAMBINO NOBABIB NOBACARBON NOBACAST NOBACATH NOBACOLLOID NOBACOMP NOBACONCHIAL NOBACOTON NOBACREPP NOBACULAR NOBACUTIS NOBADENT NOBADERM NOBADRAINAL NOBADRAPE NOBADRESS NOBADUR NOBAFAST NOBAFEEL NOBAFILM NOBAFIX NOBAFOL NOBAFORM NOBAFRACT NOBAFROTT NOBAGAZE NOBAGEL NOBAGLOVE NOBAHAFT NOBAHEBAN NOBAIDEAL NOBAKAWA NOBAKOLL NOBALAN NOBALASTIK NOBALINE NOBALINGE NOBALITE NOBALUMENAL NOBALUX NOBAMANUS NOBAMASK NOBAMED NOBAMULL NOBANATAL NOBANETZ NOBAPAD NOBAPANTS NOBAQUICK NOBARHINAL NOBARIP NOBASANA NOBASKIN NOBASLIP NOBASOFT NOBASORB NOBASPLINT NOBASTEP NOBASTRETCH NOBATAMP NOBATEL NOBATEX NOBATON NOBATOP NOBATRACHEAL NOBATRICOT NOBATUB NOBAVARO NOBAZELLTUPF NOBAZEM NOBAZINCULAST NOBI NOBILIN NOBISTRIP NOBITE NOBIVIEW NOBVA NOCTAMID NOCTAMIDE NOCUTIL NODE NODEC NODI NOLVADEX NOMOIMMUN NOMON NOMORHE NON NONCOR NONSPI NONTRONIT NOORDEN NOOTROP NOOTROPIL NOPAIN NOPAL NOPPEN NOPPENBALL NOPPENKISSEN NOPPENKISSEN/ NOPPENRING NORA NORCO NORCURON NORDIPEN NORDIPENMATE NORDITROPIN NORDSEE NORETHISTERON NORFENEFRIN NORFLEX NORFLOHEXAL NORFLOSAL NORFLOX NORFLOXACIN NORFLOXBETA NORGALAX NORICAVEN NORISTERAT NORKOTRAL NORMABRAIN NORMADERM NORMALIP NORMJECT NORMLGEL NORMO NORMOC NORMOFUNDIN NORMOGLAUCON NORMOXIN NORMUROL NORO NORPACE NORPROLAC NORTA NORTASE NORTRILEN NORVASC NORVIR NOSKITO NOSODEN NOSTALGIE NOTAKEHL NOTFAELLE NOTFALL NOTFALLKOFFER NOTFALLSCHIENE NOTFALLTASCHE NOTKONIOTOMIE NOTON NOTOUCH NOTRUFGERAET NOURKRIN NOURYTAM NOUVELLE NOVA NOVACARE NOVACTIVE NOVADERM NOVADIABET NOVAFON NOVAGEL NOVAKUR NOVALAC NOVALGIN NOVAMINSULFON NOVANOX NOVANTRON NOVANTRONE NOVASAN NOVASEPT NOVASOURCE NOVASTEP NOVATOP NOVENA NOVERIL NOVESINE NOVIAL NOVIFORM NOVIRELL NOVO NOVODIGAL NOVOFEM NOVOFINE NOVOMIX NOVONORM NOVOPEN NOVOPIN NOVOPROTECT NOVOPULMON NOVORAPID NOVOTHYRAL NOVRITHEN NOWANERVIN NOWASPASMIN NOXOM NOXOTAB NOZOVENT NPBI NR NTB NU NUBAIN NUBRAL NUBY NUCLEUS NUERNBERGER NUERTINGER NUK NUKLEINSAEURE NULLATUSS NUMIMED NUMIS NUR NUROFEN NURUNNITZAR NUSKU NUSS NUTEX NUTRAMIGEN NUTRAXX NUTRI NUTRICARE NUTRICIA NUTRICOMP NUTRIFIT NUTRIFIX NUTRIFLEX NUTRILAN NUTRIMIX NUTRINI NUTRISOFT NUTRISON NUTRISSE NUTRITECT NUTRITION NUTRITIVE NUTRITUB NUTROF NUTROMAT NUTROPOLY NUVORELL NUX NUZUT NYOGEL NYSTADERM NYSTALOCAL NYSTATIN O O.B. O2 O24 OBATRI OBERBACHIUM OBERSCHENKEL OBERSCHENKELSTUETZE OBERSCHENKEL-UND OBERTEILGEWINDE OBJECTA OBJEKTTRAEGER OBLEPICHA OBSIDAN OBSILAZIN OBST OBSTESSIG OBSTINOL OBTAPE OBTURATOR OC OCCLUSIO OCCODEM OCEAN OCERAL OCTADON OCTENIDERM OCTENISAN OCTENISEPT OCTOSITZ OCTOSTIM OCUCOAT OCUFLUR OCUL OCULARIS OCULAV OCULOGUTTAE OCULOHEEL OCULOSAN OCULOTECT OCULUS OCUTON OCUVITE ODDENT ODOL ODONTON ODOREX OEDEMASE OEFFNER OEFFNUNGSHILFE OEKO OEKOLP OEKOPAN OEL OELBAD OELEKOMPOSIT OENANTHE OERATIN OESOPHAGUS OESTRO OESTROFIT OESTRONARA OESTROVITAL OFA OFLO OFLODURA OFLOHEXAL OFLOX OFLOXACIN OFLOXBETA OFTAQUIX OH OHOOPINKY OHR OHREN OHRENBINDE OHRENHALTER OHRENKERZEN OHRENREINIGER OHRENSCHUETZER OHRENSPRITZE OHRKERZEN OHRLOCH OHRMUSCHELKISSEN OHROPAX OHRREINIGER OHRSANA OHRSCHUTZVERBAND OHTAKA OIL OILATUM OKACIN OKAI OKEIDO OKKLUDERM OKKLUFIX OKKLUPETZ OKKLUSAN OKKLUSIV OKOUBACA OKOUBAKA OKOUBARELL OKOUBASAN OKTA-LINE OKU OLBAS OLBEMOX OLDENBURGER OLEANDER OLEATUM OLEAVE OLECRANON OLEO OLEOBAL OLEOGEL OLEOTHERM OLEUM OLIBANUM OLICARD OLICLINOMEL OLIGOMIN OLIVE OLIVEN OLIVENBLATT OLIVENBLATTEXTRAKT OLIVENBLATTOELCREME OLIVENBUTTER OLIVENIT OLIVENOEL OLIVENPOLYPHENOL OLIVYSAT OLIXX OLMETEC OLPADORM OLPAGALL OLPAGRIPP OLPALYMPHON OLPANERVIN OLPAPECT OLPARHEUM OLPASCLEROL OLPASTOM OLPATOX OLYMPIA OLYNTH OM OMACOR OMAS OMCA OME OMEBETA OMEGA OMEGAMMA OMEGAN OMEGARENAL OMEGAVEN OMELICH OMELIND OMEP OMEPRAZOL OMIDERM OMNIAPHARM OMNIC OMNICAN OMNIDERM OMNIFILM OMNIFIX OMNIFLORA OMNILANCE OMNIMIN OMNIPAQUE OMNIPLAST OMNIPOR OMNISCAN OMNISEPT OMNISILK OMNISTRIP OMNITAPE OMNITEST OMNIVAL OMO OMOTRAIN OMRON ON ONAGRE ONCASPAR ONCOFOLIC ONCOTICE ONE ONEALPHA ONKANFU ONKOCRISTIN ONKODOX ONKOFLUOR ONKOPOSID ONKOSTICK ONKOTRONE ONKOWORKER ONKOXANTRON ONLY ONOPORDON ONOSMODIUM ONYCHOMAL ONYMYKEN ONYX OOLONG OP OPAL OPAQUE OPC OPC+ OPHTALMIN OPHTHALMIK OPHTOCAIN OPHTOPUR OPIFERA OPINO OPIPRAMOL OPIUM OPOBYL OPPY OPRAFLEX OPS OPSITE OPSONAT OPTALIDON OPTENYL OPTI OPTIBRUSH OPTICLEAR OPTICLUDE OPTICROM OPTIDERM OPTIDORM OPTIFLAUSCH OPTIFLUID OPTIFREE OPTIGARD OPTILECITH OPTILUX OPTIMA OPTIMAHL OPTIMOBIL OPTINEB OPTIPECT OPTIPEN OPTIPLAST OPTIPYRIN OPTIRAY OPTISKIN OPTISON OPTIVA OPTIZYM OPTO OPTOCARE OPTOLIND OPTOMED OPTOSOL OPTOVIT OPTRUMA OPTUREM OPUNTIA OPUNZIA ORA ORABET ORABETIC ORAFRESH ORAL ORALAV ORALGUM ORALPAEDON ORALTONG ORALVAC ORANGE ORANGEDERMEX ORANGEN ORANGENBLUETEN ORANGENBLUETENWASSER ORANGENSCHALEN ORAP ORASORBIL ORATOR ORBAT ORBIMED ORBIT OREGANO ORELOX ORFIRIL ORGALUTRAN ORGAMETRIL ORGAN ORGANICS ORGANOPLEX ORGANUM ORGAPLASMA ORGARAN ORGASMUS ORGATERM ORICANT ORIGANUM ORIGINAL ORIMETEN ORION ORIS ORNITHOGALUM OROBLU OROS ORPHOL ORTEL ORTHANGIN ORTHO ORTHOBASE ORTHOCLONE ORTHOEXPERT ORTHOFLOR ORTHOFLOSS ORTHOLIFE ORTHOMOL ORTHOMOLEKULARE ORTHOOSTEO ORTHOPLAST ORTHOPROTECT ORTHOSIPHON ORTHOSIPHONBLAETTER ORTHOSKAVIDENT ORTHOSOPHONBLAETTERTEE ORTHOVISC ORTHOZIME ORTITRUW ORTOLUX ORTOPAD ORTOPEDIA ORTOTON ORUDIS OS OSANIT OSMANTHUS OSMERAL OSMIL OSMIUM OSMOFUNDIN OSMOLITE OSMOSTERIL OSNERVAN OSPAMOX OSPOLOT OSPOROWELL OSPUR OSS OSSAPLAST OSSICULA OSSIDAL OSSIN OSSIPLEX OSSOFORTIN OSSPULVIT OSSY OSTAC OSTENIL OSTEO OSTEOBISS OSTEOBOLAN OSTEOCHONDRIN OSTEOHEEL OSTEOMYELITIS OSTEOPAL OSTEOPLUS OSTEOPOROSE OSTEORON OSTEOS OSTEOSAL OSTEOTEC OSTEOTRIOL OSTEOVIT OSTOCAVID OSTOMATE OSTOSTABIL OSTRIN OSWIN OSYROL OSZ OTALGAN OTIMED OTITEX OTITIS OTOBACID OTOBAR OTO-CYL OTODOLOR OTOFREN OTOS OTOSAN OTOVENT OTOVOWEN OTOWAXOL OTRISAL OTRIVEN OTTO OUT OUTBOUND OV OVA OVALLOCHPLATTE OVALPFLASTER OVARELL OVARIA OVARIA/ OVARIAL OVARIALCYSTE OVARIUM OVASTAT OVESTIN OVIDOL OVIFIT OVIOL OVITRELLE OVOCALCIN OVOMALTINE OVOPLEX OVORESTA OVU OVULA OVULATIONSTEST OXA OXACANT OXALIS OXANE OXANO OXAZEPAM OXEPA OXET OXIBAND OXICLIQ OXIFLO OXIMAX OXIS OXISENSOR OXITEST OXOFERIN OXOVASIN OXY OXYAL OXYB OXYBAG OXYBUGAMMA OXYBUTIN OXYBUTON OXYBUTYNIN OXYFIT OXYFLOW OXYLYC OXYMAT OXYMEDIN OXYPARAT OXYPLUS OXYSAFE OXYSEPT OXYTETRACYCLIN OXYTEX OXYTOCIN OXYTRON OXYUR OXYVITAL OXYWELL OYO OZIUM OZON OZONE OZONISIERTE OZONISIERUNGSFLASCHE OZONOL OZOVIT OZYM P P20 P7000 PA PABA PAC PADMA PADYCARE PAEDIACROM PAEDIAFUSIN PAEDIALGON PAEDIAMOL PAEDIAMUC PAEDIATHROCIN PAEDIATIFEN PAEDIATRISCHE PAEDISUP PAEONIA PAGALONG PAGASLING PAGAVIT PAGO PAI PAIDOFLOR PAIN PAINEX PAINFLEX PAINMATE PAISALEN PALACOS PALAMED PALAMIX PALATOL PALENUM PALL PALLADIUM PALLAS PALLASIT PALLIATIV PALMA PALMARE PALMAROSA PALMICOL PALMISAN PALOSAN PALSANEU PALUDRINE PAMBA PAMIDRO PAMIDRONAT PAMIFOS PAMO PAMORELIN PAMPELMUSE PAMPERS PAN PANALGAN PANAVULSIN PANAX PANCREARELL PANCREAS PANCREAS/ PANCREASOME PANCREATIN PANCREATINUM PANCREOLAURYL PANCURONIUM PANDALIS PANDEL PANELAST PANGAM PANGAMAT PANGEN PANGROL PANKREAPLEX PANKREAS PANKREATAN PANKREATICUM PANKREATIN PANKREOBAL PANKREOFLAT PANKREON PANKREVOWEN PANNA PANORAL PANOTILE PANOXYL PANPEPTAL PANPUR PANTEDERM PANTENE PANTHENOL PANTO PANTOGRAN PANTOLAX PANTORC PANTOSTIN PANTOVIGAR PANTOZOL PANTY PANZYNORM PANZYTRAT PAP PAPAVER PAPAYA PAPIERBINDEN PAPIERNAGELFEILE PAPIERROLLE PAPIERTASCHENTUECHER PAPIERWASCHLAPPEN PAPILLAE PAPIN PAPPELSALBE PAPRIKA PARA PARACEFAN PARACELSIA PARACETAMOL PARACODIN PARACTOL PARADENT PARADIGM PARALLEL PARAM PARAMETRIUM PARAMETRIUM/ PARAMYC PARAPAD PARAPAED PARATHYREOIDEA PARATHYREOIDEA/ PARATHYREOTROP PARATUS PARAVERTEBRAL PARAXIN PAREIRA PARENTAMIN PARENTERAL PARFENAC PARFUEMOEL PARGO PARI PARIET PARIS PARKEMED PARKERS PARKINSAN PARKINSON PARKINSONOTROP PARKOPAN PARKOTIL PARKS PARLODEL PARMA PARMAPHARM PARNASSIA PARO PARODONTAL PARODONTAX PARODONTOSE PAROEX PAROLICH PARONTAL PAROTIS PAROXAT PAROXEDURA PAROXETIN PAROZOL PARS PARSAL PARTHENA PARTUSISTEN PARVULAN PAS PASCALLERG PASCOFEMIN PASCOLIBRIN PASCOMAG PASCOMUCIL PASCONAL PASCONEURAL PASCONIER PASCOPANKREAT PASCORENAL PASCOSABAL PASCOSEDON PASCOSSAN PASCOTOX PASCOVASAN PASCOVENOL PASCOVENTRAL PASGENSIN PASISANA PASIVITAL PASPERTIN PASSIFLORA PASSIN PASSIONSBLUME PASTA PASTENKANUELEN PATCHOULI PATELLA PATELLADYN PATELLALIGNER PATENTBLAU PATENTEX PATENTSCHLOSS PATHOLOGISCHE PATIENTEN PATIENTENDREHSCHEIBE PATIENTENHALTER PATIENTENLIFTER PATIENTENOVERALL PATIENTENPAESSE PATIENTENSERVIETTEN PATIENTENUMHANG PATISON PAUKENROEHRCHEN PAUSAN PAUSCHALPAKET PAVERIWERN PAVERYSAT PAYA PAYAGASTRON PAYASANIT PC PCA PCF PCM PCR PE PEAK PEANUTS PEARL PEARLS PEBBLE PECTACARD PECTAPAS PECTIN PECTOCOR PECTORAL PECTUS-HEEL PEDAL PEDEA PEDFROH PEDI PEDIA PEDIASURE PEDIKUERE PEDIKUEREZANGE PEDILEN PEDIPEEL PEDIPRO PEDISAN PEDISENSO PEDITRACE PEDOPUR PEELING PEEP PEEP-VENTIL PEFRAKEHL PEG PEGA PEGASUS PEGASYS PEGINTRON PEHA PEHALAST PEHALURON PEHAZELL PEKANA PEKING PEKTIN PEL PELA PELINA PELLIT PELOID PELOSE PELSANO PELVICHTHOL PELVIS PEN PENANYST PENATEN PENATOL PENBETA PENDYSIN PENGUIN PENHEXAL PENICILLAT PENICILLIN PENICILLIUM PENINJECT PENIS PENISBAND PENISKLEMME PENISTASCHE PENROSE PENTACARINAT PENTACORT PENTALONG PENTAMIDIN PENTAMOL PENTASA PENTATOP PENTAVAC PENTO PENTOFURYL PENTOHEXAL PENTOSANPOLYSULFAT PENTOX PENTOXIFYLLIN PENTOXY PEP PEPCID PEPCIDDUAL PEPDUL PEPSALETTEN PEPSINWEIN PEPTAMEN PEPTISORB PEPZITRAT PERAN PERATIVE PERAZIN PERC PERCOFFEDRINOL PERCUTANA PERCUTANES PEREMESIN PERENTEROL PERFALGAN PERFAN PERFECT PERFECTOSAN PERFEKTA PERFUSIONS PERFUSIONSBESTECK PERGOLID PERGOTIME PERIAMIN PERICAN PERICARDIUM PERIDURALKATHETER PERIFIX PERIKURSAL PERILLA PERILONG PERIO PERIODONTAL PERIODONTIUM PERIODONTIUM/ PERIOGARD PERIOSTEUM PERIPAC PERIPLANT PERIPLASMAL PERITOL PERITONAEUM PERITONEALDIALYSE PERITRAST PERIURETHRALES PERIVAR PERIX PERLAMED PERLFIT PERLINGANIT PERLO PERLWEISS PERMA PERNA PERNATON PERNIONIN PERO PEROCUR PEROL PERONAEUSSCHIENE PERPHENAZIN PERPLEX PERSICO PERSKINDOL PERSONA PERSONENWAAGE PERTENSO PERTIX PERTUDORON PERTUSSIN PERTUSSINUM PERU PERYMED PERYSAN PESENDORFER PESSAR PESTWURZ PET PETADOLEX PETAFORCE PETASITES PETAXX PETEHA PETERMANN PETERSILIE PETERSILIEN PETIBELLE PETIGRAINOEL PETINUTIN PETIT PETITGRAINOEL PETNIDAN PETRASCH PETRISCHALE PETROLEUM PETROSELIN PETROSELINUM PETYLYL PETZO PEUCEDANUM PEYAWA PFANNENWENDER PFEFFER PFEFFERMINZ PFEFFERMINZBLAETTER PFEFFERMINZBLAETTERTEE PFEFFERMINZE PFEFFERMINZOEL PFEFFERMINZTEE PFEFFERMINZWASSER PFEFFEROEL PFEIL PFERDE PFERDEFETT PFERDEGEL PFERDEMARK PFERDESALBE PFIRSICH PFIRSICHKERNOEL PFLANZENEXTRAKT PFLANZENFEMIN PFLANZENOELSEIFE PFLASTER PFLASTERBINDE PFLASTERBOY PFLASTERSORTIMENT PFLASTERSTEINE PFLASTERSTRIPS PFLASTERWUNDVERBAND PFLAUME PFLAUMENASCHENLAUGE PFLEGE PFLEGEBETT PFLEGECREME PFLEGEHEMD PFLEGEMATRATZE PFLEGENDE PFLEGERS PFLEGESERIE PFLEGETASCHE PFLEGETUECHER PFLUEGERPLEX PFLUEGERS PG PH PHAEMOSAN PHALANX PHAMOPRIL PHAMOPROFEN PHAMORANIT PHAMUC PHANTASIE PHARDOL PHARKOS PHARMACOS PHARMADIES PHARMAETHYL PHARMAKOLITH PHARMASSURE PHARMASTYLE PHARMATON PHARMOS PHARYNX PHARYSYX PHASEOLAMIN PHASEOLIN PHASEOLUS PHELLANDRIUM PHENHYDAN PHENOMENAL PHENPRO PHENPROGAMMA PHENYTOIN PHILADELPHIA PHILIPS PHILONOTIS PHIMOSEGLOECKCHEN PHLEBO PHLEBODRIL PHLEBODUR PHLEBOFOAM PHLEBOHAFT PHLEBOIDEAL PHLEBOLAN PHLEBOLONG PHLEBOLONGELAST PHLEBOMULL PHLEBOPLAST PHLEBOSANA PHLEBOSILK PHLEBOSOFT PHLEBOSTRETCH PHLEBOTEX PHLEBOTUBE PHLEBOZINK PHLOGENZYM PHLOGONT PHOENIX PHOENO PHOLDYSTON PHOLEDRIN PHOS PHOSETAMIN PHOSPHALUGEL PHOSPHATIDYLCHOLIN PHOSPHATIDYLSERIN PHOSPHONORM PHOSPHOR PHOSPHORICUM PHOSPHOROCHALCIT PHOSPHORUS PHOSPHOSORB PHOSPLAN PHOSTAL PHOTODERM PHOTOSAN PHUMASOL PHYLLOTEMP PHYSIO PHYSIODERM PHYSIOGEL PHYSIOLAN PHYSIOLIGHT PHYSIOMAG PHYSIOMAT PHYSIOTENS PHYSOSTIGMA PHYSOSTIGMINUM PHYTO PHYTOBIL PHYTOBRONCHIN PHYTOCORTAL PHYTODENT PHYTODERMA PHYTODOLOR PHYTODORM PHYTODORMA PHYTOESTROL PHYTOGRAN PHYTOHEPAR PHYTOHUSTIL PHYTO-HYPOPHYSON PHYTOKAR PHYTOKOSMA PHYTOLACCA PHYTONOCTU PHYTOOESTROGENE PHYTOPECT PHYTOPROSTAN PHYTOREN PHYTORIN PHYTOS PHYTOSAL PHYTOSKIN PHYTOSOL PHYTOSTEROL PHYTOSTOP PIA PIC PICAO PICCOLO PICHI PICK PICKELEX PICKSAN PICNIC PICRINICUM PICRORHIZA PIDILAT PIEDRA PIERCING PIESEL PIGMENTAN PIGMENTFLECKEN PILBOX PILCA PILLEN PILLENBOXTIMER PILLENDOSE PILLOW PILMI PILMISON PILO PILOCARPIN PILOCARPOL PILOMANN PILOPOS PILZCIN PIM PIMA-BICIRON PIMAFUCIN PIMPINELLA PIN PINAL PINDA PINE PINGU PINGUINE PINI PINIKEHL PINIMENTHOL PINKI PINKY PINO PINODOR PINOFIT PINOIDAL PINOPON PINOSAN PINPAYA PINSEL PINUM PINUS PINZETTE PINZETTENSORTIMENT PIPAMPERON PIPELLE PIPER PIPERACILLIN PIPETTE PIPO PIPPI PIPSIMED PIRACEBRAL PIRACETAM PIRACETROP PIRATEN PIRATENGOLD PIRATOPLAST PIRENZEPIN PIRO PIROBETA PIROCUTAN PIROFLAM PIROFLEX PIRORHEUM PIROWIEB PIROX PIROXICAM PITRALON PITT PITTA PIX PIZ PJUR PK PLACENTA PLACENTABAD PLAK PLAN PLANTABEN PLANTACARD PLANTACELL PLANTAFRESH PLANTAGO PLANTAPUR PLANTAROM PLANTIVAL PLANTOFIT PLANTUBEX PLANTUROL PLANUM PLAQUE PLAQUENIL PLASMAFUSIN PLASMASTERIL PLASTIKHAENGER PLASTIKTOPF PLASTRONA PLASTUFER PLASTULEN PLATIN PLATINA PLATINEX PLATINOL PLATINUM PLATRIX PLAVIX PLAYTEX PLENDIL PLENOSOL PLEOMIX PLEON PLEURA PLEURACAN PLEURAPUNKTIONSSET PLEUROCERT PLEUROFIX PLEURO-GASTREU PLEUROTUS PLEVENT PLEXOLONG PLEXUFIX PLEXUS PLININFEKT PLISSAMUR PLUMBUM PLURAMIN PLUS PLUTIODERM PLUVONIN PM PMS PNEUMO PNEUMOCOCCINUM PNEUMODORON PNEUMOFLEX PNEUMOLASTIC PNEUMOLASTIK PNEUMOPUR PNEUMOVAX PNL PO2 PODI PODIUM PODOMEXEF PODOPHYLLUM PODOVIS PO-HO POIKIVEN POINTER POISE POKET POLAR POLARIS POLARONIL POLBAX POLCORTOLON POLEI POLIERKEGEL POLILEVO POLIMIRTILEN POLINORM POLIO POLIOMYELITIS POLITZERBALL POLLEN POLLENFLUG POLLENKAPSELN POLLENS POLLENSCHUTZ POLLENSCHUTZMASKE POLLIMED POLLIMUN POLLINEX POLLINOSE POLLIS POLLSTIMOL POLSTER POLSTERBINDE POLSTERMATERIAL POLSTERSCHAUM POLSTERSCHLAUCH POLSTERVLIES POLSTERWATTE POLY POLYARTHRITIS POLYBION POLYCLENS POLYCOLOR POLYDONA POLYDONT POLYERGA POLYESTER POLYFORM POLYGEL POLYGONATUM POLYGONUM POLYMAX POLYMEM POLYMINOL POLYMUN POLYPATHIK POLYPIN POLYPORIN POLYPORUS POLYPUS POLYRINSE POLYSAN POLYSEPT POLYSKIN POLYSPECTRAN POLYTAMIN POLYTEC POLYTEX POLYXAN POLYZINK POLYZYM POM POMERANZENSCHALEN POMERANZENSCHALENOEL POMILD POMPS PONALAR POND PONS POOLESAUGER POPO POPULUS PORELAST PORENA PORISOFTAN PORODRESS POROFIX POROTAPE PORT PORT/ZVK PORTA PORTEX PORTNADELN PORTNADELSET PORTNADELWECHSELSET PORTOLINO PORTS PORTSYSTEM PORTTUNNELER PORZELLANERDE POSIDYNE POSIFENICOL POSIFLOW POSIFORMIN POSITIONER POSORUTIN POST POSTADOXIN POSTAFEN POSTERINE POSTERISAN POST-OP POSTOPERATIVER POTABA POTENTILLA POTENZHOLZ POTERIUM POTSILO POUDRE POWER POWERBAR POWERFIT POWERGEL POWERPLAY PPS PRAEBIOTIK PRAECIGLUCON PRAECINEURAL PRAECORDIN PRAECUTAN PRAEMETA PRAEPARIERTUPFER PRAETI PRAEVENKINE PRAEVENTIVA PRAEVODERM PRAEVOSKIN PRAKTIBOX PRAMINO PRANAVITE PRASANTH PRAVA PRAVABETA PRAVAGAMMA PRAVALICH PRAVASIN PRAVASTATIN PRAVIDEL PRAXIS PRAXITEN PRAZOSIN PRE PREBET PREBIO PRECINORM PRECIPATH PRECISE PRECTAL PRED PREDALON PREDNABENE PREDNI PREDNIGALEN PREDNIHEXAL PREDNISOLON PREDNISOLUT PREDNISON PREFERENCE PREG PREGNATEST PREGTINA PREIMIN PREISEL PREISELBEER PREISELBEERE PREISELBEERSAFT PREKURSAN PRELIS PRELOX PRELUDE PREMATURE PREMIUM PREMNA PREMUS PRENANTHES PRENATAL PRENT PREOX PREPACOL PREPIDIL PRES PRESHAPE PRESINOL PRESKIL PRESOMEN PRESSELIN PRESSOTHERM PRESSURE PRETERAX PRETEST PRETTY PREVAIL PREVAL PREVENAR PREVENTEC PREVENTID PREVENTOX PREVICAL PREWASH PRI PRICKEL PRIDURAL PRIFLEX PRILACE PRIM PRIMA PRIMACAST PRIMA-COMB PRIMA-CUFF PRIM-AIR-KAN PRIM-AIR-O2 PRIMALAX PRIMAMED PRIMA-PHON PRIMAPORE PRIMASEPT PRIMA-SILK PRIMA-SILK-VENT PRIMASOFT PRIMASTOM PRIMASTOMOEL PRIMA-SUCTION PRIMAT PRIMATES PRIMEROSEOEL PRIMETTA PRIMIDON PRIMO PRIMOL PRIMOLUT PRIMROSE PRIMULA PRIMULA/CONVALLARIA PRIMUS PRIORIN PRIORIX PRISMA PRIVATE PRIVIN PRIZM PRO PRO85 PROALLER PROBENECID PROBIERSET PROBIERSTOCK PROBIO PROBIOBOLAN PROBIOS PROBIOTIK PROBIOTIKUM PROBIOTISCHES PROBLEME PROBRISE PROCAIN PROCAINUM PROCANEURAL PRO-COLON PROCOMFORT PROCOMVAX PROCORDAL PROCORSIN PROCORUM PROCTIS PROCTOSPRE PROCULIN PROCURA PROCYCLO PRODIURET PRODOLOR PRODRY PROENZYM PROFACT PROFEEL PROFELAN PROFESSORENTEE PROFI PROFIL PROFITEST PROFIX PROFLEXAN PROFORE PROFRAU PROFUE PROGASTRIT PROGESTERON PROGESTOGEL PROGLICEM PROGLUTAL PROGRAF PROGRESS PROGRESSIVE PROGUVAL PROGYLUTON PROGYNON PROGYNOVA PROHANCE PROJUVA PROKID PROLACT PROLENE PROLEUKIN PROLIN PROLINE PROLOPA PROLUTON PROMANN PROMANUM PROMED PROMENS PROMENSIL PROMETHAZIN PROMIT PROMOGRAN PROMOTE PROMPTEX PRONANO PRONERVON PRONEURIN PRONOX PRONTO PRONTOCID PRONTOPYRIN PRONTORAL PRONTOSAN PROPAFEN PROPAFENON PROPAFUCON PROPAMERCK PROPAPHENIN PROPAR PROPARAKAIN PROPECIA PROPHYIMMUN PROPHYLUX PROPHYMENTAL PROPHYSIO PROPODENT PROPODROP PROPOFOL PROPOLANO PROPOLENTUM PROPOLI PROPOLINO PROPOLIS PROPOLISEPT PROPOLISSALBE PROPOLIX PROPOLY PROPOLYSAN PROPOMINT PROPRA PROPRANOLOL PROPRANUR PROPYCIL PROREDUCT PROSAN PROSATVISION PROSCAR PROSCENAT PROSECUR PROSENA PROSLIM PROSOMNIA PROSPAN PROSTA PROSTAFORTON PROSTAGALEN PROSTAGUTT PROSTAHERB PROSTAMED PROSTAPHYT PROSTAPLANT PROSTARELL PROSTASYX PROSTATA PROSTATEKTOMIE PROSTATEKTOMIEKATHETER PROSTAVASIN PROSTAVISION PROSTAWERN PROSTESS PROSTICA PROSURE PROSYS PROTAGENT PROTAMIN PROTAPHANE PROTAXON PROTEA PROTECOR PROTECT PROTECTAID PROTECTION PROTECTIV PROTECTIVE PROTECTON PROTECTOR PROTEFIX PROTEIN PROTEINKONZENTRAT PROTEOZYM PROTHANON PROTHAZIN PROTHESE PROTHESEN PROTHESENBEHAELTER PROTHI PROTHIL PROTHO PROTHYRID PROTHYRYSAT PROTOKOLLHEFT PROTOPIC PROVAS PROVIDE PROVISC PROVITAMIN PROVOKIT PROVOX PROXCID PROXEN PROXIFUNGINE PROXIGINGIVINE PROXIMAL PROZAC PRUNUS PRUNUSEISEN PRURICALM PRURITUS PRYLEUGAN PS PSA PSILO PSOHERBA PSORADEXAN PSORALON PSORBRASIL- PSORCUTAN PSORI PSORIASIS PSORIFUG PSORIMED PSORINOHEEL PSORINUM PSORISOL PSORKAMM PSSST PSYCHOMARTIN PSYCHONEUROTICUM PSYCHOTONIN PSYLLIUM PSY-STABIL PT PTELEA PTEROCARPUS PU PUDENDUM PUETTER PUFFERZANGE PULBIL PULMANOVA PULMICORT PULMISSION PULMO PULMO/ PULMOCAR PULMOCARE PULMOCORDIO PULMO-CYL PULMO-GASTREU PULMOLL PULMONARIA PULMONEST PULMONIK PULMORELL PULMOSTAR PULMO-TIMELETS PULMOTIN PULMOTRACTAN PULMOZYME PULMYC PULPA PULPOMIXINE PULSATILLA PULSMESSGERAET PULSOXIMETER PULSUHR PULVIS PULVO PUMPEN PUMPENTASCHE PUMPENUEBERLEITSYSTEM PUNA PUNCTO PUNCTUM PUNKT PUNKTLICHTSPIEGEL PUNKTUM PUNTO PUR PURASANFT PURDUE PUREGAR PUREGON PURELINE PURETHAL PURGATIO PURI PURIFICATION PURISOLE PURODENT PURPOSE PURSEPT PUR-ZELLIN PUSH PUSSA PUSSYCAT PUTZFRISCH PVA PV-MULL PVP PYCNOGENOL PYCYSTON PYELON PYKARYL PYLORUS PYODERMIE PYOLYSIN PYRACOPHEN PYRAFAT PYRALVEX PYRARGYRIT PYRAZINAMID PYRCON PYRETHRUM PYRILAX PYRIT PYRITEC PYRMONTANA PYROFAT PYROGENIUM PYROMORPHIT PYROVAT PYROVATIN PYROWEROL PYRUVAT PZA Q Q-ANT-OX QI Q-TIPS QUADRA QUADRATPFLASTER QUADROJECT QUADRONAL QUADROPLEX QUADROPRIL QUAEKER QUALEX QUALLEN QUANTALAN QUARTAMON QUARZ QUARZ/ QUASSIA QUATOHEX QUEBRACHO QUEEN QUENDELKRAUTPULVER QUENDELOEL QUENSYL QUENTAKEHL QUENTY QUERCETIN QUERCUS QUERHOBEL QUERTO QUICK QUICKFIT QUICKIE QUICKPAD QUICKTRACH QUICKVUE QUILONORM QUILONUM QUINAPRIL QUINTESAL QUINULIN QUIT QUITTEN QUIVIA QVAR R R+P RABASTHMON RABDERM RABE RABHEPAR RABIPUR RABIVAC RABJUVEN RABNERVON RABRO RACECORD RACEDRINUM RACESTYPTINE RACHENGOLD RADEDORM RADEPUR RADICON RADIESCHEN RADINORM RADIOGARDASE-CS RADISELEN RAEUCHERWERK RAGY RAINBOW RALENOVA RALOFEKT RAMADAMA RAMALINA RAMEND RAMI RAMIGAMMA RAMIPRIL RAN RANDPOLSTER RANI RANIBERL RANIBETA RANIBLOC RANICUX RANIDURA RANIMERCK RANIPROTECT RANITAB RANITIC RANITIDIN RANITIDOC RANIWIEB RANOCALCIN RANOCESAN RANTUDAL RANTUDIL RANUNCULUS RAPAKO RAPAMUNE RAPE RAPHANUS RAPHTHISIN RAPI RAPID RAPIDAN RAPIDFIT RAPIDRHINO RAPILYSIN RAPITRIM RAPPORT RAPSSAMEN RASIERER RASIERWASSER RATANHIA RATHGEBER RATIOALLERG RATIOGAST RATIOGRIPPAL RATIOPHARM RATIOPYRIN RATIOSEPT RATIOVITA RAUCH RAUCHER RAUCO RAUCOCEL RAUCODRAPE RAUCODUR RAUCOLAST RAUCOTUPF RAUMDUFT RAUMLUFT RAUSCH RAUWOLFIA RAUWOLFIAVISCOMP RAUWOLSAN RAVENER RAVENSARA RAY RAYOBASE RAYOSOLE RC RCI RD RE REACTINE READY READYTEST REALGAR REBASIT REBETOL REBIF RECA RECARCIN RECATOL RECEPTAL RECESSAN RECHTSREGULAT RECISAN RECLEAN RECOFOL RECON RECONVAN RECORD RECTODELT RECTOPARIN RECTOSELLAN RECTUM RED REDAXA REDON REDONDO REDOVAC REDOX REDU REDUCELLE REDUCTIL REDUCTO REDUFORM REDUMED REDUMIN REDUPECT REDURAN REDUSAN REDUX REDUXEN REENERGEN REFESAN REFLEX REFLOLUX REFLOTRON REFLUDAN REFOBACIN REFRESH REGACAN REGAINE REGAL REGASINUM REGAVASAL REGAZELL REGAZYM REGEMA REGENA REGENACARE REGENAPLEX REGENASAN REGENCAPE REGENERATIO REGENERATIONS REGENERESEN REGENON REGENSCHUTZ REGENT REGENWETTER REGEPITHEL REGINA REGINON REGIO REGIVITAL REGULACOR REGULAFIT REGULAR REGULAS REGULATO REGULATOR REGULAX REGULTON REHA REHBAND REIBSCHAELER REICHELS REINIGUNGS- REINIGUNGSBUERSTE REINIGUNGSBUERSTEN REINIGUNGSMILCH REINIGUNGSTUECHER REINSERTIONSKATHETER REINSILIKON REIS REISE REISE- REISEAPOTHEKE REISEDRAGEES REISEGEHSTUETZE REISEGOLD REISEKISSEN REISERNTE REISESET REISESITZKISSEN REISESTOCK REISETABLETTEN REISETASCHE REISEWECKER REISHI REISKLEIE REISSAECKCHEN REISSVERSCHLUSSHILFE REIZSTROMTHERAPIEGERAET REJUVENAT REKAWAN REKONVIT REKTAL REKTALDRUCKMESSKATHETER REKTALKATHETER REKTALSCHILD REKTALSONDE REKTO RELAX RELAXAT RELAXATION RELAXING RELAXSAN RELEFACT RELENZA RELESS RELIVORA RELOX RELPAX REMBRANDT REMEDIUM REMERGIL REMERON REMESTAN REMICADE REMICALCIN REMID REMIFEMIN REMINYL REMIPROSTAN REMLOFECT REMOVE REMSTAL REN RENACARE RENACET RENACOR RENAGEL RENAL RENALIN RENAMIL RENAPRO RENATRIOL RENAVIT RENCO RENEEL RENELIX RENERGY RENES RENES/ RENILON RENIS RENITEC RENNIE RENOB RENODORON RENODRAIN RENO-GASTREU RENORELL RENOVISION RENTIBLOC RENTYLIN RENU REO REOPRO REPAIR REPARATURSET REPARIL REPELL REPEVAX REPHA REPHADERM REPHALGIN REPHALYSIN REPHASTASAN REPLAY REPLOGLE REPOSITIONIER REPOWINON REPROVEN REPURSAN REQUIESAN REQUIP RES RESACTIV RESANA RESANA-KAMILL RESCUEFLOW RESCUVOLIN RESERPINUM RESERVOIR RESERVOIRS RESIMATIL RESINA RESISTAN RESISTUM RESO RESOCHIN RESONIUM RESOPLEX RESORCELL RESOURCE RESOVIN RESOVIST RESPALERT RESPI RESPICORT RESPIFLO RESPIFOR RESPIGARD RESPIRGARD RESPIROGUTT RESPLANT RESTEX RESTON RESTORIC RESTRUCTA RESTYLANE RESVERA RESVERACAPS RESVERASOR RESVERATOL RESVERATROL RESVERATROLIN RETACILLIN RETICULOENDOTHELIALES RETIN RETINA RETINOL RETORTAPYRIN RETRAKTIONSFAEDEN RETROVIR RETTERSPITZ RETTICH RETTUNGSDECKE RETUSSAN REUMALESS REVASC REVAXIS REVICAIN REVITAL REVITALISIERUNGS-KUR REVITOLAN REVITORGAN REWODINA REXAM REZEPTURSCHERE RHASSOUL RHEFLUIN RHEILA RHEINGOLD RHENA RH-ENTOXIN RHEOHES RHEOMACRODEX RHEOTROMB RHEUBALMIN RHEUCASTIN RHEUCOSTAN RHEUFERM RHEUM RHEUMA RHEUMABAD RHEUMAKAPS RHEUMAMITTEL RHEUMAPLAST RHEUMASELECT RHEUMASTUETZE RHEUMATAB RHEUMATABLETTEN RHEUMATEC RHEUMATROPFEN RHEUMEDA RHEUMEX RHEUMITIN RHEUMODORON RHEUMON RHEUNERVOL RHINEX RHINISAN RHINIVICT RHINO RHINOBETA RHINODORON RHINOGUTTAE RHINOMER RHINOPRONT RHINOSOVIL RHINOSPRAY RHINOTON RHIZO RHIZOGIB RHIZOLOC RHIZOSPLINT RHODIOLA RHODIZONSAEURE RHODODENDRON RHODODENDRONEEL RHODOFORM RHODOLITH RHOMBO RHUS RHUSAN RHYTHMOVITA RI RIA RIAMET RIBES RIBINI RIBOCARBO RIBOCARE RIBODOXO RIBOFLUOR RIBOFOLIN RIBOFORM RIBOLADY RIBOMUNYL RIBOMUSTIN RIBOPAMP RIBOPOSID RIBOSLIP RIBOSOFT RICHTER RICINUS RICOLA RICURA RIDAURA RIESENTANNE RIFA RIFAMPICIN RIFATER RIFINAH RIFUN RIGA RIGI RIGOBERT RILEX RILLENBECHER RILUTEK RIMACTAN RIMCELL RIMEXEL RIMOC RIMOSTIL RING RINGELBLUME RINGELBLUMEN RINGELBLUMENMILCH RINGER RINGERLOESUNG RINGPESSAR RINGSAUGER RINGTUPFER RINOFLOW RIO RIOPAN RIPPENBAND RIPPENBRUCHBAND RIPPENBRUCHBANDAGE RIPPENBRUCHGUERTEL RIPPENGUERTEL RIPPENGURT RISATARUN RISICORDIN RISIN RISINETTEN RISPERDAL RITEX RITSCH RITTER RIVANOL RIVERSTAR RIVOLTAN RIVOTRIL RIZINUSOEL RIZOL RKR RMS RN RNA RO ROACCUTAN ROBDRAIN ROBENA ROBENATA ROBI ROBIDENT ROBINIA ROBINUL ROBIOL ROBORANTIA ROC ROCALTROL ROCEPHIN ROCEPHINE ROCHE ROCORNAL RODAVAN RODY ROE ROEKAN ROENTGEN ROEWO ROEWOPAN ROFATUSS ROFERON ROGAINE ROGASKA ROGG ROGGELAST ROGGEN ROGGENKISSEN ROGGENPOLLEN ROGGES ROGGHAFT ROGGMED ROHDE ROHO ROHYPNOL ROLECA ROLIP ROLL ROLLAEX ROLLATOR ROLLE ROLLING ROLLKUR ROLLMASSBAND ROLLMESSBAND ROLLMOBIL ROLLSTUHL ROLLSTUHLAUFLAGE ROLLSTUHLGURT ROLLSTUHLHANDSCHUH ROLLSTUHLKISSEN ROLLTRICHTER ROLTA ROMANA ROMANTIK ROMANZE ROMBELLIN ROMEA ROMYK RONDO RONDOFLEX RONDOKREPP RONDOMOLL RONDOPAD RONFNYL ROOIBOS ROOIBUSCH ROOIBUSH ROOITEA ROSA ROSACEA ROSANTEX ROSANTIN ROSATUM ROSCO ROSE ROSEN ROSENBLUETEN ROSENEISEN ROSENEISEN/ ROSENGARTEN ROSENGERANIE ROSENHOLZ ROSENHOLZOEL ROSENHYDROLAT ROSENQUARZ ROSENTAU ROSENWASSER ROSENWURZ ROSES ROSIDAL ROSMARIN ROSMARINBLAETTER ROSMARINUS ROSMARINUS/PRUNUS ROSMARINWASSER ROSOLIMED ROSSKASTANIE ROSSKASTANIEN ROSSKASTANIEN+WEINLAUB ROTALGEN ROTBART ROTBUSCH ROTBUSCHTEE ROTE ROTER ROTES ROTHS ROTIDERM ROTIPROTECT ROTKLEE ROTLICHTLAMPE ROTODENT ROT-OEL ROTOKAN ROTPUNKT ROTULGIB ROTWEIN ROTWEINEXTRAKT+ARTISCHOCKE ROVAMYCINE ROWACHOL ROWATINEX ROWENTA ROWLAND ROXI ROXIBETA ROXIDURA ROXIGAMMA ROXIGRUEN ROXIHEFA ROXIHEXAL ROXITHRO ROXITHROMYCIN ROXOID ROYAL ROYALBOLAN ROYASAN ROZEX RP RR RRR RTN RUBELLIT RUBEOLAE RUBICINA RUBICOLAN RUBIEFOL RUBIELAX RUBIEMAG RUBIEMEN RUBIEMOL RUBIERHEUM RUBIESED RUBIN RUBISAN RUBRIMENT RUBUS RUCK RUCKSACK RUCKSACKVERBAND RUDABLOCK RUDACLUDE RUDACULAR RUDADETEC RUDAFILM RUDAFIX RUDAFLEX RUDALASTIK RUDALASTOPLAST RUDAMED RUDANAHT RUDANASAL RUDAPLASTO RUDAPORO RUDAQUICK RUDASILK RUDASPORT RUDASPRAY RUDASTRIP RUDATAPE RUDAVAL RUDAVEN RUDAVLIES RUDOTEL RUEBEZAHL RUECKEN RUECKENBANDAGE RUECKENBUERSTE RUECKENKISSEN RUECKENKOMPRESSE RUECKENKRATZER RUECKENLEHNENGURT RUECKENSCHWAMM RUECKENSTUETZBANDAGE RUECKENSTUETZE RUECKENSTUETZGUERTEL RUECKENSTUETZKISSEN RUECKEN-UND RUECKENWOHL RUECKGRAT RUECKLAUFSPERRE RUECKSCHLAGVENTIL RUESCH RUFAFORMIN RUFEBRAN RUGARD RUHE RUHEWOHL RUHRSTERN RULID RULOFER RUMEX RUMPELSTILZCHEN RUNDHAKEN RUNDPFLASTER RUNDRASPEL RUNDUMBEZUG RUSCUS RUSEDAL RUSSISCHER RUSSKA RUTA RUTIN RUTINION RUTINUM RUTIVISCAL RUTSCHBRETT RV RYOL RYTESTHIN RYTHMODUL RYTMO RYTMOGENAT RYTMONORM RYTMOPASC S S&M SAB SABACUR SABADILLA SABAL SABALVIT SABDARIFFA SABINA SABONAL SABRIL SABURGEN SACCHARUM SACHERS SACHSEN SAEGEPALME SAEGEPALMEN SAENGER SAEUGLINGSWAAGE SAEULENWAAGE SAEURE SAF SAFAN SAFASAN SAFBLADE SAFE SAFEHIP SAFESKIN SAFETY SAFETYCAT SAFIDENT SAFORELL SAFRA SAFRAN SAFTY SAGELLA SAGROSEPT SAGROTAN SAINI SAINT SAIZEN SAL SALAGEN SALAI SALAIGUGGUL SALAZOPYRINA SALAZOPYRINE SALBEI SALBEIBLAETTERTEE SALBEIBLUETEN SALBEIOEL SALBEISALBE SALBEITEE SALBEITRIEBSPITZEN SALBEIWASSER SALBU SALBUBREATHE SALBUHEXAL SALBULAIR SALBULIND SALBUPP SALBUTAMOL SALCON SALDERMAN SALEMSONDE SALFIRA SALHUMIN SALI SALICORNIA SALICORT SALICYL SALICYLSAEUREVASELINE SALIKOLL SALINAS SALIVA SALIX SALLOS SALLY SALLYS SALM SALMI SALMIAK SALMINGA SALMIX SALMOCOR SALMON SALMONELLA SALMOORAN SALMUNDIN SALOFALK SALPINX SALRISOL SALT SALTADOL SALTRAT SALUS SALUSAN SALUTA SALVA SALVADITO SALVATORE SALVIA SALVIACINA SALVIAGALEN SALVIAL SALVIAMIN SALVIATHYMOL SALVIKOER SALVILIPID SALVIMULSIN SALVIPEPTID SALVIPLUS SALVIPUR SALVIZOL SALVYSAT SALWO SALWOSI SALZ SALZBAEDER SALZFISCHE SALZIGE SALZKOENIG SALZSAEURE SAM SAMADHI SAMBUCUS SAMDOSHA SAME SAMOA SAMSON SAM-SPLINT SAMSUNG SAMT SAMU SAN SANA SANABIL SANABRONZE SANADERM SANALIND SANAPERL SANAPHTHEN SANASEPTON SANASI SANASTHMAX SANASTHMYL SANATISON SANATOGEN SANAVEN SANAVITAN SANDBLATT SANDDORN SANDDORNFRUCHTPULVER SANDDORNOEL SANDEL SANDELHOLZ SANDER SANDERPLAST SANDIMMUN SANDMAENNCHEN SANDOCAL SANDOPARIN SANDOSTATIN SANDOZ SANDPAPIERFEILE SANDRENA SANDSACK SANESCO SANFIT SANFORM SANFT SANGO SANGODROP SANGOFIX SANGOQI SANGOSAN SANGUA SANGUINARIA SANGUINARINUM SANGUIS SANGUISAN SANGUISOL SANGUISORBA SANGUISORBIS SANHELIOS SANI SANICULA SANIFECT SANIFORM SANIGRAL SANIKLIN SANIPLAST SANISLIP SANITAETSTASCHE SANITAETSUMHAENGETASCHE SANIWIP SANKOMBI SANKT SANO SANOCHOND SANOFELL SANOMIT SANOPINWERN SANOSTOL SANOVITAL SANOWELL SANOXIT SANSAI SANSANAL SANSIBAL SANSIBON SANTA SANTALUM SANTALYT SANTASAL SANTAX SANTE SANTO SANUKEHL SANUS-PASTA SANUVIS SANUZELLA SANVITA SANYRENE SAPEC SAPHIR SAPONARIA SARAI SARAPIS SARIDON SAROTEN SAROTHAMNUS SARSAPARILLA SARSAPAROL SARSAPSOR SAS SATHYA SATINA SATTLER SATYRIN SAUBERMAENNCHEN SAUERKRAUT SAUERKRAUT+C SAUERKRAUTSUPPE SAUERLAENDER SAUERSTOFF SAUERSTOFFBAD SAUERSTOFFBRILLE SAUERSTOFFKATHETER SAUERSTOFFMASKE SAUERSTOFFSCHLAUCH SAUGER SAUGERKETTCHEN SAUGGLAS SAUGGLOCKE SAUGKOMPRESSEN SAUGSCHALE SAUGSCHLAUCH SAUGUNTERLAGE SAUNA SAUNAAUFGUSS SAUNAPIN SAURE SAUWETTER SAUWETTERTEE SAVERA SAVITUR SAVON SAW SAXIFRAGA SCABIOSA SCALPISIL SCANDI SCANDICAIN SCANDONEST SCANPOR SCAPULOGIB SCAR SCARA SCARABIG SCARACID SCARAFIX SCARANOL SCARASOFT SCATOL SCAVE SCD SCHACHTELHALM SCHACHTELHALMKRAUT SCHACHTELHALMTEE SCHAELER SCHAELGERAET SCHAELMESSER SCHAFFELL SCHAFGARBE SCHAFGARBEN SCHAFGARBENKRAUT SCHAFGARBENTEE SCHALLDAEMPFER SCHALLWELLEN SCHARACH SCHARFE SCHAUMA SCHAUMGUMMI SCHAUMPOLSTER SCHAUMPUMPE SCHAUMSCHWAEMME SCHAUMSTOFF SCHAUMSTOFFBINDEN SCHAUMWASCHLAPPEN SCHEFFLER SCHELLER SCHENKELSTRUMPF SCHERE SCHERENGRIFF SCHIBUTTER SCHIEBEGRIFFVERLAENGERUNG SCHIEBEHAHN SCHIEBEHILFE SCHIEDWETTER SCHIEFE SCHIELE SCHIELES SCHIENE SCHIENENBEFESTIGUNGSGURT SCHIENENPOLSTER SCHIETWETTERTEE SCHIFFCHEN SCHINDELES SCHISANDRA SCHIZANDRA SCHLAEFEN SCHLAF SCHLAFAPNOE SCHLAFBRILLE SCHLAFGUT SCHLAFKISSEN SCHLAFKRAFT SCHLAFMASKE SCHLAF-NERVENTEE SCHLAF-NERVEN-TEE SCHLAFSAUGER SCHLAFSTERNE SCHLAFTABLETTEN SCHLAFWOHL SCHLAGANFALL SCHLANK SCHLANKHEITSTEE SCHLANKPLUS SCHLANKSOHLE SCHLAUCH SCHLAUCHADPATER SCHLAUCHBAND SCHLAUCHHALTER SCHLAUCHKLAMMERN SCHLAUCHKLEMME SCHLAUCHKUPPLUNG SCHLAUCHVERBAND SCHLAUCHVERBINDER SCHLAUFENPLATTE SCHLECHTWETTERTEE SCHLEHDORN SCHLEHEPAR SCHLEIFKEGEL SCHLEIFSCHEIBE SCHLEIMABSAUGER SCHLEIMHAUT SCHLEIMHAUTTROPFEN SCHLEIMPROBENBEHAELTER SCHLEMMERDRINK SCHLEUDERHUELLE SCHLINGGAZETUPFER SCHLITZKOMPRESSEN SCHLUESSEL SCHLUESSELANHAENGER SCHLUESSELBLUMENTEE SCHLUESSELDREHHILFE SCHLUESSELHALTER SCHLUETER SCHLUMMER SCHLUPFSACK SCHMERZ SCHMERZBLOCKER SCHMERZLOS SCHMERZPUMPE SCHMIDT SCHMUSEDUFT SCHMUTZNIX SCHNABELBECHER SCHNABELTASSE SCHNARCH SCHNARCHERBINDE SCHNARCHOEL SCHNARCHSTOPPER SCHNAREXOL SCHNECKEN SCHNEEBERG SCHNEEKOPPE SCHNEIDEBRETT SCHNELLE SCHNELLVERBAND SCHNITTSTELLENKARTE SCHNUERSENKEL SCHNULLER SCHNULLERKETTE SCHNULLERTHERMOMETER SCHNUPFEN SCHOCKIES SCHOCKS SCHOELLKRAUT SCHOENHEITSBAD SCHOKO SCHOKOLADE SCHOKOMAXX SCHOLL SCHONBEZUG SCHORERS SCHORNDORFER SCHREIBGRIFFE SCHREIBHILFE SCHRITTZAEHLER SCHROEPFEN SCHROEPFGLAS SCHROEPFKOPF SCHRUNDENSALBE SCHUELLER SCHUERGERS SCHUERZEN SCHUETZE SCHUH SCHUHANZIEHER SCHUHAUSZIEHER SCHUHEINLAGE SCHUHLOEFFEL SCHUHUEBERZUG SCHULKREIDE SCHULTER SCHULTERBANDAGE SCHULTERGELENK SCHULTERPOLSTER SCHULTERSTUETZVERBAND SCHULTERTRAGETASCHE SCHUPP SCHUPPUR SCHUTZAUFLAGE SCHUTZBEZUG SCHUTZDECKE SCHUTZFINGERLING SCHUTZHANDSCHUHE SCHUTZHUELLE SCHUTZHUELLEN SCHUTZHYGIENESET SCHUTZLAETZCHEN SCHUTZMANTEL SCHUTZMASKE SCHUTZPFLASTER SCHUTZRINGE SCHUTZROLLI SCHUTZSCHAL SCHUTZSERVIETTE SCHUTZTUCH SCHUTZUEBERZUG SCHUTZUNTERLAGEN SCHWALHEIMER SCHWAMM SCHWANGER SCHWANGERSCHAFT SCHWANGERSCHAFTSBEGLEITENDER SCHWANGERSCHAFTSSTREIFEN SCHWANGERSCHAFTSTEST SCHWARZ SCHWARZE SCHWARZER SCHWARZES SCHWARZKUEMMEL SCHWARZKUEMMELOEL SCHWARZKUEMMELSAMEN SCHWARZKUEMMELTEE SCHWARZNESSEL SCHWARZRETTICH SCHWARZTEE SCHWARZWAELDER SCHWARZWALD SCHWARZWALNUSS SCHWEDENBITTER SCHWEDENKRAEUTER SCHWEDEN-TABLETTEN SCHWEDENTRUNK SCHWEDISCHES SCHWEF SCHWEFEL SCHWEFELBAD SCHWEFELPUDER SCHWEIZER SCHWENKHAHN SCHWERKRAFT SCHWERKRAFTSET SCHWESTERNHAUBE SCHWIMMKRAGEN SCHWIMMSCHUTZ SCHWOEKLIMAKT SCHWOENEURAL SCHWOERALGAN SCHWOERHEUMAL SCHWOEROCARD SCHWOEROCOR SCHWOERONERVAL SCHWOEROSIN SCHWOEROTOX SCILLA SCILLASE SCLERA SCLERAGO SCLERO SCLERON SCOLOPENDRIUM SCOOTER SCOPODERM SCORDIUM SCORODONIA-GASTREU SCOROTOX SCORPIO SCOTCHCAST SCOTT SCROFULAC SCROPHULAE SCROPHULARIA SCS SCULPTURELLE SCUTELLARIA SD SE SEA SEAFORCE SEAL SEAPOWER SEASORB SEAWEED SEBAMED SEBEXOL SEBIPROX SEBIUM SEBOPONA SEBORIN SECA SECALE SECALIN SECALOSAN SECALYSAT SECERNA SECONDARY SECURFIX SECURITEX SECUR-LOK SECUTAPE SEDA SEDACALMAN SEDACUR SEDAFUCON SEDAKATT SEDALIPID SEDAPLUS SEDARISTON SEDASAN SEDASELECT SEDATIVA SEDATIVE SEDATIVUM SEDATRUW SEDAX SEDIAT SEDICELO SEDIFIX SEDINERSAL SEDINFANT SEDNESA SEDOCARDIN SEDONIUM SEDOPRETTEN SEDOTUSSIN SEDOVENT SEDSANO SEDUM SEEALGEN SEEFELDER SEELEN SEEMANNSTAU SEESTERNE SEETHODAKA SEGUFIX SEIDENKLANG SEIFE SEIFEN SEIGLASE SEIRIN SEITENBEFESTIGUNG SEITENGITTER SEITENLAGERUNGSKEIL SEITENSCHONER SEITENWAND SEJUNGIN SEKRETBEUTEL SEKRETGLAS SEKRETOSYX SEKRETWECHSELBEUTEL SEKUSEPT SELBOL SELBSTSICHER SELDINGER SELECT SELECTOL SELECTOMYCIN SELECTOR SELEGAM SELEGILIN SELEJECT SELEM SELEMERCK SELEMUN SELEN SELENARELL SELENASE SELENBOLAN SELENE SELENIT SELENIUM SELENK SELENMINERASE SELENOKEHL SELENOMAX SELENOPRECISE SELEPARK SELFCAT SELGIMED SELIPRAN SELLAGEN SELLERIE SELMAS SELOKEEN SELOKEN SELON SELOZOK SELSUN SELTEC SELTRANS SELUKOS SELVITEAC SEMACO SEMI SEMIOSANA SEMPER SEMPERA SEMPERCARE SEMPERIT SEMPERLASTIC SEMPERMED SEMPERSOFT SEMPERVIVUM SEN SENADA SENCHA SENECIO SENEGA SENFSAMEN SENI SENICOR SENIOR SENIOREN SENIOVITA SENNA SENNESBLAETTERTEE SENSABILITY SENSI SENSIBAR SENSIBIO SENSICARE SENSICREAM SENSICUTAN SENSILUBE SENSIMAC SENSINERV SENSIOTIN SENSIT SENSITIV SENSITIVE SENSITOP SENSIVA SENSO SENSODERM SENSODYNE SENSOR SENSORANSCHLUSS SENSOREN SENTA SENTINA SENTINEX SEPIA SEPRAM SEPSO SEPTAACORD SEPTACORD SEPTANEST SEPTAPIN SEPTI SEPTO SEPTOCALCINE SEPTOCOLL SEPTODERM SEPTOGEL SEPTONSIL SEPTOPAL SEPTOQUICK SEPTUMKNOPF SEPTUMSCHIENE SEQUILAR SERAG SERAMAN SERATEC SERAVIT SERENOA SERETIDE SEREVENT SERI SERITAL SERMION SERN SEROQUEL SEROTONIN SEROXAT SERUM SERUMWERK SERVICEWAAGE SERVIX SERVO SERVOBOX SERVOCOMP SERVODERM SERVODUR SERVOFIX SERVOFLEX SERVOINJEKT SERVOLAN SERVOMED SERVOMULL SERVOPLAST SERVOPOR SERVOSILK SERVOTAPE SERVOTEST SERVOX SERVUS SESACUTON SESAMOEL SESAMSTRASSE SET SETAZYM SEVA SEVENSEYEWEAR SEVINORM SEVORANE SEXANORMA SEXUAL SEZIERMESSERGRIFF SEZIERMESSERKLINGE SFN SHAMPOO SHARPS SHARSHAPADEE SHATOME SHE SHEA SHEABUTTER SHEILA SHELDON SHIELD SHII SHIILING SHIITAKE SHIITAKIMMUN SHILEY SHITAKE SHITAKIMUN SHIZANDRA SHOPPINGTASCHE SHOWER SHOYNEAR SHUNT SI SIBELIUM SIBIRISCHER SIC SICCA SICCAPOS SICCAPROTECT SICCO SICHERHEITS SICHERHEITSGRIFF SICHERHEITSGURT SICHERHEITSKLAMMER SICHERHEITSKRUG SICHERHEITSNADELN SICHERHEITSSAUGER SICHERHEITSSLIP SICHERHEITSSTUETZGRIFF SICHERHEITSVERBINDER SICHERHEITSWANNENGRIFF SICHERUNGSRING SICHTBLENDE SICO SICORTEN SICSAC SICURA SIDDHALEPA SIDE SIDERIT SIDERITIS SIDESTREAM SIDROGA SIE SIEB SIEBEINSATZ SIEBEN SIEBPESSAR SIEGESBECKIA SIENA SIFA SIFLEX SIFROL SIGABLOC SIGABROXOL SIGACALM SIGACAP SIGACIMET SIGACORA SIGAFENAC SIGAMUC SIGAPERIDOL SIGAPRIM SIGAPROLOL SIGG SIGNAL SIGVARIS SIKA SIKAGRIPP SIKAPUR SIKKO SIL SILAMOX SILASIL SILASTIC SILASTOMED SILBER SILBERFISCHCHENSTOP SILBERKANUELE SILBERNE SILBERSPRECHKANUELE SILCARBIOL SILCATH SILENSOR SILENTAN SILENTFLOW SILEX SILFLATE SILGEL SILIA SILIBENE SILICA SILICATH SILICEA SILICIUM SILICODERM SILICOL SILICON SILICORE SILICUR SILIKON SILIKONFOLIE SILIKONSCHLAUCH SILIKONSPIRALTUBUS SILIKONTUBUS SILIMARIT SILISTAB SILIX SILKAFIX SILKIS SILKOFIX SILKOVENT SILKY SILKYMIT SILMAR SILOMAT SILON SILONDA SILSTAR SILVADOR SILVANA SILVAPIN SILVAYSAN SILVER SILVER-STOM SILVIKRIN SILY SILYBUM SILYMARIN SILYMARINE SIMAGEL SIMAPHIL SIMCARE SIMETHICON SIMPLA SIMPLASTIK SIMPLE SIMPLEJECT SIMPLEX SIMPLEY SIMPLOTAN SIMTEX SIMULECT SIMVA SIMVAAPS SIMVABETA SIMVACARD SIMVACOR SIMVADOC SIMVADURA SIMVAGAMMA SIMVAHEXAL SIMVASTATIN SINA SINAPIS SINAPSAN SINEI SINEMET SINEPRINT SINEQUAN SINFOKAL SINFRONTAL SINGLEFIX SINGLE-J SINGULAIR SINISTRO-GASTREU SINOPHENIN SINOPLAST SINPRO SINQUAN SINUC SINUFORTON SINUPAS SINUPLIN SINUPRET SINUS SINUSELECT SINUSITIS SINUSTAMPON SINUSYX SINUWIGA SIOFOR SIONON SIOZWO SIRAN SIRDALUD SIRIDERMA SIRIUS SIRMIA SIRMIOSTA SIROS SIRTAL SISARE SISEIDA SISNAUSAN SISSEL SISSI SITA SITOSTERIN SITTY SITZ SITZAUFLAGE SITZBAD SITZBADEWANNE SITZBALL SITZERHOEHUNG SITZFLAECHE SITZGURT SITZKEILKISSEN SITZKISSEN SITZRING SIXTA SIXTUFIT SIXTUMED SIXTUS SIXTUWOHL SKALPELL SKELID SKID SKIN SKINCEUTICALS SKINMAN SKINOCLEAN SKINOCYCLIN SKINOREN SKINSAN SKINSEPT SKINWONDER SKLERAN SKLEROSETROPFEN SKLEROVENOL SKORODIT SKORPION SKROFULOSE SL SLEEP SLEEPIA SLIG SLIM SLIMKO SLIMTABS SLING SLIPEINLAGE SLIPPIES SLIT SMARAGD SMELLIS SMELLSPRAY SMELLWELL SMERDS SMIG SMILE SMINT SMITH SMOKERS SMOKEY SMOOTHENING SNOEGG SNORFLEX SNUP SO SOACLENS SOAKTIV SOBELIN SOCKE SOCKENANZIEHER SOD SODA SODBRENNEN SODERM SOEHNGEN SOEHNLE SOEHNLEIN SOF SOFFBAN SOFNET SOFORT SOFRA SOFT SOFTA SOFTADERM SOFTALIND SOFTASEPT SOFTASKIN SOFTBINDE SOFTCLIX SOFTEC SOFTFLOW SOFTHAND SOFTIMA SOFTIMAC SOFTJECT SOFTLASER SOFTLIPS SOFTMED SOFTTAMPON SOFTWEAR SOGOON SOHLE SOJA SOJAFEM SOJALL SOJAMAN SOKRENA SOLAGEN SOLAGUTTAE SOLAN SOLANUM SOLAPSOR SOLARAZE SOLARIS SOLCO SOLCOSERYL SOLCOSPLEN SOLDAN SOLE SOLECTRON SOLEDUM SOLE-LATSCHENKIEFERN SOLEPFEIFE SOLFAC SOLGOL SOLIAN SOLI-CHLOROPHYLL-OEL SOLIDAGO SOLIDAGOREN SOLIDAGOSAN SOLIDEA SOLIGENTAL SOLO SOLOCARE SOLOFIX SOLOPOL SOLOSIN SOLU SOLUGASTRIL SOLUM SOLUNA SOLUPEN SOLUTIO SOLUTRAST SOLUVIT SOLVALINE SOLVEX SOLVITAN SOMA SOMAGEROL SOMALIND SOMAPLEX SOMAR SOMATOSTATIN SOMAVERT SOMCUPIN SOMISAN SOMMER SOMMERBRISE SOMMERFRISCHE SOMMERNACHT SOMMERNACHTSBAD SOMMERNACHTSTRAUM SOMMEROEL SOMMERWIND SOMNERVAL SOMNOCAP SOMNOCLICK SOMNOCOMFORT SOMNOGUARD SOMNOMASK SOMNOSAN SOMNOSMART SOMNOSTRAP SOMNOTONUS SOMNOTRON SOMNOWAVE SOMONA SOMSANIT SONADERM SONANA SONATA SONDALIS SONDEN SONDOMAT SONICARE SONIN SONIPICK SONNEN SONNENBLUMEN SONNENBLUMENKERNE SONNENBLUMENKERNOEL SONNENBLUMENOEL SONNENBRAUN SONNENHUT SONNENKRAFT SONNENOEL SONNENPFLEGEOEL SONNENSCHUTZLOTION SONNENSCHUTZTUCH SONNENTAU SONNENVITAMINE SONOCAN SONOCARE SONOFRESH SONOGEL SONOLIFT SONOSTAR SONOVUE SOPHIA SOPHTAL SORBACT SORBALGON SORBION SORBITOL SORBSAN SORIA SORMODREN SOROT SORTIS SORUSAL SOS SOSTRIL SOTA SOTABETA SOTAGAMMA SOTAHEXAL SOTALEX SOTALODOC SOTALOL SOTARYT SOTASTAD SOTAZIDEN SOUL SOVEL SOVENTOL SOY SOYA SOYAFEMIN SPA SPACE SPAGYRISCHE SPALT SPANNBETTBEZUG SPANNBETTLAKEN SPANNBETTUCH SPANNKAPPE SPANNRING SPARGEL SPARGELFIT SPARGELPULVER SPARTIOL SPARTIUM SPAS SPASCUPREEL SPASMALGAN SPASMAN SPASMEX SPASMO SPASMO-ENTOXIN SPASMOFIDES SPASMOFUGA SPASMOJECT SPASMOLYT SPASMOLYTICUM SPASMOMARTIN SPASMORELAX SPASMO-RHOIVAL SPASMOSYX SPASMOWERN SPASURET SPASYT SPATEL SPAZIERGANG SPEARMINT SPECIAL SPECIALIST SPECI-CHOL SPECIES SPECTRO SPECTROVEG SPECULA SPECULUM SPEEDICATH SPEIBECHER SPEICK SPEIKLAVENDEL SPEIKO SPEIKOCAL SPEIKOCOPAL SPEIKORANGE SPEIKOSEPT SPEISELAETZCHEN SPEKULUM SPELDORFER SPEMADOL SPEMANN SPENCO SPENDER SPENGLERSAN SPERMIX SPERSACARPIN SPERSADEX SPERSADEXOLIN SPERSALLERG SPERTI SPEZIAL SPEZIALDARMROHR SPEZIALKOMPRESSE SPEZIALSPRITZE SPHEREX SPICKER SPIELKARTEN SPIELKARTENSTAENDER SPIGELIA SPIGELON SPIK SPILAN SPILANTHES SPINAL SPINALKAN. SPINALKANUELEN SPINAT SPINOCAN SPINOPLANT SPIRAEA SPIRAL SPIRALLINIE SPIRAPHAN SPIREX SPIRITUS SPIRITUSLAMPE SPIRIVA SPIRO SPIROBETA SPIROGAMMA SPIROJECT SPIROL SPIRONO SPIRONOLACTON SPIRONOTHIAZID SPIROPENT SPIROPUR SPIRU SPIRUBAER SPIRUBONBON SPIRUCAL SPIRUCHROM SPIRUCOMPLEX SPIRUFE SPIRUFERRUM SPIRUFIT SPIRUKIDS SPIRULINA SPIRULINA+L SPIRUMANGAN SPIRU-PURE SPIRUSELEN SPIRUSKIN SPIRUZINK SPITACID SPITZBARTS SPITZFRAESER SPITZNER SPITZTUPFER SPITZWEGERICH SPITZWEGERICHHONIG SPITZWEGERICHKRAUT SPITZWEGERICHSAFT SPITZWEGERICHTEE SPIZEF SPLEN SPLENETIK SPLENUBENE SPLENUSOLAN SPLITKANUELE SPOLERA SPONDY SPONDYLAT SPONDYLON SPONDYLOSE SPONDYVIT SPONGIA SPONGOSTAN SPONSIN SPONWIGA SPORAL SPORANOX SPORLASTIC SPORT SPORT&WELLNESS SPORT+FITNESS SPORTAKTIV SPORTBETREUERKOFFER SPORTBEUTEL SPORTFLUID SPORTFRISCH SPORTGUARD SPORTINO SPORTKOFFER SPORTLER SPORTOEL SPORTSLIFE SPORTUBENE SPORTUPAC SPORTY SPORTYCOOL SPRACHLOS SPRACHVERSTAERKER SPRAY SPRECHVENTIL SPREEWAELDER SPREGAL SPREIZ SPREIZFUSSBANDAGE SPREIZHOESCHEN SPREIZHOSE SPREIZKEIL SPREIZWICKELFOLIE SPRING SPRITZEN SPRITZENPUMPENVERLAENGERUNG SPROSS SPROTTE SPRUDEL SPRUDELBAD SPRUDELTRINKBECHER SPRUDLER SPRUEHAUFSATZ SPRUEHKOPF SPRUNGGELENKBANDAGE SPRUNGGELENKSCHIENE SPRUNGGELENKSTUETZE SPRUNGPFERD SPRUNGTIER SPS SPUCKBECHER SPUCKFLASCHE SPUCKTASSE SPUELBEUTEL SPUELBUERSTE SPUNK SPUR SPURENELEMENTE SPUTUMBECHER SQUAMASOL SQUEEZY ST STAATLICH STABIGIB STABIL STABILISIERUNGSROLLE STABILIUM STABIMED STADA STADALAX STADAMED STAENDER STAHLFUEHRUNGSNADELN STAINEREASER STAL STALEVO STALORAL STAMARIL STAMORIT STAMP STAN STANDARD STANDARDKEGEL STANDGALGEN STANGYL STANILO STANNIODONSALBE STANNUM STAPES STAPHISAGRIA STAPHYLEX STAPHYLOCOCCINUM STAPHYLOCOCCUS STAR STARBRONZE STARFIT STARLIGHT STARLIX START STARTER STAS STASSFURTER STASTRA STATI STATT STAUBINDE STAUBKAMM STAUD STAUDOSAL STAURING STAURODORM STAX STAY STECHBECKEN STECKBRETT STECKLAKEN STEDIRIL STEFATOP STEHAUFTASSE STEICARDIN STEICORTON STEIFGAZEBINDEN STEINBACHS STEINBOCK STEINEXTRAKTOR STEINFANGKOERBCHEN STEINKLEE STEINSCHLEIFER STEIPROSTAT STEIROCALL STEIRODERM STEIROPLEX STEIROVIT STELLA STELLISEPT STENOCARDIE STENOCRAT STENOPTIN STENOSE STEPHALEN STEPIN STEPPES STERI STERIBLOCK STERICAN STERICOMP STERIL STERILBEZUG STERILES STERILISIERAPPARAT STERILLIUM STERILOTUPF STERILSET STERINOR STERIPAD STERIPAK STERISLIT STERISORB STERMUTU STERN STERNANIS STERNENDUFT STERNI STERNLIFE STERNSTUNDEN STERNUM STERNUMBIOPSIENADEL STERO STEROFUNDIN STERUMBIOPSIENADEL STERYL STESOLID STETHOSKOP STIBIUM STICHFREI STICHHEILER STICTA STIEFEL STIEFMUETTERCHEN STIELKAMM STIELTUPFER STIEMYCINE STIEPROX STIEPROXAL STIER STIFTE STIG STIGMATA STILLACOR STILLBUESTENHALTER STILLE STILLEINLAGEN STILLINGIA STILLKISSEN STILLOEL STILLTEE STILNOX STIM STIMMEN STIMOROL STIMU STIMULANCE STIMULATING STIMUPLEX STIMUTUR STIMUVIT STIRNTHERMOMETER STOCK STOCK- STOCKHALTER STOCKKAPSEL STOCKSCHLAUFE STOCKSITZ STODINAL STOEPSEL STOERTEBEKER STOFFCOVER STOFFWECHSEL STOFFWECHSELBAD STOFFWECHSELTROPFEN STOKO STOKODERM STOKOLAN STOKOMIN STOKOSEPT STOLLWERCK STOM STOMA STOMABOCOCIN STOMABOX STOMAC STOMACARE STOMACHICUM STOMACHIK STOMACHOL STOMACHYSAT STOMADRESS STOMAHESIVE STOMALEUCHTE STOMASAFE STOMASAN STOMEX STOMOCUR STONIE STOP STOPFEN STOPPY STORCH STORCHENSCHERE STORZ STOZZON STRAFF STRAFORTIN STRAGIN STRAHLENSCHUTZ STRAHLENSCHUTZHANDSCHUHE STRAMONIUM STRAMPELPETER STRAPPAL STRASSENSCHUH STRATA STRATH STRATUM STRAUSS STREICHELSPIEL STREIFEN STREP STREPTASE STREPTO STREPTOCCOCINUM STREPTOCOCCINUM STREPTOCOCCUS STREPTOKOKKEN STREPTOMYCIN STRESS STRESSKILLER STRETCH STRETCHBANDAGE STRETCHSLIPS STRETCHTAPE STRIA STRIATON STRIATRIDIN STRICKLEITER STROBBY STRODIVAL STROGEN STROHHALM STROMIC STRONG STRONGUS STRONTIUM STROPHACTIV STROPHANTAB STROPHANTHIN STROPHANTHUS STROPHANTHUS/ STROPHANTUS STROTAN STROVAC STRUCTOLIPID STRUMA STRUMATIK STRUMEEL STRUMPFANZIEHER STRUMPFANZIEHHILFE STRUMPFHALTER STRUMPFHOSE STRUMPFHOSENANZIEHER STRUVA STRYCHNINUM STRYPHNASAL STUD STUDIUM STUELPA STUETZ- STUETZBANDAGE STUETZKISSEN STUETZKLAPPGRIFF STUETZKNIESTRUEMPFE STUETZLEIBINDE STUETZROLLE STUETZSCHENKELSTRUEMPFE STUETZSTRUEMPFE STUETZSTRUMPFHOSE STUFEN STUFENBETT STUFENKEGEL STUFENKONNEKTOR STUFENLAGERUNGSHILFE STUHL STUHLAUFLAGE STUHLPROBEN STUHLUNTERSUCHUNGSROEHRCHEN STULLMATON STUMPF STUTENMILCH STUTVITAL STYLSLIM STYPRO STYPTIK STYPTYSAT STYRAX STYROPORKISSEN SUAN SUB SUBCUTAN SUBCUTIN SUBCUVIA SUBLINGUAL SUBLIVAC SUBOLIGO SUBREUM SUBSTIGAM SUCCINUM SUCCINYLCHOLIN SUCCOPULMON SUCONTRAL SUCRABEST SUCRALFAT SUCRAPHIL SUCTIONAID SUDOCREM SUEDSEETRAUM SUEDWIND SUESS SUESSDOLDE SUESSHOLZTEE SUESSHOLZWURZEL SUESSIN SUESSMANDELOEL SUEUESMOON SUGAR SUKRINETTEN SULARANA SULCUS SULCUSKEIL SULFADIAZIN SULFASALAZIN SULFODERM SULFOMOL SULFONAMID SULFRIN SULFUR SULFURELL SULGEN SULMYCIN SULPHUR SULPIRID SULPIVERT SULTANOL SUM SUMA SUMBI SUMBULUS SUMMAVIT SUN SUNCARE SUNLANCE SUNLET SUNNY SUNSWEET SUNVAL SUPA SUPACARE SUPER SUPER-BANISH SUPERBOLAN SUPERBRUSH SUPERCAROTIN SUPERGENUPLUS SUPERGLIDE SUPERLAXOL SUPERMINERAL SUPERMOUNTA SUPEROHTAKA SUPERPEP SUPERSLIP SUPERTENDIN SUPERWHITE SUPLA SUPLASYN SUPLENA SUPPENLOEFFEL SUPPLITT SUPPORTAN SUPRA SUPRACARE SUPRACLENS SUPRACOMBIN SUPRACYCLIN SUPRADYN SUPRAFRESH SUPRAMED SUPRANE SUPRANETTES SUPRAPUBISCHE SUPRAPUBISCHER SUPRAPUBISCHES SUPRARENIN SUPRASON SUPRASORB SUPRATHIA SUPRATONIN SUPRAVIRAN SUPRAVISION SUPRAX SUPRAZOL SUPRECUR SUPREFACT SUPREME SUPRIMA SURECAN SUREFUSER SURESKIN SURFASOFT SURFLASH SURFLO SURFONT SURGAM SURGI SURGICAL SURGICOLL SURGI-FIL SURGIFIX SURGINE SURGIPAD SURGISLIP SURGIVEST SURGUARD SURMONTIL SURNOX SUROGAT SURSHIELD SURVANTA SURVIMED SUSPENSOR SUSPENSORIEN SUSPENSORIUM SUSTIVA SUTOXOL SUTURE SUXILEP SUXINUTIN SV SVELT SWANSOL SWEAT SWEATOSAN SWEDE SWEET SWIVEL SYLASTEX SYLK SYLTER SYLVIN SYMADAL SYMBICORT SYMBIO SYMBIOFEM SYMBIOFLOR SYMBIOLACT SYMBION SYMBIOSTAD SYMONALE SYMPAL SYMPATHICUS SYMPATHIK SYMPHODENT SYMPHORICARPUS SYMPHYSEN SYMPHYSENBAND SYMPHYTUM SYNACTHEN SYNACTHENE SYNAPAUSE SYNAREL SYNARELA SYNCARPIN SYNCHROLINE SYNCHROROSE SYNEO SYNERCID SYNERGA SYNERGIQUES SYNERGON SYNERVIT SYNEUDON SYNOCROM SYNODERM SYNOVEDA SYNOVIA SYNPHASE SYNPHASEC SYNSATION SYNTARIS SYNTESTAN SYNTHAMIN SYNTHETIK SYNTHO SYNTOCINON SYNTON SYNUM SYNVISC SYPHILIUM SYRAMED SYREA SYSEUM SYSORB SYSPUR SYSTANE SYSTEM SYSTRAL SYVIMAN SYXAL SYXYL SYZYGIUM SZALAY T T2 TA TAB TABACUM TABALON TABARELL TABLAS TABLETTEN TABLETTENAUSDRUECKER TABLETTENBOX TABLETTENDOSE TABLETTENHALBIERER TABLETTENMOERSER TABLETTENSPENDER TABLETTENTEILER TABLETTENTURM TABOTAMP TABS TACHMALCOR TACHOLIQUIN TACHOTOP TACHYDARON TACHYSTIN TACTU TAFIL TAGAMET TAGESCREME TAGETES TAGONIS TAGTRAEUME TAHITI TAI TAIGA TAIGAWURZEL TAIGUTAN TAIKI TAKE TAKTODOR TAKTOSAN TAKUS TAKY TAL TALCID TALIDAT TALOXA TALSO TALUSIN TALVOSILEN TAMALINDE TAMANY TAMANYBONSAN TAMAPECT TAMARINDUS TAMBOCOR TAMIFLU TAMLOO TAMOKADIN TAMOPHAM TAMOX TAMOXIFEN TAMOXIMERCK TAMOXISTAD TAMOXIWIEB TAMPASEPT TAMPOGRASS TAMPON TAMPONA TAMPONADE TAMPONADEBINDE TAMPONADESTREIFEN TAMPOSIT TAN TANACET-HEEL TANACETUM TANATRIL TANDEM TANG TANGERINE TANGO TANITA TANNACOMP TANNALBIN TANNEN TANNENBAUM TANNENDUFT TANNENGOLD TANNENSIA TANNENZAPFEN TANNOLACT TANNOSYNT TANTUM TAOMED TAPE TAPEVERBAND TAR TARA TARALEON TARANTULA TARAXACUM TARDOCILLIN TARDYFERON TARGOCID TARGRETIN TARIVID TARKA TARMED TARR TARTARUS TARTEPHEDREEL TASCHE TASCHEN TASCHENFEILE TASCHENINHALATOR TASCHENKATHETERSET TASCHENLUPE TASCHENMASKE TASCHENSCHERE TASCHENTUECHER TATTOO TAUBNESSEL TAULIZ TAUREDON TAURIN TAUROLIN TAUSENDGUELDENKRAUT TAVANIC TAVEGIL TAVOR TAXILAN TAXOFIT TAXOL TAXOTERE TAXUS TAYGA TAZOBAC TD TDT TEA TEAM TEARS TEBASAN TEBESIUM TEBONIN TECHNOGEL TECNOL TED TEE TEEBAUM TEEFLASCHE TEELOEFFEL TEENY TEER TEESAUGER TEFILIN TEGADERM TEGAGEN TEGAPORE TEGASORB TEGRETAL TEGRETOL TEINACHER TELACOMP TELAPREP TELASLING TELASORB TELCOR TELE TELEBRIX TELELAST TELERGON TELETUBBIE TELETUBBIES TELFA TELFAST TELLER TELLERRAND TELLERRANDERHOEHUNG TELLURIUM TELOS TELTONAL TELZIR TEMA TEMAGIN TEMAZEP TEMEDIACELLBINDE TEMNO TEMODAL TEMP TEMPASEPT TEMPERATURFUEHLERSENSOR TEMPERATURFUEHLERSET TEMPIL TEMPO TEMPOLAX TEMPUR TENA TENASET TENCKHOFF TENDERCARE TENDERSKIN TENDERWET TENDO TENDO/ TENERETIC TENO TENORETIC TENORMIN TENS TENSIMED TENSIOMIN TENSITRUW TENSIVE TENSOBAN TENSOBON TENSOFLUX TENSOPLAST TENSOPLUS TENSOPRESS TENSOSTAD TENSOVAL TENTRINI TENUATE TEOTIHUACAN TEOTIHUACANOEL TEPAM TEPE TEPESCOHUITE TEPI TEPIGEL TEPILTA TEPUI TERA TERABLOCK TERANAR TERAZID TERAZOFLO TERAZOSIN TERBUL TERBUTALIN TEREBINTHINA TERFEDURA TERFEMUNDIN TERFENADIN TERIZIDON TERMOKUEL TERRA TERRACORTRIL TERRADERM TERRAKRAFT TERRAMYCIN TERRAZYM TERUFUSION TERUMO TERUSAFE TERZOLIN TESLASCAN TESOPREL TESTA TESTAKTIV TESTERELL TESTES TESTES/ TESTICULUS TESTIS TESTOGEL TESTOMIN TESTOSTERON TESTOVIRON TESTSTREIFEN TETANOL TETANUS TETESEPT TETHEXAL TETRA TETRACYCLIN TETRAGYNON TETRAMDURA TETRARELAX TETRAVAC TETRAZEP TETRAZEPAM TETRILIN TETRISAL TEUCRIUM TEUFEL TEUFELSKRALLE TEVETEN TEXTIL TEXTUS TEXX TG THALAMUS THALASSO THALLIUM THAM THANAKA THAPSIA THE THEA THEANIN THEISS THENARDIT THEO THEOLAIR THEOMOL THEOPHYLLIN THERA THERABAND THERABITE THERABREATH THERAMED THERAPEP THERAPIE THERAPIEBAENDER THERAPIEBALL THERAPIEBAND THERAPIEKITT THERAPIEKNETE THERAPIESCHUH THERAPIETISCH THERASTICK THERAVAC THERAZYM THERIDION THERM THERMAL THERMO THERMO-AKKU THERMOBECHER THERMOGENE THERMOKISSEN THERMOMETER THERMOPAPIER THERMOPIN THERMOPLAST THERMOSENEX THERMOVAL THERMOVENT THESIT THETA THEVIER THIABET THIAMAZOL THIAMIN THIASIL THIAZID THICK THILO THILOADREN THILOCANFOL THILODIGON THILORBIN THIO THIOBITUM THIOCTACID THIOGAMMA THIOGUANIN THIOGUANINE THIOLASE THIOPENTAL THIORIDAZIN THIOSINAMINUM THIOTEPA THOHELUR THOMAEAMIN THOMAEDEX THOMAEGELIN THOMAEJONIN THOMAEMANNIT THOMAPYRIN THOMASIN THOMBRAN THORAXKATHETER THORNTON THRESHOLD THROMBAREDUCT THROMBEXIN THROMBOCID THROMBOCUTAN THROMBOCYTEN THROMBO-GASTREU THROMBOPHOB THROMBOSE THROMBOSEN THUERINGER THUJA THUJACTIV THUJARELL THYBON THYM THYMIAN THYMIANKRAUTTEE THYMIANTEE THYMIPIN THYMIVERLAN THYMO THYMOGLANDAM THYMOGLOBULIN THYMOJECT THYMOPECT THYMOPHYSIN THYMORELL THYMU THYMUS THYMUS/ THYM-UVOCAL THYPROTECT THYREO THYREOBAL THYREOCOMB THYREODORON THYREOGUTT THYREOIDEA THYREOIDEA/ THYREOIDINUM THYREOSTAT THYREOTOM THYREOTROP THYROLIBERIN THYRONAJOD THYROPHAN THYROTARDIN-INJECT THYROZOL TIAL TIAMON TIAPRID TIAPRIDAL TIAPRIDEX TIARE TIBET TIBETAN TIBETISCHES TIBETO TICLO TICLOPIDIN TICODOLOR TIE TIEGEL TIELLE TIEMANN TIERBERUHIGUNGSSAUGER TIERFORM TIFLEX TIGER TIKLID TIKLYD TILADE TILI TILIA TILICOMP TILIDALOR TILIDIN TILIDURA TILIGETIC TILIMERCK TILNALOX TILSON TIM TIMA TIME TIMELESS TIMEUPHRASIN TIMO TIMOHEXAL TIMOLOL TIMOMANN TIMONIL TIMOTEI TIMOX TIMPILO TINATOX TINGELHOFF TINNIMED TINNITUS TINSET TINTI TINY TIOALGA TIORFAN TIOVIT TIP TIRGON TIROLER TISCH TISCHHALTERUNG TISCHRECHNER TISCHSTAENDER TISCHSTATIV TISCHWECKER TISPOL TISSUCONE TISSUDURA TISSUFLEECE TISSUFOIL TISSUPOR TITACATH TITAN TITANIUM TITANPORT TITMUS TITRALGAN TITRETTA TIVA TIVOLI TMP TMS TNA TOBI TOBRA TOBRAMAXIN TOCO TOCOPLUS TOCORELL TOCOTRIENOLE TOCOVITAL TODAY TODDYS TOE TOELZER TOEPFER TOETH TOFRANIL TOGAL TOGASAN TOGU TOILETTENAUFLAGE TOILETTENAUFSATZ TOILETTENBRILLEN TOILETTENEIMER TOILETTENHOCHSITZ TOILETTENROLLSTUHL TOILETTENSITZ TOILETTENSITZERHOEHER TOILETTENSITZERHOEHUNG TOILETTENSITZGESTELL TOILETTENSTUETZGESTELL TOILETTENSTUHL TOKALON TOKO TOL TOLBUTAMID TOLID TOLLWUT-IMPFSTOFF TOLNAFTAT TOLU TOLUIDINBLAU TOLUPECT TOLVIN TOM TOMATE TOMATEN TOMATENROT TOMATENSUPPE TOMESA TOMESOL TOMISAL TONALIN TONCARD TONDINEL TONERDE TONERDEMASKE TONG TONGA TONIC TONICO TONIFORM TONIZIN TONKA TONKABOHNE TONOFTAL TONSI TONSILGON TONSILLA TONSILLAE TONSILLARPFROEPFE TONSILLITIS TONSILLOPAS TONSILLOSYX TONSIOTREN TONSIPRET TONUSTAB TOP TOPAMAC TOPAMAX TOPAS TOPFIT TOPFITZ TOPIBIOTIN TOPIGEL TOPIK TOPINAMBUR TOPINOX TOPISOLON TOPPER TOPSCRUB TOPSY TOPSYM TOPTEX TORACARD TORADIUR TORASEMID TOREM TORF TORMENTILLA TORNIX TORRAT TORUS TOTAL TOTALCARE TOTES TOTOCORTIN TOTRAUMVERGROESSERER TOUHY TOVENE TOX TOXEX TOXI TOXICERNA TOXIMER TOXISELECT TOXOGONIN TOXOPLIN TOXOROBAL TP TPE TRABECULUM TRACH TRACH.KANUELE TRACHEA TRACHEAL TRACHEALSPREIZER TRACHEALTUBUS TRACHEO TRACHEOFIX TRACHEOFOAM TRACHEOLIFE TRACHEOPORT TRACHEOSOFT TRACHEOSPREIZER TRACHEOSTOMA TRACHEOSTOMIE TRACHEOTEX TRACHI TRACITRANS TRACLEER TRACOE TRACRIUM TRACTOCILE TRACUTIL TRADELIA TRADOL TRADON TRAENE TRAENENFLUSSREGLER TRAEUMSUESS TRAGE TRAGEGURT TRAGEKOFFER TRAGELAKEN TRAGENGURT TRAGENLAKEN TRAGETASCHE TRAMA TRAMABETA TRAMADOC TRAMADOL TRAMADOLOR TRAMADURA TRAMAGETIC TRAMAGIT TRAMAL TRAMAWIEB TRAMUNDIN TRANCOPAL TRANQUASE TRANQUILITY TRANS TRANSA TRANSAFIX TRANSANNON TRANSAPORT TRANSBRONCHIN TRANSELAST TRANSFERCONNEKTOR TRANSFERHILFE TRANSFERSET TRANSFIX TRANSFLAC TRANSFUSIONSGERAET TRANSFUSIONSSET TRANSPORE TRANSPORT TRANSPORTTASCHE TRANSPULMIN TRANSURETHRALER TRANSURETHRALES TRANXILIUM TRAPANAL TRASICOR TRASITENSIN TRASITENSINE TRASYLOL TRAUBENEXTRAKT TRAUBENKERN TRAUBENKERNE TRAUBENSILBERKERZE TRAUBENZUCKER TRAUDELS TRAUER TRAUMA TRAUMA-CYL TRAUMAKATT TRAUMANASE TRAUMAPLANT TRAUMASENEX TRAUMASEPT TRAUMASIVE TRAUMATA TRAUMEEL TRAUMENSALBE TRAUMHAFT TRAUMON TRAUMREISE TRAVABON TRAVATAN TRAVEL TRAVELMED TRAVELNEB TRAVELSOX TRAVOCORT TRAXATON TRAXIT TRAY TRAZODON TREDALAT TREGOR TREKKING TRELOC TREMARIL TREMARIT TRENANTONE TREND TRENNUNGSSCHMERZ TRENTAL TREPRESS TREVILOR TRH TRI TRI.-THIAZID TRIAKTIVIN TRIAM TRIAMGALEN TRIAMHEXAL TRIAMIT TRIAMPUR TRIAMTEREN TRIAPTEN TRIARESE TRIASTONAL TRIATEC TRIAZID TRIBULUS TRICHINOYL TRICHLOROL TRICHTER TRICODUR TRICOFIX TRICOPLAST TRICOT TRIDIN TRIENOCT TRIETTE TRIFIT TRIFLEX TRIFLUMANN TRIFORM TRIGASTRIL TRIGOA TRIGONELLA TRIGONUM TRIGYNON TRIJODTHYRONIN TRIKO TRIKOTSCHLAUCHBINDE TRILEPTAL TRILLIUM TRILOC TRIMIDURA TRIMINEURIN TRIMIPRAMIN TRIND TRINITON TRINITROSAN TRINK TRINKBECHER TRINKGELATIN TRINKGELATINE TRINKHALME TRINKROHR TRINORDIOL TRI-NORMIN TRINOVIN TRINOVUM TRIO TRIONIC TRIPHALA TRIPLE TRIQUILAR TRISANA TRISENOX TRISEQUENS TRISISTON TRIS-KONZENTRAT TRISTEP TRI-S-ZYM TRITICUM TRI-TORRAT TRITTFREQUENZMESSER TRIVASTAL TRIVITAMIN TRIXO TRIZIVIR TRO TROJECTOR TROKARKATHETER TROMCARDIN TROMETHAMOL TROMLIPON TROMPHYLLIN TROPAEOLUM TROPE TROPFENSENSOR TROPFENWINKEL TROPFENZAEHLER TROPFSTOP TROPFSTOPP TROPFURINAL TROPHICARD TROPHOSAN TROPONIN TROPT TROSPI TROXERUTIN TROXEVEN TRU TRUGUIDE TRULAP TRUNCUS TRUSOPT TRUW TRUXAL TRYASOL TSCHAMBA-FII TTS TUBA TUBER TUBERCULINUM TUBERKULIN TUBERKULINTEST TUBEROSE TUBIFAST TUBIGRIP TUBINETTE TUBOCURARE TUBULCUS TUBUSVERLAENGERUNG TUCH TUCHMATTE TUEBINGER TUECHER TUERKISCH TUIM TULIPA TULOTRACT TULPEN TULSI TUMA TUMAROL TUMOGLIN TUMORSCHIENE TUNGS TUNICA TUNYA TUO TUPFER TUPFERBEFEUCHTER TUR TURBO TURBOLINE TURBOSTARTER TURFA TURIMONIT TURIMYCIN TURINEURIN TURIXIN TURNERA TUSS TUSSAFUG TUSSAMAG TUSSED TUSSIDERMIL TUSSIFLORIN TUSSILAGO TUSSINFANT TUSSISANA TUSSISTIN TUSSORET TUTOFUSIN TUTOPLAST TUTTI TUTTIFRUTTI TUTTOZEM TV TWIN TWINADAPTER TWINRIX TWISTOFF TYOL TYOSAL TYPHIM TYROSIN TYROSUR UBICHINON UBICOMP UBISTESIN UBITEC UBRETID UCS UD UDC UDICIL UDIMA UDM UDR UDRAMIL UDRIK UEBE UEBERFUEHRUNGSHILFE UEBERHOSE UEBERKINGER UEBERLEITGERAET UEBERLEITSYSTEM UEBERLEITUNGSGERAET UEBERLEITUNGSKANUELEN UEBERMATRATZE UEBERSCHUHE UEBERZIEHSCHUHE UEBERZUG UEBUNGEN UEBUNGSBOEGEN UFLEX U-FOAM UFT U-GURT UK U-KATH U-KON ULCERCARE ULCO-CYL ULCOGANT ULCU ULCURILEN ULCUS ULFIRY ULI ULKUR ULLUS ULMA ULMER ULMUS ULNARE ULNOR ULTEC ULTILAC ULTIMA ULTIMATE ULTRA ULTRABAS ULTRACAIN ULTRACARBON ULTRACLEAN ULTRACORTENOL ULTRAFIT ULTRAFREE ULTRAJEKT ULTRAKLAR ULTRAKURZZUGBINDE ULTRALAN ULTRALIP ULTRANA ULTRAPHIL ULTRASCHALL ULTRASHEER ULTRASICC ULTRASITE ULTRASONEX ULTRASUN ULTRATARD ULTRAVIST ULTRAZYME ULTREON UMANE UMBICULUS UMCKALOABO UMFANGSMESSBAND UNA UNACID UNALTA UNAT UNCARIA UNDERCOVER UNDERPAD UNEXYM UNGUENTACID UNGUENTOLAN UNGUENTUM UNI UNICARE UNIFINE UNIFIX UNIFLEX UNIGAMOL UNIGLOVES UNIHAFT UNIJECT UNILAIR UNILET UNILUX UNIMAX UNIPHYLLIN UNIPOLAR UNIQUE UNISAFE UNISALIN UNISELEN UNISOFT UNISPEC UNISTIK UNIVERSAL UNIVERSALADAPTER UNIVERSALBINDE UNIVERSALGRIFF UNIVERSALHALTEGRIFF UNIVERSALHALTERUNG UNIVERSALMESSER UNIVERSUM UNIZINK UNIZYME UNMUTU UNO UNOMED UNOPLAST UNOTEX UNTER UNTERARMGEHSTUETZE UNTERARMKRUECKE UNTERARMSTUETZE UNTERLAGE UNTERLEGPOLSTER UNTERSCHENKELLAG.SCHIENE UNTERSCHENKELLAGERUNGSSCHIENE UNTERSUCHUNGSFINGERLINGE UNTERSUCHUNGSHANDSCHUHE UP UPELVA UPLIFT U-PREP UPRIMA UR URALYT URATAPE URATON URBA URBAN URBASE URBASON UREA UREATA UREM UREOFIX UREOTOP URESIN URETER URETERALADAPTER URETER-BOUGIERSET URETEROPLAST URETERSCHIENE URETERSCHIENEN URETHRA URGENIN URGENS URGO URGOBAND URGOCOR URGODERM URGOFILM URGOFIX URGOFLEX URGOHAFT URGOKLEBER URGOLAN URGOLAST URGOMULL URGOPAD URGOPLAST URGOPORE URGOSOFT URGOSORB URGOSPORT URGOSTRAPPING URGOSTRIPS URGOSYVAL URGOTUBE URGOTUEL URGOTUPFER URGOWUND URGOZINK URGRAS URI URIBAG URIBENZ URICOSYX URICULT URIDUCT URIEL URIFIX URIHESIVE URIMAC URIMED URIMETER URIN URIN/SEKRET URINAL URINALHAFTSTREIFEN URINAR URINARE URINBECHER URINDRAINAGEBEUTEL URINDRAINAGESYSTEM URINELLE URINFLASCHE URINFLASCHENTRAEGER URINGEFAESS URINGLAS URINMESS URINMESSGERAET URINOCOL URINSAMMELGEFAESS URINSAMMELGLAS URINSCHIFFCHEN URINVASE URION URIPHON URIPLAN URIPLUS URISTIX URITAPE URITEST URITOP URO UROCARE UROCLEAN UROCOM URODYNAMIK UROFLO UROFOSSAT UROGARD UROGOMULL UROKATT UROKINASE UROKIT UROL UROLIX UROLUX UROMATE UROMATIC UROMED UROMETER UROMETHIN UROMITEXAN UROMYKOL URONET URONOR URONOVIS UROPLANT UROPOL URORENAL UROSAFE UROSANA UROSELECT UROSPASMON UROSTAND UROTECH UROTRACTAN UROTRUW UROVISION UROXATRAL UROZOSIN URSO URSOCHOL URSOFALK URSOMIX URSOVITAL URSULAN URTIAS URTICA URTIVIT URUPAN URVITAL USKAN USNEA USNEABASAN USTILAGO USTILAKEHL USUCOR UT UTEROBRUSH UTERUS UTILIN UTK UTROGEST UTROGESTAN UV UVA UVALYSAT UVAU UVB UVEA UVESOL UVIRGAN UWOBLETTEN UZARA V VA VAC VACCININUM VACCINIUM VACU VACULIFT VACURECT VACUSEAL VADEMECUM VADORMED VAGANTIN VAGI VAGICILLIN VAGIFEM VAGIMID VAGIMORAN VAGINA VAGINAE VAGINAL VAGINALDEHNER VAGINALKUGELN VAGINALSONDE VAGINALSTENT VAGISAN VAGITRON VAKUUM VAKUUMFLASCHE. VALACLEAN VALAFIT VALAMASK VALAPLAST VALAPOR VALATEX VALBIL VALCYTE VALDENTI VALDISPERT VALERIANA VALETTE VALGO VALGULOC VALIQUID VALIUM VALOCORDIN VALORON VALPRO VALPROAT VALPRODURA VALPROFLUX VALPROINSAEURE VALPROLEPT VALPRONA VALTREX VALU VALVA VALVERDE VALVULA VAMP.STAMP VAN VANADIUM VANADYL VANCO VANCOMYCIN VANDRAL VANILLA VANILLE VAOPIN VAPORISATOR VAQTA VARI VARICEX VARICOSAN VARICYLUM VARIDASE VARIFOAM VARIHESIVE VARILIND VARIMATE VARIN VARIO VARIOLINE VARIOSUN VARISATIONS VARISMA VARIX VAROLAST VASA-GASTREU VASCAL VASCO VASCU VASCUSEL VASELIN VASELINE VASELITULLE VASENOL VASESANA VASO VASOCAN VASOFIX VASOMOTAL VASOPOS VASOSAN VASOTONICUM VASTRIBIL VATA VATERSCHAFTSTEST VAUBROLAX VAUCHERIA VAXICUM VB VCM VECOVA VECTAVIR VECURONIUM VEDERNJAK/JUHASZ VEET VEGABOLAN VEGEFLEX VEGETAR VEGIFERRUM VEILCHEN VEILCHENWURZEL VELA VELADERM VELBAND VELCADE VELEMINT VELESSE VELIND VELOPURAL VELOSULIN VELVET VEN VENA VENAHAFT VENALITAN VENALOT VENAPERDUR VENAPERT VENAPERTAN VENAPLAST VENELBIN VENEN VENENBESTECK VENENDRUCK VENENGEL VENENKISSEN VENENLEIDEN VENENMITTEL VENENPUNKTIONSKANUELE VENENSORIN VENENSTAUER VENENTAB VENENTABS VENENTRAINER VENEN-UND VENENVERWEILKANUELEN VENENVERWEILKATHETER VENERE VENESSO VENEX VENI VENI-DUR VENO VENOBEN VENOBIASE VENOCUX VENODILAT VENODURA VENOFA VENOFER VENOKATT VENOMENHAL VENOMIL VENOPAS VENOPHAN VENOPLANT VENOPYRONUM VENORBIS VENORELL VENORUTON VENOSAN VENOSCHAUM VENOSELECT VENOSIN VENOSTASIN VENOTRAIN VENOTRULAN VENOXAL VENTA VENTAO VENTIL VENTILASTIN VENTILAT VENTOLAIR VENTRACID VENTRI VENTRICON VENTRICULUS VENTRIGUTT VENTURI VENUS VENUSKIN VENUSURKICHER VEPESID VERA VERABETA VERAGAMMA VERAHEXAL VERAMEX VERANORM VERAPAMIL VERAPOL VERASAL VERATIDE VERATRUM VERAVITA VERBA VERBANDFOLIE VERBANDKASSETTE VERBANDKASTEN VERBANDKISSEN VERBANDKLAMMERN VERBANDKOFFER VERBANDKOMPRESSEN VERBANDMITTELSET VERBANDMULL VERBANDPAECKCHEN VERBANDPFLASTER VERBANDSCHERE VERBANDSCHRANK VERBANDSCHRANK. VERBANDSCHUH VERBANDSET VERBANDSTOFF VERBANDSTOFFFUELLUNG VERBANDSTOFFSPENDER VERBANDSTOFFUELLUNG VERBANDTASCHE VERBANDTUCH VERBANDWATTE VERBANDWECHSELSET VERBANDZELLSTOFF VERBAPLAST VERBASCUM VERBENA VERBINDER VERBINDUNGSGURT VERBINDUNGSLEITUNG VERBINDUNGSSCHLAUCH VERBINDUNGSSTUECK VERBRAUCHSMITTELSET VERDAUUNGS VERDAUUNGSELIXIER VERDAUUNGSTONIKUM VERDUENNER VERDUENNUNGSLOESUNG VERFA VERFACOLOR VERGENTAN VERIFRESH VERINTEX VERKEHRSSTOCK VERLA VERLADYN VERLAENGERUNGSGURT VERLAENGERUNGSLEITUNG VERLAENGERUNGSSCHLAUCH VERLAENGERUNGSSET VERLAENGERUNGSSTREIFEN VERMICULITE VERMOX VERMURO VERMUZZ VERNEBLER VERNEBLERKAMMER VERNEBLERMUNDSTUECK VERNEBLERSET VERNEBLERTOPF VERNEBLERVENTIL VERNUELEN VERO VERONICA VEROPTINSTADA VEROSON VEROSPIRON VERRES VERRUCID VERRUMAL VERSAL VERSATUS VERSCHLUSS VERSCHLUSSDECKEL VERSCHLUSSKAPPE VERSCHLUSSKONEN VERSCHLUSSSTOPFEN VERSIVA VERSTEIFUNGSKANUELE VERSTIMMUNGEN VERSTOPFUNG VERTEBRA VERTEBRADYN VERTEBRAL VERTIGO VERTIGOHEEL VERTIGOMARTIN VERTIGOPAS VERTIGOTROPFEN VERUM VERVEINE/EISENKRAUT VERWOEHN VERWOEHNDICH VESANOID VESDIL VESICA VESIHERB VESIKUR VESPA VESTA VESTAGEL VESTASAN VESTASOL VESTATEX VETAB VETIVER VETIVEROEL VETREN VEXOL VFEND VIA VIABOL VIACELL VIAFLEX VIAGRA VIAL VIALOG VIAMINO VIANI VIAPUR VIASAN VIASORB VIATIM VIBA VIBAMIN VIBOLEX VIBRACELL VIBRADERM VIBRAMYCIN VIBRATIONS VIBRO VIBURCOL VIBURNUM VICARTIN VICHY VICOFERELL VICOLON VICORDIN VICRYL VIDAL VIDEO VIDEX VIDIRAKT VIDISEPT VIDISIC VI-E VIER VIERFUSSGEHILFE VIERFUSSGEHSTUETZE VIERPUNKT VIETA VIGANTOL VIGANTOLETTEN VIGODANA VIHAUBAL VILJA VILLA VILLE VILOCUR VILOVERA VILOX VILUNA VIMERE VINBLASTIN VINBLASTINSULFAT VINCA VINCAMIN VINCETOXICUM VINCO VINCRISTIN VINCRISTINSULFAT VINELL VINO VINOBENE VINOCELL VINOY VINUM VINYL VINYLHANDSCHUHE VINYLSCHLAUCH VIOL VIOLA VIOMIN VIONELL VIOXX VIOXXDOLOR VIP VIPERA VIPRATOX VIQU VIRACEPT VIRAGIL VIRAMUNE VIRAX VIRAZOLE VIREAD VIRGAMELIS VIRIDAL VIRIDIS VIRILIS VIRILIT VIRILITY VIRITEEN VIRO VIROBIN VIROPECT VIRU VIRUBACT VIRUDERMIN VIRUNGUENT VIRUPOS VIRUSEEN VIRZIN VISADRON VISAN VISANO VISC VISCASAN VISCO VISCOAT VISCOHEEL VISCOL VISCOPED VISCOSEAL VISCOSPOT VISCUM VISCUM/BRYONIA VISI VISI-ESOFT VISI-INTEGRAL VISIOCATH VISIODRAIN VISIOFIX VISIOFLUX VISIOKON VISIOL VISIOLIX VISIOMAX VISION VISIOSTAR VISIOSTENT VISIPAQUE VISISOFT VISKALDIX VISKEN VISLUBE VISMED VISOCOR VISOLA VISOMAT VISTAGAN VISTHESIA VISTIDE VISTIL VISTOXYN VISUDYNE VIT VIT. VITA VITABIOTIN VITABIT VITABRAUN VITACIDOPHILUS VITADRAL VITAFERRO VITAFLUID VITAGARTEN VITAGEL VITAGNOST VITAGOLD VITAGREENS VITAGUTT VITAHES VITAHYDROLYSAT VITAION VITAKONZEPT VITAL VITALBAD VITALDRINK VITALEVRE VITALGEL VITALIMED VITALIPID VITALIS VITALITY VITALIVE VITALMED VITALOBACT VITALOG VITALOGRAPH VITALONGA VITALP VITALSED VITALSTOFF VITALSTOFFKOMPLEX VITALTONIKUM VITALUX VITAMAG VITAMENTAL VITAMIN VITAMINCHEN VITAMINERAL VITAMINS VITAMINUS VITAMOBIL VITAMOL VITAMUN VITANA VITAPLUS VITAPOWER VITARENAL VITARGO VITARO VITAROYAL VITASAN VITASANA VITASPRINT VITASPUR VITASTAD VITASUNRISE VITATRANS VITATRONIC VITATRUM VITAVERLAN VITAWIN VITAX VITAZELL VITAZINK VITEC VITEK VITEST VITIS VITIVEN VITIX VITMERI VITMINERAL VITOSAL VITOTAL VITRASERT VITRENA VITREOLUX VITREX VITS VIVA VIVALAN VIVAQUELL VIVENTIS VIVIANIT VIVIDRIN VIVIL VIVILACT VIVIMED VIVINOX VIVISCAL VIVIVIT VIVURAL VLESI VLIESBESCHICHTUNG VLIESHUELLEN VLIESKITTEL VLIESKOMPRESSEN VLIESSTOFF VLIESVORLAGE VLIESWINDELN VLIKO VLIWAKTIV VLIWASOFT VLIWAZELL VLIWIN VM VOBADERM VOBAMYK VOCO VOCORWEN VOEMEL VOGUE VOICE VOL.INFUSIONSPUMPE VOLDYNE VOLL VOLLMERS VOLLMOND VOLLWERT VOLLWERTKOST VOLMAC VOLON VOLONIMAT VOLTAREN VOLTARENE VOLTAX VOLUMA VOLUMED VOLUVEN VOLVIC VOMACUR VOMEX VOMI VOMITUSHEEL VORFUSSENTLASTUNGSSCHUH VORINA VORLAGE VORTEX VORTEXPORT VOTUM VOWEN VRP VS V-TABLOPEN VTHE VULNOSORB VULNOSTIMULIN VULPUR VYGON VYGONUELE WAAGE WACH WACHOLDER WACHOLDERBEER WACHOLDERBEERE WACHOLDERBEEREN WACHOLDERBEERENTEE WACHOLDERHOLZ WACHTELFROH WADEN WADENSCHUTZ WADENSTRUMPF WADENSTUECK WAERME WAERME/KAELTE WAERMEBETT WAERMEKISSEN WAERMENDES WAERMEPACK WAERMEPACKUNG WAERMEROLLE WAERMESCHUTZFOLIE WAERMESTRAHLER WAERMFLASCHE WAESCHE WAFFLE WALDBEEREN WALDDUFT WALDHONIG WALDSPAZIERGANG WALKMED WALNUSS WALTERS WAMBO WANDBODENSTUETZGRIFF WANDKLAPPGRIFF WANDLIFTER WANDSPENDER WANG WANGS WANNEN WANNENBRETT WANNENDUSCHSITZ WANNENSITZ WAPPEN WARENAL WARIACTIV WARM WARME WARMHALTEBOX WARMHALTETELLER WARTEC WARTNER WARZ-AB WARZEN WASA WASCH WASCH- WASCHBECKENSTUETZGRIFF WASCHEN WASCHHANDSCHUHE WASCHLAPPEN WASCHLOTION WASCHMITTEL WASCHTUCH WASSER WASSERFALLE WASSERFILTER WASSERHALTIGE WASSERKISSEN WASSERMANN WASSERMATRATZE WASSERSTOFFPEROXID WASSERWAAGE WATER WATERJEL WATERPIK WATTE WATTEBAELLE WATTEGLAS WATTEKUEGELCHEN WATTEPADS WATTEROLLE WATTESTAB WATTESTAEBCHEN WATTETAMPONS WATTETRAEGER WATTETUPFER WB WC WD WEBKANTMULLBINDEN WECESIN WECHSELDRUCK WECHSELDRUCKKISSEN WECHSELDRUCKKOMPRESSOR WECHSELDRUCKMATRATZE WECHSELDRUCKMATRATZEN WECHSELDRUCKSYSTEM WECHSELSET WECKAPPARAT WEGA WEHAFIX WEICHE WEICHLAGERUNGSKISSEN WEICHMASKE WEICHTEILBIOPSIE WEIDENRINDE WEIDENROESCHENKRAUT WEIGHT WEIHNACHTEN WEIHNACHTSBAER WEIHNACHTSDUFT WEIHNACHTSFRUECHTE WEIHNACHTSOEL WEIHNACHTSTUCH WEIMERQUIN WEINBLAETTER WEINDRICH WEINEXTRACT WEINGUMMI WEINLAUB WEINRAUTE WEISSDORN WEISSDORNBLAETTER WEISSDORNTEE WEISSE WEISSER WEISSES WEISSKOHL WEISSTANNE WEISSTANNENOEL WEITHALSFLASCHEN WEIZEN WEIZENFLAKES WEIZENGRAS WEIZENKEIM WEIZENKEIME WEIZENKEIMOEL WEIZENKLEIE WEKO WEKOMED WELEDA WELL WELLA WELLAFLEX WELLAFORM WELLAND WELLION WELLNESS WELLNOISE WELLVONE WELTECKES WELTER WENDEHILFE WENENWOHL WENN WERDER WERMUT WERMUTKRAUT WERMUTTEE WERO WEROCIN WERODON WEROLIN WEROMED WEROPYROL WEROSEPT WEROTUSSIN WESPEN WESPENSTOP WET WETBELL WEWA WHEAT WHEY WHITE WIBA WIBOPHORIN WIBOTIN WICK WICKEL WICKELFOLIEN WICKELTISCHSTRAHLER WIDDER WIDMER WIE WIEDEMANN WIEDER WIEDERS WIEDIMMUN WIEFRISCH WIEGEMESSER WIEGENLIEDER WIEMANNS WIENER WIESENBADER WIESENKOENIGIN WIESENKRAEUTER WIKINGER WILA WILD WILDAPFEL WILDE WILDFRUCHT WILDKIRSCH WILDKRAEUTER WILDKRAEUTEROEL WILDROSE WILDROSENOEL WILDUNGER WILHA WILKINSON WILPRAFEN WIN WINAR WIND WINDEL WINDELHOESCHEN WINDELHOSEN WINDELN WINDOL WINDSAFTERL WINDSALBE WING WINKELGRIFF WINTER WINTERBALSAM WINTERFREUDE WINTERFREUDEN WINTERMAERCHEN WINTERNACHT WINTERTAG WINTERTEE WINTERTRAEUMEREI WINTERTRAUM WINTERWALD WINTERZAUBER WIRBELSAEULEN WIRKBINDE WISMUTH WITHERIT WITSCHI WOBE WOBENZYM WOCHENBETTPACKUNG WOECHNERINNENVORLAGE WOERISHOFENER WOERTHER WOFACUTAN WOFASEPT WOFASTERIL WOHLFUEHL WOHLFUEHLEN WOHLFUEHLMISCHUNG WOHLFUEHLSPRAY WOHLFUEHLTUCH WOLFF WOLKENFLUG WONDER WONDERBOTTOM WONNESTUNDEN WOODIES WORLD WR WRIGLEY WS WU WUCHASENG WUERFELMATRATZE WUERFELPESSAR WUND WUNDAUFLAGEN WUNDDRAINAGEKOLLEKTOR WUNDERVOLLER WUNDHAKENBEZUEGE WUNDHYGIENE WUNDKLAMMER WUNDKLEE WUNDNADELN WUNDPFLASTER WUNDPLAST WUNDSALBE WUNDSCHNELLVERBAND WUNDSCHUTZ WUNDSPRITZE WUNDSTRIPS WUNDVERBAND WURZELSEPP WURZELTOD WUTA WUTAPOON WUWEIZI WV WVP WWW. WYBERT WYDORA WYETHIA X XALACOM XALATAN XANAX XANEF XANTHIUM XANTHOXYLON XAPRO XATRAL XCELL XELODA XENETIX XENICAL XENODERM XENOFIT XERONIT XIDAN XILOPAR XIMOVAN XIPAMID XITIX XOTIC XPHE X-RAY XUSAL XYLESTESIN XYLIDENT XYLISMILE XYLIT XYLITOL XYLO XYLOCAIN XYLOCITIN XYLONEST XYLONEURAL XYLONOR XYLOTOCAN XYNDET XYO XYSMALOBIUM XYTO XYZALL Y YA YACON YAGE YAL YAM YAMAMOTO YAMS YAMSAN YAMSWURZEL YANG YANKAUER YASMIN YAVAPED YAVATOP YAYABAER YENTREVE YERBA YERKA YES YIN YINYANG Y-KONNEKTOR YLANG YMEA YNA YOCON YOGA YOGHURELLA YOGI YOHIMBIN YOHIMBINUM YOMESAN YOMOGI YOUNG YOUR YOUTHAIR YPSELAST YPSIBAL YPSIFIX YPSIFLEX YPSIGAZE YPSILIN YPSILOHEEL YPSINETZ YSOP YSOPKRAUT YUCCA YUMA YUMMI Y-VERBINDER Y-VERBINDUNGSSET YXIN ZACPAC ZACTOLINE ZADITEN ZAEHLKAMMER ZAHLENSCHLOSS ZAHN ZAHNBUERSTE ZAHNBUERSTEN ZAHNBUERSTENHALTER ZAHNBUERSTENKOECHER ZAHNFIT ZAHNHOELZER ZAHNOEL ZAHNPFLEGE ZAHNPINZETTE ZAHNPOLIERER ZAHNPROTHESEN ZAHNPROTHESENBUERSTE ZAHNPROTHESENDOSE ZAHNPUTZBECHER ZAHNPUTZUHR ZAHNREINIGUNGS ZAHNSCHMERZTABLETTEN ZAHNSEIDE ZAHNSPIEGEL ZAHNSTOCHER ZAHNUNGSOEL ZAHNWATTEROLLEN ZAHNWEISS ZAHNWURZEL ZALAIN ZALDIAR ZANGE ZANLAN ZANTIC ZANZARIN ZAPPELIN ZARELLA ZARMONT ZATOFUG ZAUBER ZAUNRUEBE ZAVEDOS ZAVESCA ZEA ZEAXANTHIN ZECKEN ZECKENENTFERNER ZECKENFLUID ZECKENPINZETTE ZECKENSCHLINGE ZECKENSET ZECKENZANGE ZECKWECK ZEDAN ZEDAR ZEDER ZEDERNBLATT ZEDERNHOLZ ZEDEROEL ZEEL ZEFFIX ZEHENHAUBE ZEHENRINGE ZEHENSOCKEN ZEHENSPREIZER ZEHNAGELSCHERE ZEISS ZEIT ZELDOX ZELL ZELLAFORTE ZELLAKTIV ZELLETTEN ZELLFIT ZELLSCHUTZ ZELLSTOFF ZELLSTOFFTUPFER ZELLSTOFFWATTE ZELLSTOFFZUSCHNITTE ZELLTIP ZELLTUPF ZELLULISAN ZELLWA ZELTU ZEMIDE ZEMOX ZEMUKO ZEN ZENAPAX ZENIAC ZENTRAGRESS ZENTRAMIN ZENTROPIL ZERADERM ZERIT ZEROSORIN ZERVI ZESTRIL ZETA ZETIR ZETUVIT ZEWA ZHENCIDIAN ZHULING ZIAGEN ZICROMA ZIEGENBUTTER ZIEGENFETT ZIEGENKOLOSTRUM ZIEGENMILCH ZIEGENMOLKE ZIEGENVOLLMILCH ZIENAM ZILAST ZILO ZIMPEL ZIMPELS ZIMT ZIMTAPFEL ZIMTBLAETTER ZIMTKASSIE ZIMTOEL ZIMTORANGE ZIMTRINDE ZIMTRINDEN ZIMTSTERNE ZINACEF ZINCFRIN ZINCUM ZINDACLIN ZINERYT ZINGIBER ZINK ZINKAMIN ZINKASPART ZINKBRAUSE ZINKGLUCONAT ZINKGLUKONAT ZINKHEFE ZINK-INJEKT ZINKIT ZINKLEIMBINDE ZINKLETTEN ZINKOEL ZINKOKEHL ZINKOLAST ZINKORELL ZINKOROT ZINKOROTAT ZINKOTASE ZINKOXID ZINKOXYDPFLASTER ZINKPASTE ZINKPLUS ZINKSALBE ZINKSPIRULINA ZINKSULFAT ZINNAT ZINNKRAUT ZINNOBER ZINTONA ZIRBELKIEFER ZIRKULIN ZITHROMAX ZITRO ZITRONE ZITRONELLA ZITRONELLGRAS ZITRONEN ZITRONENBASILIKUM ZITRONENFASER ZITRONENGRAS ZITRONENKUR ZITRONENMELISSE ZITRUSGARTEN ZITWERWEIN ZIVIS ZIZIA ZM ZOCOR ZODORMDURA ZODURAT ZOELLER ZOERBIGER ZOFRAN ZOFRON ZOLADEX ZOLDEM ZOLIM ZOLIPARIN ZOLIRIN ZOLOFT ZOLPI ZOLPIDEM ZOLPINOX ZOMACTON ZOMETA ZOMIG ZOP ZOPI ZOPICALM ZOPICLODURA ZOPICLON ZOPICLONLICH ZORAC ZOSTEX ZOSTRUM ZOTON ZOVIRAX Z-PORT ZUBEHOER ZUBEHOERSET ZUCCHINI ZUCKERFREI ZUCKERROHR ZUECKLI ZUFRIEDEN ZUIDEX ZUK ZUMBA ZUNEHMENDER ZUNGENLAEPPCHEN ZUNGENLAPPEN ZUNGENREINIGER ZUNGENSCHABER ZUNGENSPATEL ZUNGENZANGE ZUR ZUSPRITZADAPTER ZVK ZWEI ZWEIKAMMER ZWEIWEGEHAHN ZWEIZUG ZWICKY ZWIEBEL ZWILLINGE ZWILLINGSUEBERLEITGERAET ZWIRNHANDSCHUHE ZYBAN ZYDERM ZYKLOLAT ZYKLOMAT ZYKLOTHERMOMETER ZYKLUS ZYLORIC ZYLOSIEB ZYMAFLUOR ZYOFOLIN ZYPLAST ZYPRESSE ZYPRESSEN ZYPRESSENWASSER ZYPREXA ZYRTEC ZYSTENPUNKTIONSBESTECK ZYSTOMANOMETRIE ZYTOSTATIKA ZYTRIM ZYVOXID

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.00 copay for using the Telehealth program.  I recommend you register now, before you get sick, so that your medical information and history is available already to the Telehealth providers. Then, the service will be there for you when you need it. Click here to sign up today, or call 844-733-3627 (844-SEE-DOCS). To learn more about our telehealth vendor, American Well (Amwell), click here. Please note: Until programming of Amwell’s site is completed, you will have to use a code when you use Amwell, so you will not be charged for the service. We are mailing the code to all Foreign Service Benefit Plan (FSBP) Benefit Plan members in a letter shortly. If you have signed up to receive e-mail communications from us, the code is in the e-mail we are sending you in a few days. If you have not signed up to receive e-mail communications, you may do so for future emails through our Member Portal at https://secure.myafspa.org/. We encourage you to do this so that we can keep in touch.

Many people make resolutions to improve their health at the start of a new year. This may include quitting smoking, losing weight, or developing a regular exercise routine. In 2017, let FSBP assist you with your goals. We have many programs that fit your individual needs. Utilize the Mediterranean Wellness Program, an eight-week interactive online program, to reach your fitness and nutrition goals. Health Coaching sets you up with a one-on-one health coach to help you make and reach your health goals regarding stress management, tobacco cessation, nutrition, exercise plans, and more. Click here to see a full list of Healthy Actions that are available to you. Don’t forget the discounts you receive on Weight Watchers and Jawbone Fitness Trackers just for being an FSBP member. Click here and go to the Non-FEHB Programs tab for more information on all our discount programs.

Now that the holiday season has ended, please use your massage therapy benefits to relieve any additional stress. No medical referral is required. FSBP covers 40 visits per year, up to per visit. That is over three massages a month. January is a great time to get started.

I wish you a prosperous and healthy New Year. As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

4Jan
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

New Indications for Adynovate

Shire’s Adynovate® (antihemophilic factor [recombinant], PEGylated), a long-acting factor VIII product originally  approved by the U.S. Food and Drug Administration (FDA) in November 2015, gained  two additional indications on Dec. 27, 2016. Initially indicated to treat bleeding episodes and to reduce the frequency of bleeds for patients with hemophilia A who are 12 years of age and older, Adynovate is now also approved for use by patients younger than 12 years. Additionally, it received FDA approval for use to control bleeding for patients with hemophilia A of any age during surgery. Adynovate can be injected as needed to manage bleeding episodes. To prevent bleeds, it is given intravenously (IV) on a twice-weekly schedule with dosing based on the patient’s weight. Full prescribing information is available here.

 

28Dec
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Pediatric Indication for Tresiba

On December 16, 2016, Novo Nordisk’s Tresiba® (insulin degludec) received approval from the U.S. Food and Drug Administration (FDA) for an expanded indication. Tresiba now can be used to improve glycemic (blood sugar) control for teens and children as young as one year old. It is approved for patients with either type 1 or type 2 diabetes. A basal (long-acting) insulin that is injected once daily, it is available in both 100 units/mL (U-100) and 200 units/mL (U-200) FlexTouch® insulin pen delivery devices. Each disposable pen is prefilled with 3mL of Tresiba. Doses up to 80 units (of U-100) or 160 units (U-200) may be given in one injection. However, it should not be used for patients whose doses are 5 units or less. A new pen needle should be used for each injection and each insulin pen should be used by only one person, even after the needles are changed. Click here for Tresiba’s full prescribing information.

Spinraza Approved to Treat Spinal Muscular Atrophy

Spinraza™ (nusinersen) was approved by the U.S. Food and Drug Administration (FDA) on December 23, 2016. It is the first drug indicated to treat spinal muscular atrophy (SMA), a rare genetic condition that causes increasing weakness in muscles. Spinraza will be given intrathecally (directly into the fluid around the spinal cord) by a healthcare provider who is trained to perform spinal procedures. Recommended dosing is three 12mg doses administered at two-week intervals, followed by a fourth dose one month after the third; and then by one dose every four months. Ionis Pharmaceuticals developed Spinraza, which will be marketed by Biogen, Inc. Launch is expected this week. It will be available exclusively through Accredo Specialty Pharmacy and CuraScript Specialty Distribution. For complete prescribing information click here. 

 

28Dec
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Rubraca Approved for Ovarian Cancer

The U.S. Food and Drug Administration (FDA) granted accelerated approval for Rubraca™ (rucaparib – Clovis Oncology, Inc.) on Dec. 19, 2016. It is indicated for ovarian cancer that has progressed despite at least two chemotherapy treatments and that has a deleterious BRAC genetic mutation as confirmed by an FDA-approved diagnostic test. Accelerated approval is given for drugs with clinical study information showing promise for treating serious or life-threatening diseases, even though studies are not completed. Rubraca is an oral drug with recommended dosing of 600mg twice a day until the cancer worsens or the patient cannot take the drug any longer. Clovis Oncology plans on launching Rubraca as soon as possible. It will be available through a limited network of specialty pharmacies that doesn’t include Accredo. Prescribing information is available here. 

  • Brand (Generic) Name: Rubraca™ (rucaparib)
  • Manufacturer: Clovis Oncology, Inc.
  • Date Approved: December 19, 2016
  • Indication: Monotherapy for advanced ovarian cancer that has been treated two or more times with chemotherapy and that has BRAC deletions as verified by FDA-approved companion diagnostic testing
  • Dosage Forms Available:  200mg and 300mg tablets
  • Launch Date: Launch date for Rubraca is not known at this time; however, Clovis plans on bringing it to market “as quickly as possible”.
  • Estimated Annual Cost: Pricing information is not yet available
  • Specialty Status:  Rubraca will be added to Express Scripts’ specialty drug list.
  • According to the National Cancer Institute, approximately 22,000 cases of ovarian cancer are diagnosed each year in the U.S. Between 15% and 29% of ovarian cancers have BRAC mutations.
  • Rubraca is a poly ADP-ribose polymerase (PARP) inhibitor that destroys cancer cells or limits their growth by interfering with DNA repair.
  • In clinical trials, tumors shrank at least partially for over one-half of patients receiving Rubraca. Response lasted a little over nine months, on average.

FDA also approved the FoundationFocus™ CDxBRCA™ companion diagnostic made by Foundation Medicine, Inc. for use with Rubraca.

 

20Dec
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Synjardy XR Approved

Eli Lilly and Boehringer Ingelheim announced on December 12, 2016, that the U.S. Food and Drug Administration (FDA) had approved their jointly-marketed, long-acting combination, Synjardy® XR (empagliflozin/metformin extended-release) tablets. It is taken once daily to improve glycemic (blood sugar) control for adults with type 2 diabetes mellitus when treatment with both empagliflozin and metformin is appropriate. Empagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, a drug class that blocks reabsorption of glucose in the kidneys. Metformin lowers glucose production and raises insulin utilization. As with all drug products that include metformin, Synjardy XR carries a boxed warning and has a medication guide about the possibility that it may cause lactic acidosis -- a rare, but potentially dangerous, accumulation of acids in the body. Launch date and pricing have not been announced. Complete prescribing information is available here.

Restylane Refyne and Restylane Defyne Dermal Fillers Approved

On December 12, 2016, Galderma announced the FDA approval of Restylane® (Refyne) and Restylane® (Defyne) for the treatment of nasolabial folds or “laugh lines” in patients over 21 years of age. Restylane Refyne is approved to treat moderate to severe facial wrinkles and folds while Restylane Defyne is approved to treat moderate to severe, deep facial wrinkles and folds. These Restylane products are next-generation hyaluronic acid dermal fillers. Several other Restylane products are currently available on the market. Additional information is available here.

Mylan Launches an EpiPen Authorized Generic

Mylan announced the launch of an authorized generic (AG) to EpiPen® (epinephrine injection) auto-injector, a product indicated for the emergency treatment of severe allergic reactions, including anaphylaxis. An AG is the brand product in generic-looking packaging. According to Mylan, the wholesale acquisition cost (WAC) for the AG is 0 for a two-pack of epinephrine auto-injectors. It is available in 0.15 mg and 0.3 mg strengths and should be in retail pharmacies beginning next week. In 2015, U.S. annual sales for EpiPen were approximately.7 billion.

Basaglar Now Available

Lilly and Boehringer Ingelheim’s Basaglar® (insulin glargine), the first follow-on to Sanofi’s Lantus® (insulin glargine) was launched in the U.S. on December 15, 2016. It is a long-acting insulin indicated to improve glycemic control for adult and pediatric patients with type 1 diabetes, and for adults with type 2 diabetes. It is supplied in cartons of five KwikPen® devices that each contain 3mL of U-100 (100 units per mL) of Basaglar. Recommended dosing is individualized according to the patient’s blood glucose levels. Basaglar is given as one subcutaneous injection daily at about the same time of day.  Basaglar Wholesale Acquisition Cost (WAC) is 6.85 for a pack of five pens. Additional competition within the long-acting insulin market should help alleviate some of the price increases common to this category.  Full prescribing information is available here.

MedWatch Update

Pioglitazone

After analyzing additional information from post-marketing studies, FDA has reaffirmed a previous warning for the oral diabetes drug, pioglitazone. In 2010 and 2011, interim study data suggested that taking pioglitazone could be associated with an increased incidence of bladder cancer. Although more recent results are mixed, further study shows that a relationship between pioglitazone use and a slightly higher risk of bladder cancer is more likely; especially for patients on long-term therapy. Pioglitazone is a thiazolidinedione that works by helping body tissues use insulin more efficiently. In the U.S., it is sold as generics, as the brand name, Actos® (Takeda), and in four combination drugs, which also are made by Takeda: Actoplus Met® (pioglitazone/metformin), Actoplus Met® XR (pioglitazone/metformin extended-release), Duetact® (pioglitazone/glimepiride) and Oseni (pioglitazone/alogliptin). More information on the warning is available here.  

 

15Dec
Clinical Matters News Flash

Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

Eucrisa Approved for Atopic Dermatitis

On December 14, 2016, the U.S. Food and Drug Administration (FDA) approved Pfizer’s Eucrisa™ (crisaborole) ointment, 2%. It is the first topical phosphodiesterase 4 (PDE-4) inhibitor indicated to treat eczema (chronic inflammatory skin conditions) in patients two years of age and older. Atopic dermatitis is a common form of eczema. Eucrisa is applied as a thin coating on the affected skin twice a day. Full prescribing information is available here.

  • Brand (Generic) Name: Eucrisa™ (crisaborole)
  • Manufacturer: Pfizer
  • Date Approved: Dec. 14, 2016
  • Indication: Topical treatment of mild-to-moderate eczema for patients at least two years of age
  • Dosage Forms Available: 2% ointment in 60Gm and 100Gm tubes
  • Launch Date: Early 2017
  • Estimated Cost: A 60Gm tube will retail for 0.
  • Eczema is a group of chronic skin diseases that involve inflammation and cause itchy, irritated bumps, crusts and scales on the skin. It usually begins in childhood, with most patients having a first episode before the age of five. Symptoms may improve and worsen unpredictably. Inflammation and scratching eventually can thicken and toughen the skin.
  • According to the National Eczema Association, about 11% of American children have eczema and most will continue to have symptoms into adulthood.
  • Eucrisa reduces the activity of phosphodiesterase 4 (PDE-4) to decrease inflammation.
  • In clinical studies, eczema cleared or almost cleared for about one-third of patients using Eucrisa. Only between one-fifth and one-fourth of patients using the identical ointment base with no active ingredients in it had significant symptom improvement. Study participants used the products for 28 days.
  • Side effects from Eucrisa include pain and stinging at the site of application.
  • Eucrisa will compete with current topical drug treatments for eczema; including topical steroids, such as betamethasone and fluocinolone, and calcineurin inhibitors, such as Elidel® (pimecrolimus).

 

13Dec
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Jardiance Receives Cardiovascular Indication

Eli Lilly and Boehringer Ingelheim announced on December 2, 2016, that their jointly-marketed diabetes drug, Jardiance® (empagliflozin) has a new indication from the U.S. Food and Drug Administration (FDA). It is the first diabetes drug indicated to decrease the risk of cardiovascular (CV)-related deaths for adults who have both type 2 diabetes and CV disease. Diabetes patients are more likely to have CV disease than individuals without diabetes. In the EMPA-REG OUTCOME® study, fewer patients who took Jardiance along with their usual diabetes and CV drugs died from heart attacks or strokes than patients who took standard drugs with a placebo. Jardiance is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, a class of drugs that lowers blood sugar by blocking its absorption in the kidneys and forcing more to be eliminated in the urine. It was first FDA approved in August 2014 as combination therapy with lifestyle changes to improve glycemic control for adults who have type 2 diabetes. Recommended dosing for Jardiance is one tablet (either 10mg or 25mg) every morning. Its complete prescribing information is available here.

Generic Available for Latisse

Sandoz launched a generic for Latisse® (bimatoprost ophthalmic solution, 0.03% -- Allergan) on December 7, 2016. Bimatoprost is a prostaglandin that is indicated to treat hypotrichosis (thinning) of the upper eyelashes. When applied regularly to the base of the eyelashes on each upper eyelid, it darkens, lengthens and thickens lashes. Dosing is one drop to each upper eyelash every evening applied with disposable, single-use applicators that are dispensed with the solution. Available sizes are 3mL in a 4mL bottle (with 70 applicators) and 5mL in an 8mL bottle (with 140 applicators). Treated eyelids may darken, itch or swell and the colored parts of the eyes may darken, often irreversibly, as well. As estimated by IMS Health, sales for Latisse amounted to million in the U.S. during the 12-month period that ended on October 31, 2016.

New Indication for Avastin

On December 6, 2016, FDA approved Genentech’s Avastin® (bevacizumab) as treatment for patients with epithelial ovarian, fallopian tube or primary peritoneal cancers that return six months or longer after being treated with a platinum-based therapy. For such platinum-sensitive cancers, Avastin will be used in addition to chemotherapy with carboplatin and either gemcitabine or paclitaxel. In clinical trials, progression-free survival (PFS) was about four months longer for participants who used Avastin along with chemotherapy as compared to those using only chemotherapy. Avastin is a monoclonal antibody that blocks vascular endothelial growth factor (VEGF), a protein that helps tumors grow and spread. It has been granted several additional indications, including one for treating platinum-sensitive cancers that recur within six months after platinum chemotherapy ends, since its original FDA approval in 2004. To treat platinum-sensitive cancers, Avastin is given in combination with the other drugs as an intravenous (IV) infusion once every three weeks for at least six cycles. If used with carboplatin and paclitaxel, up to two additional combination cycles may be given; if used with carboplatin and gemcitabine, up to four more combination cycles may be used. After the last combination-therapy cycle, Avastin is then given alone once every three weeks. Dosing is 15mg per Kg of body weight. A boxed warning cautions that Avastin may cause hemorrhaging, punctures in the gastrointestinal (GI) tract or complications with wound healing. Because it may interfere with healing, using it should be stopped 28 days or longer before planned surgery and not resumed until after the surgical incision is totally healed (at least 28 days after the procedure). Full prescribing information may be found here.  

Generic to Zetia Launched

On December 12, 2016 Par Pharmaceuticals announced the launch of its AB-rated generic to Merck’s Zetia® (ezetimibe), a drug approved to reduce elevated LDL cholesterol (LDL-C) in patients with hyperlipidemia. Available dosing is 10 mg tablets. As estimated by IMS Health, sales for Merck’s Zetia® (ezetimibe) amounted to.6 billion in the U.S. for the most recent twelve months ending in Sept. 2016.  The company was also granted 180 days of generic exclusivity, preventing FDA from approving additional generics until June 2017. Vytorin® (ezetimibe/simvastatin – Merck) will lose patent protection on Apr. 25, 2017. Several manufacturers are expected to launch once this patent expires. According to IMS Health, this product had approximately 4 million in U.S. sales in 2015.     

Generic Approved for Tamiflu

On December 12, 2016 Alvogen, the U.S. partner of Natco Pharma, announced that it has introduced the first generic for Tamiflu® (oseltamivir - Genentech) to the American market. Oseltamivir is a neuraminidase inhibitor approved by the U.S. Food and Drug Administration (FDA) to treat and prevent influenza A and influenza B under specific circumstances. Available dosage forms are 30mg, 45mg and 75mg capsules. Recommended dosing is one capsule twice a day for five days or 10 days, but some patients take it for up to 12 weeks, depending on the indication and the patient.  Oseltamivir does not replace the need for an annual influenza vaccination.  For adults, starting oseltamivir within 48 hours from the onset of flu symptoms reduced the duration of symptoms by about one-third (from an average of approximately 103 hours to around 72 hours).  According to IMS Health, 2015 U.S. sales for Tamiflu were about 3 million.  FiercePharma reports that Alvogen will have 180 days of exclusivity before other companies can launch additional generics.

 

13Dec

FEDVIP Open Season Extension

  • Staff
  • FSBP   fsbp411   All  

OPM has announced that it has extended the opportunity to make FEDVIP dental and vision enrollments/change/cancellations until midnight on Wednesday, December 14, 2016.

The dental and vision enrollment website, BENEFEDS.com, is currently undergoing repairs due to technical issues, however, the call center (1-877-888-3337) is open until midnight on Wednesday, December 14, 2016, Eastern Time to process FEDVIP changes.  Those wishing to enroll or make changes can do so by calling the call center. 

 

 

5Dec
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Veltassa Labeling Change

Veltassa® (patiromer) is a potassium-trapping drug used to reduce hyperkalemia (high blood levels of potassium) -- primarily for patients with chronic kidney disease or heart failure. It was approved by the U.S. Food and Drug Administration (FDA) in October 2015. Its labeling included a boxed warning about its possible interactions with other oral drugs and directions to separate taking it by at least six hours from other drugs. After further testing, FDA is allowing Veltassa’s manufacturer, Relypsa, to delete the boxed warning, to move interactions information to other parts of the label and to change the interval between taking Veltassa and other drugs to three hours. Recommended dosing is one packet (containing 8.4 Gm, 16.8 Gm or 25.2 Gm of Veltassa) dissolved in at least one-third cup of water. Patients drink the Veltassa mixture along with food, but it should not be heated or mixed into hot liquids. Prescribing information is available here.

Full FDA Approval for Iclusig

FDA accelerates approval for some drugs that appear promising in mid-stage clinical trial data to treat patients who have serious conditions that are not controlled by existing therapies. The tyrosine kinase inhibitor (TKI), Iclusig® (ponatinib – Ariad Pharmaceuticals, Inc.), was granted an accelerated approval on December 14, 2012, after it showed effectiveness in phase II trials of patients with two rare types of leukemia. Based on the results of continuing studies, FDA gave it full approval for treating both conditions on November 28, 2016. Iclusig treats adults who have no other TKI therapy options for either chronic phase, blast phase or accelerated phase chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). It also is indicated for CML or Ph+ ALL that is T315I-positive -- a specific kind of mutation that resists treatment with some other TKIs. Approximately one-third of clinical trial participants using Iclusig experienced some degree, including some fatal events, of artery blockages while taking the drug. Smaller numbers of participants developed venous thromboembolisms (blood clots in the veins), heart failure or liver damage. Iclusig’s label has a boxed warning about all of these potentially severe side effects. It is an oral drug with recommended initial dosing of 45mg once a day. However, doses frequently are lessened to 30mg or 15mg per day depending on the patient’s condition, response and side effects. Complete Iclusig prescribing information is available here.

 

 

1Dec
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All  

To our Valued Members,

As 2016 comes to a close, I find myself thinking about the past year, and looking forward to the new year. I am grateful to our American Foreign Service Protective Association (AFSPA) members. I also am grateful to the AFSPA employees who provide you with the level of service you expect. We hope to continue our strong relationship with you in 2017.

I want to remind you that Open Season ends on December 12. You have a few days left to review your options carefully and make changes to your Federal Employee Health Benefit (FEHB) Program enrollment, your Federal Employees Dental and Vision Insurance Program (FEDVIP) enrollment, and your FSAFEDS enrollment. Please consider AFSPA’s many services when making these important decisions.

On another note, we encourage you to wear a red ribbon this month to show support to the millions of people living with HIV. December 1 marks World AIDS Day. This annual day of reflection is an opportunity for people worldwide to unite in the fight against HIV. There still is a vital need to increase awareness, fight prejudice, and improve education. The Foreign Service Benefit Plan (FSBP) covers HIV screening and counseling at 100% when you visit an in-network provider. It is important to get tested regularly and to know your status.

Finally, this time of year is a time to make positive lifestyle changes. Focus on a balance of food and activity this holiday season. Incorporate healthier recipes in your meals and don’t forget to exercise. You also can take advantage of FSBP’s “Simple Steps to Living Well Together” Program which can help you identify your health risks and assist in achieving your health goals.   

As always, our mission is to provide you with “unparalleled service.” It is our pleasure to serve you and we thank you for entrusting us with your healthcare needs. I wish you and your loved ones a wonderful and healthy holiday season.

 

To Your Health,

Paula S. Jakub, RHU

CEO, AFSPA

Executive Director, Senior Living Foundation

 

1Dec
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Expanded Indication for Darzalex

On November 21, 2016, The U.S. Food and Drug Administration approved two drug regimens that include Janssen Biotech’s Darzalex® (daratumumab) injection for intravenous use. For treating patients who have multiple myeloma that has been treated once previously, Darzalex now is indicated along with dexamethasone and Revlimid® (lenalidomide – Celgene Corporation) or Velcade® (bortezomib – Millennium Pharmaceuticals). Darzalex is a monoclonal antibody with specific activity against CD38, a protein on the surface of multiple myeloma cells. Originally, Darzalex was FDA approved in November 2015 to be used by itself after multiple-myeloma patients had tried at least three other treatments, including an immunomodulator, such as Revlimid, and a proteasome inhibitor, such as Velcade. For use with Revlimid, the recommended dosing schedule for Darzalex is once a week for eight weeks, then once every two weeks until week 24 and then once every four weeks. With Velcade, the schedule is Darzalex once every week for nine weeks, once every three weeks between weeks 10 and 24 and then once every four weeks. Darzalex continues to be administered by a healthcare provider until it stops working. Although infusion rates may vary, the recommended dose for all Darzalex indications is 16mg/Kg of the patient’s body weight. Complete prescribing information is available here.  
Quadrivalent FluLaval Approved for Young Children

FluLaval® Quadrivalent, an inactivated influenza (flu) vaccine made by GlaxoSmithKline, has been FDA approved for vaccinating children between the ages of six months and three years. The vaccine, which contains two strains of influenza A virus and two strains of influenza B, received its first U.S. approval in 2013 for adults and children three years of age and older. The recommended dose, 0.5mL injected intramuscularly (IM), is the same for all age groups. For infants, toddlers and children through age eight years, who have never had a flu vaccine; the most common dose schedule is two injections given at least one month apart. Children who have been previously vaccinated, and all individuals who are nine years and older, only require one shot per year. Updated prescribing information is available here.  

 

30Nov
Clinical Matters News Flash

Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

Soliqua and Xultophy Approved for Type 2 Diabetes

The U.S. Food and Drug Administration (FDA) simultaneously approved Sanofi’s and Novo Nordisk’s fixed-dose long-acting insulin and glucagon-like peptide 1 (GLP-1) agonist combination products for treating type 2 diabetes. Soliqua™, from Sanofi, is a fixed dose combination product of Lantus® (insulin glargine) and Adlyxin® (lixisenatide). Novo Nordisk’s Xultophy® combines the company’s Tresiba® (insulin degludec) and Victoza® (liraglutide). Both products are dosed once-daily by subcutaneous injection. Soliqua will be available in U.S. retail pharmacies in January 2017 while Xultophy’s launch will occur in the first half of 2017.

Soliqua prescribing information can be found here.

Xultophy prescribing information can be found here.

  • Brand (Generic) Name:
    • Soliqua™ (insulin glargine & lixisenatide injection - Sanofi)
    • Xultophy® (insulin degludec & liraglutide injection - Novo Nordisk)
  • Date Approved: November 21, 2016
  • Indication: Treatment of adults with type 2 diabetes inadequately controlled on basal insulin or GLP-1 agonists as monotherapy.
  • Dosage Forms Available:
    • Soliqua: 100 units of Lantus (insulin glargine) per mL and 33 mcg of Adlyxin (lixisenatide) per mL in a 3 mL single-patient-use pen.
    • Xultophy: 100 units of Tresiba (insulin degludec) per mL and 3.6 mg of Victoza (liraglutide) per mL in a 3 mL single-patient-use pen.
  • Launch Date: Soliqua will be available in U.S. retail pharmacies in January 2017. Xultophy will launch sometime in the first half of 2017.
  • Estimated Annual Cost: Pricing information is not available at this time.
  • Type 2 diabetes is the most common form of the disease affecting about 29 million people in the US; it accounts for more than 90% of diabetes cases.
  • Sanofi estimates that approximately half of patients, or 4 million Americans, treated with basal insulins are not at the American Diabetes Association's HbA1c goal of <7%. Many of these patients may be candidates for the long-acting insulin/GLP-1 agonist combination products.
  • Implications:  Express Scripts is currently investigating the data around Soliqua and Xultophy for a possible utilization management strategy.

 

30Nov
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Bonjesta Approved to Treat Nausea and Vomiting of Pregnancy

Duchesnay, Inc. received U.S. Food and Drug Administration (FDA) approval on November 7, 2016, for Bonjesta (doxylamine/pyridoxine) extended-release tablets. Bonjesta combines 20mg each of an antihistamine (doxylamine) and a form of vitamin B6 (pyridoxine). It is indicated to treat nausea and vomiting associated with pregnancy when conservative treatment, such as dietary modification, is not effective. If the recommended dose of one tablet at bedtime does not control symptoms, an additional tablet may be added in the morning. No more than two tablets should be taken per day and they should be swallowed whole with a full glass of water but no food. Bonjesta may cause sleepiness. It has not been tested among patients who are under the age of 18 years or who have hyperemesis gravidarum, a serious condition that may need hospitalization. Duchesnay also manufactures Diclegis® (doxylamine/pyridoxine) delayed-release tablets, which was FDA approved in April 2013. Also indicated for pregnancy-related nausea and vomiting, Diclegis contains 10mg of each ingredient in Bonjesta. Although Bonjesta’s launch and pricing plans are not yet public, its prescribing information is available here.   

 

 

Express Scripts is currently investigating the data around Bonjesta for a possible utilization management strategy.

 

 

First Prescription Prasterone Approved

On November 17, 2016, FDA announced that it approved EndoCeutics’ Intrarosa™ (prasterone) vaginal inserts to treat vulvovaginal atrophy (VVA). This is a condition that makes having sex painful and difficult for many women after menopause due to alkalinity, dryness, irritation and thinning of the female lower reproductive tract. Also widely known as DHEA (dehydroepiandrosterone), prasterone is a natural steroid hormone produced mainly by the adrenal glands and then converted into estrogens and androgens. Biological prasterone production gradually decreases, beginning at about 30 years of age, resulting in declining levels of the sex hormones. At menopause, estrogen levels drop further. Usually marketed as DHEA, oral forms of prasterone are sold over the counter as nutritional supplements, but no evidence supports their effectiveness for any medical condition. Intrarose is the first prescription prasterone to be FDA approved. It will be available as 6.5mg vaginal inserts that are used once a day. Price, launch details and prescribing information are currently not available.

 

23Nov

Happy Thanksgiving!

  • Kyle Longton, COO
  • All  

In observance of the Thanksgiving holiday, AFSPA will close at 12 noon ET on Wednesday, November 23. We will remain closed on Thursday and Friday, November 24 and 25, and we will resume normal business hours at 8:30 am ET on Monday, November 28.

Throughout the year, the Board of Directors and Staff of AFSPA are grateful for the loyalty and membership of all our members around the world. Thank you for trusting us to serve you and your family. We wish each of you a very Happy Thanksgiving!

 

11Nov

The governor of North Carolina has declared a State of Emergency

  • Staff
  • FSBP   fsbp411   All  

The governor of North Carolina has declared a State of Emergency in the following counties due to wildfires: Alexander, Avery, Buncombe, Burke, Caldwell, Catawba, Cherokee, Clay, Cleveland, Gaston, Graham, Haywood, Henderson, Jackson, Lincoln, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga and Yancey.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

9Nov

Deadline for Taking Your HRA and Biometric Screening

  • Staff
  • FSBP   fsbp411  

Deadline for Taking Your Health Risk Assessment and Biometric Screening

We want you to be healthy.  We also want you to be able to earn our Wellness Incentives as part of our Simple Steps to Living Well Together Program. 

You still can sign into My Online Services and take your Health Risk Assessment (HRA). An HRA is like an interview you take online. You share information about your health habits and history.  Then, you get a personalized health summary that can help you understand your health needs.  Taking an HRA will earn you a 0 incentive reward.  Do it today, if you haven’t already done so.  You have until 12/31/16 to take this year’s HRA.

If you haven’t already obtained your Biometric Screening, you should do so now.  The deadline for the screening is 12/9/16 (Note:  You must take the HRA before the biometric screening to qualify for the separate 0 biometric screening incentive reward, so time is running very short for the screening.).  Your screening serves as a benchmark and can help evaluate changes in health status over time. 

And, don’t forget the Healthy Actions we offer.  There’s still time to complete some of them before the end of the year.  Doing so will earn you yet another separate incentive reward.

See your 2016 FSBP Brochure for complete details

 

7Nov
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Generics to Azor Launched

On November 2, 2016, Ajanta Pharma announced the launch of its AB-rated generic to Daiichi Sankyo's Azor® (amlodipine / olmesartan medoxomil) tablets. Azor contains amlodipine, a dihydropyridine calcium channel blocker, and olmesartan medoxomil, an angiotension II receptor blocker. Azor is approved for the treatment of hypertension (high blood pressure). Additional generic manufacturers have received approval from the U.S. Food and Drug Administration (FDA) for their AB-rated generics to Azor; however, they have not announced the launch of these products. Sun Pharma has also launched an authorized generic to Azor. According to IMS Health, 2015 annual sales for Azor were 0 million.

 

2Nov
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Generics to Seroquel XR Launched

Par Pharmaceutical, an operating company of Endo Pharmaceuticals, began shipping four strengths of quetiapine extended-release tablets to U.S. wholesalers on November 1, 2016. Par’s generics are AB-rated to AstraZeneca’s Seroquel XR®, a once-daily atypical antipsychotic. It is indicated for bipolar disorders, depression, mania and schizophrenia. As the result of a settlement agreement, Par is launching one year before the Seroquel XR patent expires. It has 180-days of exclusivity for the 50mg, 150mg, 200mg and 300mg tablet strengths. A separate agreement allows Accord Healthcare, Inc. to launch the 400mg strength, effective November 1, as well.

  • Brand Drug: Seroquel XR® (quetiapine extended release - AstraZeneca)
  • Indications: add-on treatment for patients with major depressive disorder that does not respond to antidepressants, alone; acute depressive, manic or mixed episodes in bipolar disorder; maintenance of bipolar disorder and schizophrenia
  • Generic Manufacturer: Par Pharmaceutical; Accord Healthcare, Inc.
  • Launch Date: November 1, 2016
  • Dosage Forms Available: 50mg, 150mg, 200mg and 300mg extended-release tablets from Par: 400mg extended-release tablets from Accord
  • Annual U.S. Sales: For the four strengths that Par has launched, IMS Health estimates U.S. sales at 1 million for the 12-month period that ended on September 30, 2016. For calendar year 2015, U.S. sales of Seroquel XR 400mg amounted to approximately 0,000.
  • Seroquel XR is the first extended-release atypical antipsychotic to face generic competition in the U.S.
  • Other extended-release atypical antipsychotics are all brand-name and all injectable: Abilify Maintena® (aripiprazole extended-release powder for suspension for injection - Otsuka), Invega Sustenna® and Invega Trinza® (paliperidone extended-release suspension for injection - Janssen), Risperdal® Consta® (risperidone powder for solution for injection – Janssen) and Zyprexa® Relprevv™ (olanzapine powder for suspension for injection – Lilly).
  • The market for immediate release atypical antipsychotic medications includes Abilify (aripiprazole - Bristol-Myers Squibb/Otsuka, generics) Clozaril® (clozapine - Novartis, generics), Fanapt™ (iloperidone – Vanda), Geodon® (ziprasidone – Pfizer, generics), Invega™ (paliperidone – Janssen), Latuda® (lurasidone– Sunovion), Rexulti® (brexpiprazole – Otsuka/Lundbeck), Risperdal® (risperidone - Janssen, generics), Saphris® (asenapine – Merck / Actavis), Seroquel® (quetiapine – AstraZeneca, generics) Vraylar® (cariprazine - Allergan) and Zyprexa® (olanzapine – Lilly, generics).

 

1Nov
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Welcome to November 2016!

As the year comes to an end, this season calls for planning and preparation for the upcoming year. Open Season starts this month, which is a great time to take a look at all your benefits. Consider adding dental coverage, life insurance, or a disability plan from AFSPA. Many of you trust us with your medical health, why not trust with your other needs too?   

To start, the Self Plus One rate for the Foreign Service Benefit Plan (FSBP) actually is lower than the Self and Family rate this year. For two person families, this Open Season may be the time to switch to Self Plus One. The Self Plus One enrollment type covers the enrollee and one other eligible family member you designate to be covered. In 2017, those on a Self and Family plan may want to explore Self Plus One to see if it works for you.

Many of our members have chosen to join us on Facebook. With nearly 300 fans, AFSPA is able to hear from you in a whole new way. We share healthy living ideas, fitness tips, and member benefits. This Open Season, AFSPA will use social media to connect with you even more. We will post useful information every day during Open Season. Please check our Facebook page every day between mid-November and mid-December. You will learn something new to use all year long.
Open Season officially begins Monday, November14, 2016. As you know, AFSPA staff travel to various regions of the globe in preparation for Open Season. Any direct hire Federal employee who is enrolled or is eligible to enroll in any plan under the FEHB Program may want to  attend these briefings. This year’s topics include OPM Initiatives, Prescription Drugs, Access to Care, Wellness Programs, FSAFEDS, and FEDVIP. Please plan to attend and bring your questions. See the November schedule below (subject to change – check with local HR offices):

November 1- Wiesbaden, Open Season Briefing (Teachers), Wiesbaden Middle School, Media Center, 3:30pm

November 2- Stuttgart, Open Season Briefing (Teachers), Patch Elementary School, Library, 3:15pm

November 3 – Yokosuka, Open Season Briefing (Civilians), Building A-20, Classroom, 10:30am

November 3 – Yokosuka, Open Season Briefing (Teachers), Sullivan School Complex, Multi-Purpose room, 3:00pm

November 3- Kaiserslautern, Open Season Briefing (Civilians & Teachers), Kaiserslautern Middle/High School, Pulaski Barracks Info Center, 3:30pm

November 4 – Embassy Tokyo, Open Season Briefing, Foley Room (2nd Floor), 9:00am

November 7- Kadena, Medicare & FEHB, Building 721, 2nd Floor, 9:30amNovember 7-Kadena, Open Season Briefing (Teachers), Kadena High School, Library, 4:00pm

November 7 – Yokota Air Force Base, Open Season Briefing (Teachers), Mendel Elementary School, Training Room, 3:00 pm

November 8- Kadena, Open Season Briefing (Civilians), Building 721, 2nd Floor, 11:00am

November 8- Kadena, Open Season Briefing (Teachers), Lester Middle School, Library, 4:00pm

November 8- Atsugi, Open Season Briefing (Teachers), Shirley Lanham Elementary School, Library, 3:00pm

November 8- Frankfurt, Combined Open Season and Medicare & FEHB Briefing U.S. Consulate Auditorium, 10:00am

November 8- Frankfurt, Combined Open Season and Medicare & FEHB Briefing, U.S. Consulate Auditorium, 2:00pm

November 10 – Embassy Seoul, Open Season Briefing, 1st Floor Conference Room, 11:30 am

November 14 – Yongsan, Medicare & FEHB, South Post Chapel, Room 208 and 209, 9:30am

November 14 – Yongsan, Open Season Briefing, South Post Chapel, Room 208 and 209, 1:00pm

We hope to see you at one of our Open Season Briefings.

In addition, we will be attending several domestic Agency / Department Open Season Health Fairs.

By the way, Happy Thanksgiving! This year, thank your body by maintaining a healthy diet during the traditional gatherings. Reduce your salt intake, control your portions, and load your plate with vegetables. This might be a good time to take advantage of the Live “Not One Ounce” Program offered by the Mediterranean Wellness Program.  See page 83 of the 2016 FSBP Brochure for details.

As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

31Oct
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Zinplava Approved

A monoclonal antibody, Zinplava™ (bezlotoxumab – Merck), was approved on October 21, 2016, as ancillary treatment to decrease the likelihood of a relapse with a specific bacterial infection. It is approved by the U.S. Food and Drug Administration (FDA) for use in combination with an antibacterial drug, for preventing recurrence of Clostridium difficile (C. diff) infection for patients who are at least 18 years old, who are undergoing antibacterial treatment for C. diff and who are at high risk of acquiring the infection again. The chance of an initial C. diff infection is greater for patients who recently have taken antibiotics, especially individuals with immunocompromising conditions, those who are hospitalized and those living in a nursing facility. About 25% of patients once infected with C. diff will become reinfected, and around 10% will have more than one additional C. diff infection. Toxic substances produced by C. diff attack the linings of the stomach and intestines to cause abdominal pain, diarrhea and fever. Although it is not an antibacterial drug, Zinplava sticks to toxin B, reducing its ability to damage gastrointestinal (GI) cells. Recommended dosing is 10mg/Kg given as a single intravenous (IV) infusion over a one-hour period. It must be used in conjunction with an antibacterial agent. Zinplava, which will be packaged in single-use, 40mL vials containing 25mg/mL (1,000mg total), will be launched early in 2017. Click here for Prescribing information.

New Indication for Keytruda

On October 24, 2016, Merck’s Keytruda® (pembrolizumab) received FDA approval as initial therapy for metastatic non-small cell lung cancer (NSCLC) without epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) genomic tumor aberrations, but expressing 50% or more of programmed death ligand 1 (PD-L1). The presence of PD-L1 must be verified by an FDA-approved diagnostic test. In a labeling change announced at the same time, additional information was added from studies of patients who have metastatic NSCLC that produces at least 1% of PD-L1 and that advances despite treatment with chemotherapy regimens containing platinum. For NSCLC, 200mg of Keytruda is given once every three weeks as a 30-minute IV infusion. Previous approvals for Keytruda include melanoma and head and neck cancers. Click here for Keytruda’s full prescribing information.

New Generic for Concerta

Last week, FDA announced that it was initiating actions to revoke approval for two extended-release methylphenidate products that are rated BX (presumed therapeutically inequivalent) to Concerta® (methylphenidate – Janssen). Only a few days later, on October 21, 2016, an AB-rated (therapeutically equivalent) generic for Concerta gained FDA approval. Its AB rating means that the new generic is interchangeable with Concerta. Its manufacturer, Mylan, has not yet released any launch or pricing details. Actavis distributes an authorized generic, which will remain on the market.

MedWatch Update

Testosterone

FDA is requiring new warnings for prescription products that contain testosterone as well as other anabolic androgenic steroids. In the U.S., all anabolic androgenic steroids are Schedule 3 (C-III) controlled substances. In a safety alert dated Oct. 25, 2016, FDA now requires that labeling for testosterone and other anabolic steroids include more information about their side effects as well as about the risks of abuse and dependence that may be associated with using them. The additions highlight that anabolic androgenic steroids can cause severe side effects that include heart attacks, liver damage and strokes. Among other serious adverse effects that may be associated with using drugs in the class are depression, hostility, infertility and insomnia. Even though it is approved for treating low testosterone levels caused by certain disorders, testosterone is not indicated to counteract the normal effects of aging. It also is misused in other unapproved ways, such as by bodybuilders attempting to increase their muscle mass. Additionally, individuals who use anabolic androgenic steroids may become dependent. For more information, the FDA advisory is available here.

 

27Oct
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Generic Benicar Launched

Mylan announced the launch of its AB-rated generic to Daiichi Sankyo's Benicar® (olmesartan) and Benicar HCT® (olmesartan/ hydrochlorothiazide). Benicar and Benicar HCT are indicated for the treatment of hypertension (high blood pressure). Mylan currently is the only manufacturer that has final FDA approval for these generics. However, the company’s eligibility for 180 days of generic exclusivity is not known. As a result, additional manufacturers may be able to introduce generics earlier than April 2017, depending on court orders and final FDA approvals. Mylan has already begun shipping its generics.

  • Brand (Generic) Name: Benicar® (olmesartan - Daiichi Sankyo) and Benicar HCT® (olmesartan/ hydrochlorothiazide – Daiichi Sankyo)
  • Manufacturer: Mylan
  • Indication: Treatment of hypertension, alone or with other antihypertensive agents, to lower blood pressure.
  • Dosage Forms Available: Generics to Benicar are available as 5mg, 10mg and 20mg tablets. Generics to Benicar HCT, expressed as olmesartan/hydrochlorothiazide, are available as 20mg/12.5mg, 40mg/12.5mg and 40mg/25mg tablets.
  • Launch Date: October 26, 2016
  • Annual U.S. Sales: According to IMS, U.S. annual sales for Benicar and Benicar HCT are approximately billion and 5 million, respectively.
  • Benicar belongs to a class of drug for treating high blood pressure known as angiotensin II receptor blockers, or ARBs.
  • Other competing ARBs include: Atacand® (candesartan -- AstraZeneca, generics), Avapro® (irbesartan -- Sanofi, generics), Cozaar® (losartan -- Merck, generics), Diovan (valsartan -- Novartis, generics), Edarbi® (azilsartan -- Arbor/Takeda), Micardis® (telmisartan -- Boehringer Ingelheim, generics) and Teveten® (eprosartan -- AbbVie, generics).
  • Sun Pharma launched authorized generics (AGs) to Benicar and Benicar HCT. The company also launched AGs to Daiichi Sankyo’s Azor® (amlodipine/olmesartan) and Tribenzor® (amlodipine/olmesartan/hydrochlorothiazide), two additional combination products for treating high blood pressure.
  • True AB-rated generics to Azor and Tribenzor have also been approved. However, we have yet to see a press release announcing a product launch. These products had U.S. annual sales of 0 million and 8 million, respectively.

 

25Oct
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Tecentriq Approved for Lung Cancer

On October 18, 2016, Genentech’s Tecentriq™ (atezolizumab) was approved by the U.S. Food and Drug Administration (FDA) to treat patients with metastatic non-small cell lung cancer (NSCLC) who have disease progression during or following platinum-containing chemotherapy, and have progressed on an appropriate FDA-approved targeted therapy if their tumor has EGFR or ALK gene abnormalities. Tecentriq is a programmed death receptor-ligand 1 (PD-L1)-blocking antibody. It is an immunotherapy that helps the body’s immune system attack cancer cells. Tecentriq was originally approved on May 18, 2016, for the second-line treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC). The recommended dose of Tecentriq for NSCLC and mUC is 1200mg as an intravenous infusion over 60 minutes once every three weeks. Click here for full prescribing information.

First Vagifem Generic Launched

Yuvafem® (estradiol vaginal inserts), the first generic for Novo Nordisk’s Vagifem® was released in the U.S. by Amneal Pharmaceuticals on October 17, 2016. Each intravaginal insert contains a low dose of estradiol intended to treat atrophic vaginitis (dryness, irritation, itching and pain) after menopause. Dosing is one insert per day for the first two weeks, then two inserts per week spaced about three days apart. Yuvafem will be dispensed in packages of eight and 18 inserts -- each in a disposable applicator. Its labeling carries boxed warnings common to all estrogens. Used alone, it may raise the risk of breast or endometrial cancers, blood clots or strokes. When used along with a progestin, estrogens may contribute to cardiovascular conditions and possibly to dementia. No cost information is available for Yuvafem. IMS Health estimates that sales of Vagifem totaled 3 million for the 12-month period ending July 31, 2016.

Inflectra to Launch in Late November

On October 17, 2016, Pfizer announced that it will launch Inflectra™ (infliximab-dyyb), a biosimilar to Janssen’s Remicade®, in late November. Inflectra was approved on April 5, 2016, for all Remicade-approved indications, except pediatric ulcerative colitis. It will be used for treating patients with rheumatoid arthritis, adult ulcerative colitis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis and adult and pediatric Crohn’s disease. Inflectra, a tumor-necrosis factor (TNF) blocker, was the first biosimilar monoclonal antibody to gain FDA approval. Based on the wholesale acquisition cost (WAC), Inflectra will be priced at a 15% discount to Remicade. Sandoz’s Erelzi™ (etanercept – szzs), a biosimilar to Amgen’s Enbrel®, and Amgen’s Amjevita™ (adalimumab – atto), a biosimilar to AbbVie’s Humira® are additional TNF blocker biosimilars that have been FDA approved. The launch of Erelzi and Humira could be delayed for two or more years due to patent litigation.

New Dose Form for Lucentis

Genentech announced on October 14, 2016, that it has received FDA approval for pre-filled syringes each containing 0.5mg of Lucentis® (ranibizumab injection). Lucentis is a monoclonal antibody that is injected into the vitreous humor (jellylike filling of the eyeballs) once a month by ophthalmologists who are specifically trained in its use. It is indicated to treat wet age-related macular degeneration (AMD), diabetic macular edema (DME) and macular edema caused by retinal vein occlusion (RVO). By blocking receptors for vascular endothelial growth factor (VEGF), it lessens new blood vessel formation and helps to keep blood from seeping out of leaky vessels. Pre-filled syringes simplify the injection procedure by eliminating the need to draw the medication from a vial. They are expected to be marketed early in 2017. Click here for prescribing information.

MedWatch Update

Generics for Concerta

Following up on previous actions, FDA has begun proceedings to rescind its approvals for two generics of Janssen’s Concerta® (methylphenidate) extended-release tablets. In November 2014, FDA amended its Draft Guidance on Methylphenidate Hydrochloride to revise the methods for determining bioequivalence (interchangeability) of methylphenidate products. At that time, FDA notified the manufacturers of the two generics available in the U.S. that the bioequivalence ratings of their products changed from AB-rated (therapeutically equivalent) to BX (presumed therapeutically inequivalent) under the new guidance. No safety issues were found with either generic, so they still can be prescribed and dispensed. However, they cannot be interchanged automatically with Concerta. Both companies, Mallinckrodt and Kudco, had the options of removing their generic product from the U.S. market or carrying out biequivalency studies to show therapeutic effects comparable to Concerta’s. Kudco subsequently was sold to UCB/Kremers Urban, which then was bought by Lannett in 2015. Neither Lannett nor Mallinckrodt has complied with the FDA directive, so both have been given 30 days to request a hearing. If a hearing is granted, an additional 30 days is allowed for all information needed to prove the generic is bioequivalent. If they do not respond or fail to support bioequivalence, FDA will withdraw approval and the products will no longer be available in the U.S. An authorized generic made by Janssen will continue to be distributed under the Actavis label. For more information, please see the FDA Drug Safety Communication by clicking here. 

Updated Hepatitis C Issues Document Available

The standard of care for treating chronic hepatitis C (CHC) has been evolving. This Issues Document is intended to describe current and pipeline medications for treating hepatitis C and how Express Scripts and Accredo can effectively manage the evolving market. This latest update includes the recent approval of Viekira XR. The pipeline table has also been updated. Click here for the Hepatitis C Issues Document.

 

21Oct
Clinical Matters News Flash

Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

Lilly Receives Approval for Lartruvo

Lartruvo™ (olaratumab injection, 10mg/mL – Eli Lilly and Company) received U.S. Food and Drug Administration (FDA) approval on October 19, 2016. It is the first monoclonal antibody to be indicated for treating adults with soft tissue sarcomas (STS) that have histologic subtypes appropriate for an anthracycline-containing regimen, but that are not amenable to curative treatment with radiation or surgery. Recommended dosing for Lartruvo is on 21-day cycles with 15mg/Kg given as a 60-minute intravenous (IV) infusion on the first and eighth days. Doxorubicin is given along with Lartruvo for the first eight cycles. Treatment continues until the patient can no longer tolerate side effects or until the cancer ceases to respond. In the open-label, phase II JGDG clinical trial, median overall survival was nearly one year longer among patients using Lartruvo and doxorubicin than among patients on doxorubicin alone. Accredo will be the exclusive provider for Lartruvo. Click here for full prescribing information.

  • Brand (Generic) Name: Lartruvo™ (olaratumab injection, 10mg/mL)
  • Manufacturer: Eli Lilly and Company
  • Date Approved: October 19, 2016
  • Indication: Along with doxorubicin for initial treatment of adults with soft tissue sarcoma (STS) with a histologic subtype for which an anthracycline-containing regimen is appropriate and which is not amenable to curative treatment with radiotherapy or surgery
  • Dosage Forms Available: single-use, 50mL vials each containing 500mg of Lartruvo
  • Launch Date: Lilly expects Lartruvo to be available within the next few weeks.
  • Estimated Annual Cost: Not yet available
  • Specialty Status: Lartruvo will be added to Express Scripts’ specialty drug list.
  • Sarcomas (cancers in connective tissues) can occur in various types of soft tissues, such as cartilage, fat, muscles and nerves.
  • According to the National Cancer Institute (NCI), approximately 12,000 Americans per year are diagnosed with an STS.
  • Lartruvo is the first monoclonal antibody to be FDA approved for treating STS.
  • It will be infused along with doxorubicin on days one and eight for eight 21-day cycles. If further treatment is needed, Lartruvo is used alone.
  • Under FDA’s Accelerated Approval, Breakthrough and Fast-Track procedures, approval for Lartruvo was granted from phase II clinical data. It also has been designated as an orphan drug. Positive results from the ongoing phase III ANNOUNCE trial will be needed for full approval.

 

18Oct
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Intravenous Carbamazepine Approved

On October 7, 2016, the U.S. Food and Drug Administration (FDA) approved the first intravenous (IV) form of carbamazepine, a medication that treats epilepsy. Lundbeck’s Carnexiv™ (carbamazepine) is indicated for adults who need temporary (seven days or less) replacement for oral epilepsy therapy. It is approved for patients who have generalized tonic-clonic seizures, partial seizures with complex symptomology, certain kinds of mixed seizure patterns and other generalized or partial seizures. All carbamazepine products, including Carnexiv, have a boxed warning about potentially life-threatening skin reactions, such as Stevens-Johnson syndrome, that they may cause, especially for patients of Asian backgrounds. With launch expected early in 2017, Carnexiv will be dispensed as 200mg/20mL single-use vials. Recommended dosing is 70% of the daily oral dose that the patient had been taking divided into four infusions each given over 30-minutes at six-hour intervals. Click here for prescribing information.

FDA Approves Flublok Quadrivalent

Protein Sciences Corporation announced on October 11, 2016, that FDA has approved a quadrivalent (effective against four different influenza strains) formulation of its Flublok® (influenza vaccine). It is indicated for adults 18 and older. Because it contains more active antigens than other flu vaccines available in the U.S., Flublok Quadrivalent may provide better protection than vaccines with fewer antigens, particularly for individuals who are 50 and older and patients with immunocompromising conditions. Additionally, all Flublok vaccines are recombinant -- they are made in cultured cells without antibiotics, animal cells, eggs, live influenza virus or preservatives. Flublok Quadrivalent will be launched next year in pre-filled, single-dose syringes for intramuscular (IM) injection.

Generic to Beyaz Available

Teva Pharmaceuticals announced the launch of its A-rated generic to Bayer’s Beyaz® (drospirenone, ethinyl estradiol and levomefolate calcium tablets, 3 mg/0.02 mg/0.451 mg and levomefolate calcium tablets, 0.451 mg), an oral contraceptive primarily used by women to prevent pregnancy. It can also be used to treat premenstrual dysphoric disorder (PMDD) and moderate acne for women at least 14 years of age. Teva’s generic, made available under the trade name of Rajani™, is available in 28-day blister packs.  According to IMS Health data, Beyaz had annual sales of approximately 3 million in the U.S. for the 12 months ending July 2016.

Infant-Specific Dose of Pertzye Approved

On October 11, 2016, Digestive Care, Inc. and Chiesi USA announced that FDA approved Pertzye® (pancrelipase) in a 4,000 USP lipase units delayed-release capsule strength. Pertzye is a combination of porcine-derived lipases, proteases, and amylases indicated for the treatment of exocrine pancreatic insufficiency due to cystic fibrosis or other conditions. The recommended dose for infants up to 12 months of age is 4,000 lipase units (one capsule) per 120mL of formula or per breast-feeding. Pertzye has been on the market since 2012 and is currently supplied as delayed-release capsules containing 8,000 USP lipase units and 16,000 USP lipase units. It is approved for use in patients of all ages; dosing varies depending on a patient’s weight and age. Click here for updated prescribing information.

2016-2017 Influenza Season Issues Document Available

The best way to keep from getting influenza (flu) is to get an influenza vaccination before the start of the flu season each year. This document provides a general update for the 2016?2017 flu season and highlights Express Scripts program offerings. Click here for the Issues Document.

Generics to Benicar Issues Document Available

U.S. Patents on Daiichi-Sankyo’s Benicar® (olmesartan) expire on October 25, 2016. The first generics for it and for its combination product – Benicar HCT® (olmesartan/hydrochlorothiazide) are expected to be launched soon thereafter. Generics for other olmesartan combinations, Azor® (olmesartan/amlodipine) and Tribenzor® (olmesartan/amlodipine /hydrochlorothiazide), also could reach the U.S. market. This document provides information regarding the high blood pressure market, focuses on the impact of olmesartan generics, and highlights how Express Scripts’ utilization management programs help to assure affordable, clinically appropriate care. Click here for the Generics to Benicar Line Issues Document.

Updated Biosimilars Issues Document Available

The Emerging Therapeutics department has updated the Biosimilars Issues Document to note the approvals of Sandoz’s Erelzi™ (etanercept–szzs) and Amgen’s Amjevita™  (adalimumab–atto). Click here for the Biosimilars Issues Document.

 

12Oct
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

New Strength for Zubsolv

A new, low strength of Zubsolv® (buprenorphine 0.7mg/naloxone 0.18mg) sublingual tablets was approved by the U.S. Food and Drug Administration (FDA) on October 4, 2016. Zubsolv is a CIII controlled substance that -- along with counseling and psychosocial support -- treats adults with opioid dependence disorder. It already had been FDA approved in five higher strengths for both of its components. Its manufacturer, Orexo US, believes that the range of available strengths will better allow prescribers to tailor each patient’s therapy to individual needs. After patients show signs of opioid withdrawal, Zubsolv is given as several doses on the first day, and then decreased to once a day. A Medication Guide and product labeling warn that it contains buprenorphine, an opioid that can be abused. As with all opioids, it also can cause potentially severe breathing problems and it can be life-threatening if swallowed by children. The naloxone component has very little activity when taken sublingually, but it blocks the euphoric effects of buprenorphine if the tablets are crushed, dissolved and injected. Zubsolv patients should be supervised by a healthcare professional and refills for prescriptions should be limited to a few days at a time, at least until an effective dose is determined. Orexo plans on launching the new strength early next year. Click here for complete prescribing information for current strengths of Zubsolv. 

MedWatch Update

Direct-Acting Antivirals

FDA is requiring a boxed warning to be added to the labeling and Medication Guides of direct-acting antiviral (DAA) drugs, which are used to treat chronic hepatitis C. On October 4, 2016, FDA released a Safety Communication warning that hepatitis B may return or be worsened for patients who take a DAA and who have or who have had hepatitis B. Between late November 2013 and mid-July 2016, FDA documented over 20 cases of hepatitis B that was reactivated by a DAA. Three of the cases were severe – resulting in a liver transplant or death. Before starting treatment for hepatitis C, patients should let their doctors know if they also have or had hepatitis B. Additionally, patients taking a DAA should immediately report symptoms, such as extreme fatigue, light-colored stools, loss of appetite, nausea, vomiting and yellowed eyes or skin, that could indicate liver damage from reactivated hepatitis B. Healthcare providers are advised to test hepatitis C patients for hepatitis B, as well. All DAAs will carry the new warning. Those currently approved in the United States, are Daklinza™ (daclatasvir), Epclusa® (sofosbuvir/velpatasvir), Harvoni® (sofosbuvir/ledipasvir), Olysio® (simeprevir), Technivie® (ombitasvir/paritaprevir/ritonavir), Viekira® Pak and Viekira XR™ (dasabuvir/ombitasvir/paritaprevir/ ritonavir) and Zepatier™ (elbasvir/grazoprevir). Click here for more information about the new warning.

Updated DrugWatch Document Available

The Emerging Therapeutics department has updated DrugWatch, a document that highlights near-term pipeline drugs as well as potential new generic opportunities. Click here for the updated DrugWatch document.

 

5Oct

The governors of Florida, Georgia, North Carolina and South Carolina have declared a state of emergency

  • Staff
  • All   FSBP  

The governors of Florida, Georgia, North Carolina and South Carolina have declared a state of emergency as a result of Hurricane Matthew for the following counties:
Florida:  All counties are affected

Georgia: Brantley, Bryan, Bulloch, Camden, Charlton, Chatham, Effingham, Evans, Glynn, Liberty, Long, McIntosh and Wayne

North Carolina: Alamance, Anson, Beaufort, Bertie, Bladen, Brunswick, Camden, Carteret, Caswell, Chatham, Chowan, Columbus, Craven, Cumberland, Currituck, Dare, Davidson, Davie, Duplin, Durham, Edgecombe, Forsyth, Franklin, Gates, Granville, Greene, Guilford, Halifax, Harnett, Hertford, Hoke, Hyde, Johnston, Jones, Lee, Lenoir, Martin, Montgomery, Moore, Nash, New Hanover, Northampton, Onslow, Orange, Pamlico, Pasquotank, Pender, Perquimans, Person, Pitt, Randolph, Richmond, Robeson, Rockingham, Sampson, Scotland, Stokes, Surry, Tyrrell, Vance, Wake, Warren, Washington, Wayne, Wilson, and Yadkin.

South Carolina: All counties are affected.
Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

3Oct
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • FSBP   Prescription  

Generic Launched for Epzicom

On September 28, 2016, Teva Pharmaceutical Industries introduced to the U.S. market a generic for the combination drug, Epzicom® (abacavir/lamivudine). Taken once daily, it is indicated for use along with other antiretroviral drugs for treating HIV-1 infection in adults and children who weigh at least 25Kg (55 pounds). Each tablet contains 600mg of abacavir and 300mg of lamivudine. Both are nucleoside reverse transcriptase inhibitors (NRTIs). Labeling carries a boxed warning about the drug’s potential to cause hypersensitivity reactions, lactic acidosis and hepatomegaly. It also may worsen hepatitis B for co-infected patients who take it. The status of additional generics is not yet known.

  • Brand (Generic) Name: Epzicom® (abacavir/lamivudine)
  • Brand Manufacturer: ViiV Healthcare
  • Generic Manufacturer: Teva Pharmaceutical Industries
  • Indication: In combination with other antiretroviral agents for treating HIV-1 infection
  • Dosage Forms Available: tablets containing 600mg of abacavir and 300mg of lamivudine

 

3Oct
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Stelara Approved for Crohn’s Disease

The U.S. Food and Drug Administration (FDA) authorized an additional indication for Janssen Biotech’s Stelara® (ustekinumab) on September 23, 2016. Stelara, a monoclonal antibody that targets interleukins 12 and 23 (IL-12 and IL-23), is already FDA approved for treating psoriasis and psoriatic arthritis. Its new indication is to treat adults who have moderate to severe active Crohn’s disease that has not responded to corticosteroids, immunomodulators or tumor necrosis factor (TNFα) inhibitors. A first dose of up to 520mg is determined by the weight of the patient and infused intravenously (IV) by a healthcare provider. Then, beginning eight weeks after the initial dose, recommended dosing is 90mg of Stelara subcutaneously once every eight weeks. A Medication Guide dispensed with each prescription informs patients and caregivers how to use pre-filled syringes for giving the injections. Click here for updated prescribing information.
Orkambi Receives New Indication

A combination cystic fibrosis drug made by Vertex pharmaceuticals received an additional FDA indication on September 28, 2016. Orkambi® (lumacaftor/ivacaftor) now is approved to treat cystic fibrosis patients who have two mutated copies of F508del on the cystic fibrosis transmembrane conductance regulator (CFTR) gene and who are between six and 12 years of age (approximately 2,400 American patients). Orkambi initially was approved by FDA in July 2015 for treating patients age 12 years and older who have the same genetic mutation (about 8,500 U.S. patients). It is the only drug that specifically affects F508del mutations, which are the most common ones in cystic fibrosis. Lumacaftor corrects CFTR and ivacaftor enhances it. For children between six and 12 years of age, the recommended dose is two tablets containing 100mg of lumacaftor and 125mg of ivacaftor once every 12 hours. To maximize its absorption, Orkambi should be taken along with foods, such as cheese, eggs and peanut butter, which contain fat. Vertex is conducting further clinical studies on Orkambi’s use for children as young as two years of age. Click here for prescribing information.

Labeling Update for Rexulti 

Rexulti® (brexpiprazole) was granted FDA approval on September 23, 2016, to include the results from a clinical trial in its prescribing information. In July 2015, it was FDA approved as a single therapy to treat schizophrenia and as add-on treatment for major depression. The continuation of a previous trial found that patients with schizophrenia who were stabilized on Rexulti and kept taking it had longer times to relapse than study patients who were switched to an inactive placebo. Labeling now can include information about its use as schizophrenia maintenance therapy. Rexulti is an atypical antipsychotic that is believed to work by partially activating both dopamine and serotonin receptors to help regulate neurotransmitter levels. A boxed warning cautions that Rexulti should not be used by elderly patients with psychoses due to dementia and that patients younger than 24 years of age should be watched for behavioral changes while they take it. Rexulti was developed jointly by H. Lundbeck A/S and Otsuka Pharmaceutical Company. Click here for complete prescribing information.

 

1Oct
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Welcome to Fall 2016!

I am so pleased to announce the Foreign Service Benefit Plan’s 2017 Premiums:

Foreign Service Benefit Plan 2017 Premiums

Bi-Weekly Premium

 

Monthly Premium

Self Only            Code 401

Self Plus One Code 403

Self & Family Code 402

 

Self Only Code 401

Self Plus One Code 403

Self & Family     Code 402

$  64.44

7.84

9.41

 

 9.62

  1.99

   5.40

 

 

 

 

 

 

 

At a time when the average increase in premiums for the Federal Employees Health Benefits Program is 6.2%, we are most gratified to have kept our premiums stable.  Our Self Only and Self and Family premiums are increasing only 2%, while our Self Plus One premium has gone down 12¢.

See our Open Season announcement on our home page for complete information about benefit enhancements.

In many parts of the world, Fall means transitioning from warm weather to cold weather. You may want to consider getting a flu shot. For the best protection, every family member over the age of six months should get vaccinated annually. The Foreign Service Benefit Plan (FSBP) covers flu vaccinations at 100% when obtained at an in-network provider or provider outside the U.S.

So, have you moved? If so, please let us know. As you leave one post for another, please send us your updated mailing address, telephone number(s), and e-mail address. You can update your contact information via the Member Portal. We want you to receive your reimbursement checks and member communications in a timely manner. Please tell us if you change locations so we can stay in touch.

Open Season is fast approaching. This year, the enrollment period is from November 14 to December 12, 2016. AFSPA staff always travel to various regions of the globe in preparation for Open Season. Any Direct Hire Federal employee who is enrolled or is eligible to enroll in any plan under the Federal Employees Health Benefits (FEHB) Program is invited to attend.  This year’s topics include:

  • Benefits and OPM Initiatives
  • Prescription Drugs
  • Access to Care
  • Wellness Programs
  • Overseas Considerations
  • FSAFEDS
  • FEDVIP

See a few October dates below:

October 24 – Alconbury Middle School, Library – 3:15pm

October 25 – Lakenheath High School, Library – 4pm

October 26 – US Embassy, London, Cafeteria Lobby – 9:00am

For a complete list of our Open Season visits this year, please email [email protected].

If you are in the area, please plan to attend one of our Open Season briefings. And look out for our new Fall Newsletter in your mailbox. It is full of new information about our new 2017 benefits.

As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

26Sep
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Amjevita, a Biosimilar to Humira, Approved

On September 23, 2016, the U.S. Food and Drug Administration (FDA) approved Amgen’s Amjevita™ (adalimumab – atto), a biosimilar to AbbVie’s Humira®. Amjevita is approved for treating adults with rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis. It is also approved for treating children four years of age and older with polyarticular juvenile idiopathic arthritis. The dose of Amjevita varies depending on the indication. While Amgen’s launch plans for Amjevita are unknown, it is possible that launch could be delayed for several years due to patent litigation. Amjevita will be added to Express Scripts’ specialty drug list. Express Scripts is reviewing the data around Amjevita for a possible utilization management strategy. Click here for full prescribing information.

Kyleena Long-Acting Contraceptive Approved

On September 16, 2016, the U.S. Food and Drug Administration (FDA) approved Bayer Pharmaceuticals’ Kyleena™ (levonorgestrel-releasing intrauterine system). It is a long-acting reversible contraceptive (LARC). As an intrauterine device, (IUD), Kyleena must be inserted and removed by a healthcare provider. It prevents pregnancy for up to five years by slowly releasing a low dose of progestin. It may be removed earlier, if needed; and it does not affect fertility after removal. Hormonal IUDs, such as Kyleena, are more effective at preventing pregnancy than other reversible forms of contraception. Bayer plans to launch it in October 2016. It will be available through a limited network of specialty pharmacies that does not include Accredo. Kyleena will be added to Express Scripts’ specialty drug list. Click here for complete prescribing information.

Lomaira Approved for Weight Loss

KVK-Tech, Inc. received FDA approval on September 12, 2016, for Lomaira™ (phentermine) tablets, 8mg. Lomaira is indicated to be used no longer than a few weeks for patients 18 years of age and older who need to lose weight. Behavior modification, calorie restriction and exercise are recommended along with its use. It is intended for patients who have a body mass index (BMI) in the obese range (30kg/m2 or above) and for overweight patients (BMI between 27kg/m2 and 30kg/m2) who have additional risk factors, such as diabetes and high cholesterol. The recommended dose is one tablet three times a day, one-half hour before each meal. Although Lomaira is scheduled for launch on September 26, 2016, its pricing is not yet available. Click here for full prescribing information.

FDA Approves Invokamet XR

Invokamet® XR, (canagliflozin/metformin extended-release) tablets, a once-daily form of Janssen’s Invokamet® (canagliflozin/metformin), was approved by FDA on September 20, 2016. A fixed-dose combination sodium-glucose co-transporter 2 (SGLT2) inhibitor and extended-release metformin, Invokamet XR is indicated for the first-line treatment of adults with type 2 diabetes. Tablets will be available in four strengths -- either 50mg or 150mg of canagliflozin, and either 500mg or 1000mg of extended-release metformin. Recommended dosing is two tablets every morning along with breakfast. Because metformin may be associated with lactic acidosis, an uncommon, but serious condition, labeling for Invokamet XR includes a boxed warning. A Medication Guide will be dispensed with each prescription. No launch plans have been announced. Click here for prescribing information.

New Indications for Ilaris

FDA has granted three new indications for Ilaris® (canakinumab – Novartis). It is the first biological treatment to be FDA approved for treating familial Mediterranean fever (FMF), mevalonate kinase deficiency (MKD) and tumor necrosis factor-receptor associated periodic syndrome (TRAPS). MKD also may be called hyperimmunoglobulin D syndrome (HIDS). All three newly approved indications are for forms of the rare autoimmune disorder, periodic fever syndromes. They cause episodes of fever along with inflammation, joint and muscle pain, rashes and swelling. Ilaris originally was FDA approved in 2009 to treat patients four years of age and older who have another periodic fever syndrome, cryporin-associated periodic syndromes (CAPS). A second U.S. indication, to treat systemic juvenile idiopathic arthritis patients at least two years old, was approved in 2013. A monoclonal antibody that inhibits interleukin-1 beta (IL-1β), Ilaris is injected subcutaneously to decrease inflammation. Dosing depends on the patient’s body weight and dosing intervals depend on the condition being treated. It is dispensed in single-use vials containing 180mg of active drug after being mixed with 1mL of sterile preservative-free water. A Medication Guide supplied with Ilaris warns that patients using it have a higher than normal risk of developing serious infections. Click here for updated prescribing information. 

 

26Sep
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

I am excited and pleased to announce that the Foreign Service Benefit Plan (FSBP) was awarded a three-year term of accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC).  Accreditation demonstrates that we have standards of quality in place and assures the public that we have made a commitment to continually enhance the quality of services and programs offered to our members and we continue to focus on the satisfaction of the members served.

Read more about our three-year accreditation, how we prepared for it, and what accreditation means to you – our members –  in our Fall newsletter that you will receive just before Open Season.

As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

23Sep

Scheduled Maintenance Notice

  • Staff
  • All   FSBP  

Please be advised that on Sunday, September 25, 2016  both www.afspa.org and www.slfoundation.org websites may be unavailable from 11:00pm - 1:00 am EDT as they will be undergoing maintenance.
Our secure Member Portal (https://secure.myafspa.org/) will not be affected by this scheduled maintenance.
We apologize for the inconvenience

 

21Sep
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Exondys 51 Approved

The U.S. Food and Drug Administration (FDA) approved Exondys 51™ (eteplirsen) injection on September 19, 2016. Exondys 51 is the first FDA-approved drug indicated to treat patients who have Duchenne muscular dystrophy (DMD). It specifically is for patients that have been confirmed to have mutations of dystrophin genes amenable to exon 51 skipping. It is given once every week as an intravenous (IV) infusion at 30mg/kg of body weight. Single-use vials contain 50mg/mL in either 2mL or 10mL sizes. Sarepta plans on launching Exondys 51 immediately. It will be available through a limited distribution network that does not include Accredo. Click here for complete prescribing information.

Exondys 51 will be added to Express Scripts’ specialty drug list. Express Scripts currently is investigating the data around Exondys 51 for a possible utilization management strategy.

Cuvitru Immune Globulin Approved

The U.S. Food and Drug Administration (FDA) approved a new immune globulin formulation on September 13, 2016. Shire’s Cuvitru [Immune Globulin Subcutaneous (Human)] 20% Solution treats primary immunodeficiency disorders including congenital agammaglobulinemia, Wiskott-Aldrich syndrome,  severe combined immunodeficiencies, common variable immunodeficiency and several others. Indicated for patients who are at least two years old, it is given subcutaneously through a portable infusion pump. Depending on the patient’s response, dosing can be as often as once a day; but some patients need only a few doses a week and others can be treated as infrequently as once every other week. When a dosing pattern is established, it should continue on a regular schedule, but adjustments in the amount of drug for each infusion are common. Cuvitru will be dispensed as 200mg/mL in single-use 5mL, 10mL, 20mL and 40mL vials. All immune globulins have a boxed warning that cautions they have the potential to cause blood clots and that advises patients to drink adequate fluids before each dose. It further recommends that the lowest effective amount be given over the minimum practical infusion time. Shire plans to release Cuvitru on the U.S. market within the next few weeks. It will be distributed by a limited network of specialty pharmacies that includes Accredo. Click here for complete prescribing information. 

Cuvitru will be added to Express Scripts’ specialty drug list. Express Scripts is reviewing the data around Cuvitru for inclusion in our Adjunctive Specialty Prior Authorization Program.

Yosprala Approved

Yosprala™ (aspirin/omeprazole) delayed-release was FDA approved on September 14, 2016. It is indicated for preventing cardiovascular events, such as heart attacks, and cerebrovascular events, such as strokes, for adults who already have had an event and who are likely to get stomach ulcers if they take aspirin. Each tablet contains 40mg of immediate-release omeprazole, a proton pump inhibitor (PPI) that protects the stomach. Either 81mg or 325mg of slow-release aspirin is included, too. The aspirin is enteric coated, so it does not dissolve in the stomach until after the omeprazole changes the levels of stomach acid. As a result, the chances of ulcer-causing damage in the stomach are reduced. Yosprala should be swallowed whole once a day an hour or more before a meal. It does not substitute for immediate-release aspirin in emergency situations and it cannot be interchanged with separate omeprazole and aspirin tablets. A medication guide for patients will be dispensed with each prescription filled. The manufacturer, Aralaz Pharmaceuticals, Inc. announced that Yosprala will be launched during the week of October 2, 2016. Click here for full prescribing information.  

Express Scripts is currently investigating the data around Yosprala for a possible utilization management strategy. 

Authorized Generic of Cubicin Launched

On September 15, 2016, Teva announced the launch of an authorized generic of Merck’s Cubicin® (daptomycin for injection), 500mg vials. Cubicin is indicated to treat adults with complicated skin and skin structure infections (cSSSI) caused by susceptible isolates of certain Gram-positive bacteria. In addition, it is indicated to treat adults with Staphylococcus aureus bloodstream infections. Annual sales of Cubicin are approximately.6 billion. True, A-rated generics to Cubicin are expected to launch in the near future.

 

12Sep
Clinical Matters News and Notes

Clinical Matters News and Notes

  • Express Scripts
  • FSBP   Prescription  

Blincyto Approved for Children

On August 30, 2016, the U.S. Food and Drug Administration (FDA) approved Amgen’s supplemental biologics license application (sBLA) for Blincyto® (blinatumomab). A bispecific CD19-directed CD3 T-cell engager, Blincyto was first FDA approved in 2014 for treating adults who have Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia (ALL) that has recurred or that is no longer responding to previous treatment. FDA now has approved it for children and teens with the same type of relapsed or refractory ALL. It is dosed by weight for patients who weigh at least 45kg (99 pounds), and by body surface area (BSA) for patients who weigh less. Blincyto is given on 42-day cycles. It is infused through a continuous intravenous (IV) pump for 28 days, which is followed by 14 days with no drug. Patients should be treated in a healthcare facility for the first nine days of their first treatment cycles, and for the first two days of cycle two. Up to five cycles may be needed for a course of treatment. Labeling for Blincyto carries boxed warnings about potentially fatal neurological toxicity and cytokine release syndrome that it could cause. Additionally, its use may be associated with a number of other possibly severe side effects including infections, neutropenia, pancreatitis and tumor lysis syndrome. For complete updated prescribing information click here.

 

7Sep
Express Scripts Clinical Matters News and Notes

Express Scripts Clinical Matters News and Notes

  • Express Scripts
  • FSBP   Prescription  

Afluria Quadrivalent Flu Vaccine Approved

On August 29, 2016, Seqirus announced that the U.S. Food and Drug Administration (FDA) approved Afluria® Quadrivalent (influenza virus vaccine) for adults as active immunization against the two strains of influenza B as well as the two strains of influenza A that are included in the vaccine. It will be supplied in single-dose, preservative-free pre-filled syringes. Seqirus plans to launch Afluria Quadrivalent in time for the 2016-2017 flu season. Click here for full prescribing information for Afluria Quadrivalent. 
 

Expanded Arzerra CLL Indication Approved

On August 31, 2016, FDA approved Novartis’ monoclonal antibody Arzerra® (ofatumumab) for intravenous (IV) infusion in combination with fludarabine and cyclophosphamide to treat patients with relapsed chronic lymphocytic leukemia (CLL). This is the fourth CLL indication approved for Arzerra. CLL is the most common form of adult leukemia; it affects approximately 105,000 Americans – mostly over 55 years of age. Click here for updated prescribing information.
 

Generic Nitrostat Launched

On August 29, 2016, Dr. Reddy’s announced the launch of A-rated generics to Pfizer’s Nitrostat® (Nitroglycerin) sublingual tablets, a product approved for the treatment and prevention of chest pain (angina pectoris) due to coronary artery disease. Dr. Reddy’s nitroglycerin sublingual tablets are available in 0.3mg, 0.4mg and 0.6mg strengths. According to IMS Health, Nitrostat had U.S. sales of approximately 8 million for twelve months ending in March 2016.

 

2Sep

States of Emergency due to Tropical Storm Hermine – Florida, Georgia and North Carolina

  • Staff
  • FSBP   fsbp411   All  

The Governors of Florida, Georgia and North Carolina have declared States of Emergency due to Tropical Storm Hermine.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

2Sep

States of Emergency due to Tropical Storm Hermine

  • Staff
  • fsbp411   All   FSBP  

The Governors of Florida and Georgia have declared States of Emergency due to Tropical Storm Hermine.

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

1Sep
Express Scripts Clinical Matters News Flash

Express Scripts Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

FDA Approves Erelzi, a Biosimilar to Enbrel

On August 30, 2016, the U.S. Food and Drug Administration (FDA) approved Sandoz’s Erelzi™ (etanercept – szzs), a biosimilar to Amgen’s Enbrel®. Erelzi was approved for all Enbrel-approved indications. It can be used for treating patients with rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and polyarticular juvenile idiopathic arthritis. The dose of Erelzi varies depending on the indication. While Sandoz’s launch plans for Erelzi are unknown, it is possible that launch could be delayed two years or more due to patent litigation. Click here for full prescribing information.

  • Brand (Generic) Name: Erelzi™ (etanercept – szzs)
  • Manufacturer: Sandoz
  • Date Approved: August 30, 2016
  • Indication: Erelzi was approved for all Enbrel-approved indications. It can be used for treating patients with rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and polyarticular juvenile idiopathic arthritis.
  • Dosage Forms Available: 25mg/0.5mL and 50mg/mL solution in single-dose prefilled syringes and 50 mg/mL solution in single-dose prefilled Sensoready® Pens for subcutaneous injection
  • Launch Date: Launch plans for Erelzi are not known at this time.
  • Estimated Annual Cost: Pricing information is not available at this time.
  • Specialty Status: Erelzi will be added to Express Scripts’ specialty drug list.
  • Erelzi represents the third FDA approval for a biosimilar. Sandoz’s Zarxio® (filgrastim – sndz) was approved in March 2015, and launched in September of the same year. Pfizer and Celltrion’s Inflectra™ (infliximab – dyyb) was approved in April 2016, and launch is still pending.
  • Erelzi is not considered a generic medication nor is it considered automatically interchangeable with its innovator brand, Enbrel.
  • Erelzi is the second biosimilar tumor-necrosis factor (TNF) blocker to gain FDA approval, following Inflectra.

 

 

1Sep
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and Welcome to September 2016! That means summer is almost gone and a new school year is in full swing.

We continue to update and improve our website, based in good part from member input. This time around, we have restructured the navigation flow of our website! What is new? We have grouped information, in order to improve navigation experience.

You will now be able to find information under “ALL ABOUT FSBP” related to:

• Enrollment

• Claims

• Members overseas

• Providers

• Convenience, such as Electronic Funds Transfer

• My right to know

• FSAFEDS Transition

Our new “Wellness Incentives” section covers:

• Healthy Actions

• Discount Programs

• More Wellness Programs

• myStrengthTM

There are many more changes to explore at www.afspa.org.  

Another very important and timely topic is the Federal Long Term Care Program’s (FLTCIP) increase in premiums. Many of you who have the federal plan have a major decision to make this month.  Despite the bad press, long term care insurance, in general, while admittedly very pricey, is an excellent choice to add to your financial portfolio. While the premiums seem exorbitant, they are a far cry from the,000 average cost of a nursing home. Members have come to us for advice and here is what we tell them:

  • If you can afford the premium increase, by all means keep the policy at the benefit level you have.
  • If you can’t afford the premium increase, then try to work with one of the Federal LTC counselors to determine what benefit level you would receive at your current premium.
  • But do try to keep the policy.  Even at the increased premium, it is far less expensive then starting over with a new policy at your current age.

Over the years AFSPA has sponsored LTC plans through three different companies – Mutual of Omaha, John Hancock, and Prudential Insurance Company of America. We contacted all three and the representatives of each company reassured us that they monitor the stability of the plans on a regular basis (not only every 7 years as is the case with the FLTCIP).  None of the companies anticipate a premium adjustment in the immediate or even near future. This is good news for our members who put their trust in AFSPA.

Read more about this topic as well as good news about the 2017 Foreign Service Benefit Plan in our Fall newsletter that you will receive just before Open Season.

As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

 

29Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Abuse-Deterrent Troxyca ER Approved

Troxyca® ER, an extended-release, abuse-deterrent formulation of oxycodone and naltrexone, was approved by the U.S. Food and Drug Administration (FDA) on Aug. 19, 2016. It is a CII opioid agonist/opioid antagonist combination that is indicated for continual maintenance treatment of severe pain that has not responded to other treatment options. In Troxyca ER, naltrexone is encased in oxycodone. When swallowed, the oxycodone releases slowly over several hours. If the capsules are crushed, however, the naltrexone and oxycodone mix together, essentially cancelling any euphoric effects from the oxycodone. Although Troxyca ER is formulated specifically to limit abuse, it still carries the boxed warning on all opioids -- that taking it may be associated with abuse, addiction, misuse, overdose and death. Babies born to women who use it during pregnancy may suffer neonatal withdrawal syndrome and older children may overdose from accidentally taking it. Troxyca ER will be marketed in six strengths and it is taken at 12-hour intervals. The manufacturer, Pfizer, recommends that a healthcare provider experienced in prescribing opioids to control chronic pain should prescribe the lowest effective dose of Troxyca ER. Doses above 80mg/9.6mg should be reserved for patients who have developed tolerance to high doses of other opioids. No release date or pricing information has been announced. Click here for complete prescribing information.

 

 

26Aug

OPM Selects New FSAFEDS Contractor

  • Staff
  • fsbp411   All   FSBP  

As previously noted, the Office of Personnel Management (OPM) selected WageWorks, Inc. as the new Federal Flexible Spending Account Program (FSAFEDS) contractor.    
The effective day of the contract was March 1, 2016.  Transition activities are well underway and will continue until WageWorks, Inc. assumes full administration of FSAFEDS in September. This change will have no impact on enrollee balances, contributions or eligible expenses.  To find out the latest information, please go to the FSAFEDS home page.
Please send any questions and/or comments to [email protected].

 

25Aug

AFSPA Website Redesign

  • Yancy Meiller, IT Manager
  • fsbp411   All   FSBP  

Greetings!
As you may have noticed, we have redesigned our website. The information has been grouped together to improve the navigation as well as to make information easier to locate.
Looking for information related to Enrollment, Claims, Providers, EFT, FSAFEDS Transition? Please check out our new "ALL ABOUT FSBP" section.

Visit our new "Wellness Incentives" to find information related to Health Risk Assessment, Healthy Actions, Discount Programs, More Wellness Programs and myStrengthmyStrengthTM

Information related to prescription costs, safety alerts, RX information and specialty medications can be located in our new "Prescription" section.

Our new "Overseas Partners" section includes information related to overseas facilities with whom we have direct billing relationships. 

Questions or Comments? Please send your feedback via our Survey:
https://www.afspa.org/secureform.cfm?formname=Feedback Survey (web)

Thank you,
Yancy Meiller

 

 

22Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

MedWatch Update

Ambien

Warnings on the labels of Ambien® (zolpidem) and Ambien CR® (zolpidem extended-release) tablets have been revised to highlight their potential association with psychomotor (conscious input into movement) problems. The U.S. Food and Drug Administration (FDA) is requiring the manufacturer, Sanofi, to explain more clearly the possibility that residual effects, such as dizziness, drowsiness, slowed response time and vision changes, may interfere with driving and other tasks on the day following Ambien use. Patients taking either product to treat insomnia are cautioned that they should allow at least seven hours for sleep after taking Ambien or Ambien CR. Additionally, doses should not be repeated during the night and patients should not take doses that are higher than recommended amounts. Patients also should avoid taking certain other drugs (including some antidepressants and antifungal agents) and drinking alcohol while they are using Ambien or Ambien CR. Click here for revised prescribing information

 

18Aug

The Governor of California has declared a State of Emergency

  • Staff
  • FSBP   fsbp411   All  

The Governor of California has declared a State of Emergency in the following counties due to fires: Lake, San Luis Obispo and San Bernardino. 

Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

17Aug

State of Emergency due to Flooding in Louisiana

  • Foreign Service Benefit Plan
  • Prescription   Services   Helpful-Links   All   FSBP   fsbp411   Health-Programs   in-network-provider  

The Governor of Louisiana has declared a State of Emergency due to flooding. All counties in Louisiana are affected.  Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide temporary alternate addresses (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.

 

15Aug

Claim submission system temporarily down

  • Staff
  • All   Benefit-Information   FSBP   fsbp411  

Please be advised our claim submission system was down starting Sunday, August 14, at 12:00PM (EST) through Monday, August 15, around 11:50am (EST). If you submitted FSBP claims during these hours and are unsure if we received them or not, please feel free to contact our Member Portal (AFSPAConnect) team via the following secure form:
https://www.afspa.org/secureform.cfm?formname=Contact%20AFSPAconnect
We will confirm receipt of your claims.
Thank you,
AFSPA

 

 

15Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Sustol Approved

Heron Therapeutics announced on August 10, 2016, that the U.S. Food and Drug Administration (FDA) had approved Sustol® (granisetron) extended-release injection. Sustol is indicated for preventing chemotherapy-induced nausea and vomiting (CINV) that occurs both immediately after chemo and for several days after the chemo session ends. Its patented extended-release formulation maintains therapeutic blood levels for five days or longer. A member of the serotonin-3 (5-HT3) receptor inhibitor class, it will be used in combination with other drugs, such as dexamethasone, that also help to prevent CINV. Recommended dosing for adults is 10mg given subcutaneously on the first day of chemotherapy; one-half hour or more before chemotherapy begins. It is packaged in pre-filled, single-dose syringes that should be administered by a healthcare professional. Because Sustol is thicker than most injectables, it can take up to 30 seconds to inject. Additionally, it may be more likely to cause injection site reactions such as bruises, pain and swelling – which may not appear until several days after the injection. No more than one dose should be given per week and Sustol should be used for no longer than six consecutive months. Launch is expected in the fourth quarter of 2016. Click here for prescribing information.

Keytruda Labeling Extended

Under its accelerated approval process, FDA approved a new indication for Merck’s Keytruda (pembrolizumab). On August 5, 2016, Keytruda received approval for patients who have recurring or metastatic head or neck squamous cell carcinoma (HNSCC). It is an intravenous (IV) drug that will be used during or following platinum-based therapy that is not controlling the cancer. A humanized monoclonal antibody, it blocks a protein (PD-L1), to enhance immune response. It previously was indicated for treating unresectable or metastatic melanoma and metastatic non-small cell lung cancer (NSCLC) that expresses PD-L1 and that has progressed during or after platinum-containing chemotherapy. NSCLC patients must be tested for PD-L1 before beginning Keytruda. To treat HNSCC, 200mg of Keytruda is infused over a 30-minute period once every three weeks. HNSCC patients will not need PD-L1 testing. To gain full FDA approval for HNSCC, Merck will need to conduct further studies. Click here for complete prescribing information.

MedWatch Update

PharmaTech Recall Expanded

PharmaTech is a company that manufactures multiple oral liquid medications for distribution by other companies. Many of them are over-the-counter products, such as vitamin drops and laxative syrups. In mid-July, Burkholderia cepacia (B. cepacia) bacteria were found in samples of Diocto Liquid (docusate sodium) oral solution that were made by PharmaTech and distributed by Rugby® Laboratories. PharmaTech recalled all lots of Rugby-labeled Diocto at that time. On August 8, 2016, PharmaTech extended the recall to include numerous other products distributed not only by Rugby, but also by Bayshore Pharmaceuticals, Centurion Labs, Major® Pharmaceuticals, Metron and Virtus Pharmaceuticals. B. cepacia infections usually are not serious, but they can be life-threatening for patients with lung conditions or immune system disorders. Only oral liquid dosage forms of the recalled drugs and supplements are affected by the recall. Click here for more information, including a complete list of affected products.

 

 

11Aug

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

  • Staff
  • fsbp411   All   FSBP  

Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess. Click here to find out what you said about FSBP.

 

8Aug

OPM Selects New FSAFEDS Contractor

  • Staff
  • All   FSBP   fsbp411  

The Office of Personnel Management (OPM) has selected WageWorks, Inc. as the new Federal Flexible Spending Account Program (FSAFEDS) contractor.   

 The effective day of the contract was March 1, 2016.  Transition activities are underway and will continue until WageWorks, Inc. assumes full administration of FSAFEDS in the Fall. This change will have no impact on enrollee balances, contributions or eligible expenses.  To find out the latest information, please go to the FSAFEDS home page.

 Please send any questions and/or comments to [email protected]

 

8Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Dysport Approved for Children

Ipsen Biopharmaceuticals received U.S. Food and Drug Administration (FDA) approval on August 1, 2016, for a new Dysport® (abobotulinumtoxinA) indication. It already was approved for several adult conditions, including cervical dystonia and upper limb spasticity. Dysport now also can be used to treat lower limb spasticity (inflexibility, spasms or stiffness in the leg muscles) for children as young as two years old. Lower limb spasticity is fairly common for children who have cerebral palsy, head injuries, multiple sclerosis (MS), spinal cord injuries or stroke. Recommended pediatric dosing, which depends on the weight of the patient, the number of affected muscles and the severity of spasticity, is 10 units to 15 units per Kg of body weight. Dosing should not exceed 15 units/Kg per leg or 1000 units total per treatment. Injections should be given at intervals of at least 12 weeks. All botulinum toxin products, including Dysport, carry a boxed warning that they may migrate away from the areas where they are injected and possibly cause widespread side effects, such as serious breathing or swallowing problems. Migration and side effects can happen even several months after the product has been injected. Children may be especially prone to having adverse effects and Dysport should not be used for patients who are allergic to cow’s milk. Click here for complete prescribing information.

First Generic Approved for Tamiflu

The first generic for Roche’s Tamiflu® (oseltamivir) capsules was FDA approved on August 3, 2016. Oseltamivir is an oral neuraminidase inhibitor that is indicated to treat influenza (flu) for patients who are at least two weeks old and who have had flu symptoms for no longer than two days. Patients take it twice a day for five days. For periods of up to 12 weeks, it also can be used to reduce the chance of getting flu for individuals who are at high risk and who are one year old or older. According to a lawsuit settlement, the generic manufacturer, Natco Pharma, and its U.S. distribution partner, Alvogen, can launch the generic capsules prior to the expiration of Tamiflu’s last exclusivity on February 23, 2017. An exact release date has not been set, but Natco/Alvogen will have 180 days of exclusivity before other generics can enter the U.S. market. Generics for Tamiflu Oral Suspension are not yet FDA approved. IMS Health estimates that 2015 sales of Tamiflu accounted for 3 million in the United States.

Over-the-Counter Flonase Sensimist

On August 2, 2016, FDA approved GlaxoSmithKline’s request to change the marketing status of Veramyst® (fluticasone furoate, 27.5mcg) from prescription-only to over-the-counter (OTC). With the new brand name, Flonase® Sensimist™ Allergy Relief, it is labeled to treat nasal congestion, sneezing and runny nose from both seasonal and perennial allergies for patients age two and older. Patients who are at least 12 years old also can use it to manage itching, watering eyes caused by allergies. Plans are to introduce Flonase Sensimist well before the 2017 spring allergy season. Flonase® Allergy Relief Spray (fluticasone propionate, 50mcg) has been an OTC product since early 2015.

Orphan Drugs Issues Document Available

Interest in developing drug treatments for small populations of patients with rare (orphan) conditions is gaining momentum. Advancing technology, changing pharmaceutical markets, emerging advocacy groups, targeting therapies and better understanding of disease processes all have increased awareness of conditions with relatively few patients. Click here for the Orphan Drugs Issues document that discusses orphan drugs and their growing impact on pharmacy spending.

Repurposing Pharmaceuticals Issues Document Available

More drugs than ever before are being re-investigated for usefulness in treating conditions other than the ones they originally were developed to manage. By one estimate, 30% of the drugs and vaccines approved by the U.S. Food and Drug Administration (FDA) in the last few years have been repurposed in some way. Click here for the Repurposing Pharmaceuticals Issues document. 

Updated DrugWatch Document Available

The Emerging Therapeutics department has updated DrugWatch, a document that highlights near-term pipeline drugs as well as potential new generic opportunities. Click here for the DrugWatch document.

 

1Aug
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  

Greetings and Welcome to August 2016! That means summer is winding down and a new school year is coming quickly. This is a good time to visit the pediatrician and the dentist to ensure a successful and healthy school year.

Along the same lines, please make sure your children are up-to-date on vaccines before sending them back to school. According to the Centers for Disease Control and Prevention, all school-age children need vaccines. The Foreign Service Benefit Plan (FSBP) covers immunizations recommended by the American Academy of Pediatrics at 100% when obtained at an in-network provider or providers outside the 50 Untied States. Having your child vaccinated can be important as it can affect their long-term health.

FSBP is seeking accreditation through the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC). The surveyors will be onsite August 17 -19, 2016. We voluntarily requested this survey as a means of assisting our own efforts to improve the quality of health care and member services. FSBP has been preparing for the accreditation process for over a year. We are confident that our health plan will be evaluated favorably. Seeking this accreditation status is part of our ongoing “Commitment to Service” to you.

Lastly, have you moved? If so, please let us know. As you prepare to leave one post for another, please send us your new address. Your employing agency does not notify FSBP when you change your contact information. Please send a note with your updated mailing address, telephone number(s), and email address. You also can change your contact information via the Member Portal.

Look for your Summer Newsletter in the mail. It highlights AFSPA’s activities, services, and new programs, provides information on prescription drugs and offers suggestions on avoiding “ransomware” attacks. We also share some tips on how to manage stress effectively.

As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

31Jul

OPM Selects New FSAFEDS Contractor

  • Staff
  • FSBP   fsbp411   All  

The Office of Personnel Management (OPM) has selected WageWorks, Inc. as the new Federal Flexible Spending Account Program (FSAFEDS) contractor.    
The effective day of the contract was March 1, 2016.  Transition activities are underway and will continue until WageWorks, Inc. assumes full administration of FSAFEDS in the Fall. This change will have no impact on enrollee balances, contributions or eligible expenses.  To find out the latest information, please go to the FSAFEDS home page.
Please send any questions and/or comments to [email protected]

 

2Aug

AFSPA Open Again

  • Kyle Longton, COO
  • All  

AFSPA will resume normal operations at 8:30 am today. We resolved the network connectivity issues we experienced yesterday and look forward to serving you soon.

Thank you for your patience and understanding while we addressed our connectivity issues on Monday.

 

1Aug

AFSPA NETWORK DOWN

  • Kyle Longton, Chief Operating Officer
  • All  

AFSPA is experiencing a network connectivity issues at our office. The issue does not affect the security of any member data only our ability to access it at this time. We are working diligently to resolve the issue. However, we have suspended phone operations for the rest of the day and are not able to respond to emails. I anticipate that network access will be restored in time for AFSPA to open our phones at 8:30 on Tuesday morning.

I sincerely apologize for this inconvenience. Thank you for your understanding and patience while resolve the issue.  

- Kyle Longton, COO

 

1Aug
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Qbrelis Approved for High Blood Pressure
On July 29, 2016, the U.S. Food and Drug Administration (FDA) approved Silvergate Pharmaceuticals’ Qbrelis™ (lisinopril oral solution) to treat high blood pressure in adults and children at least 6 years of age. It is also approved for use as an adjunct (add-on) therapy for heart failure and treatment of acute myocardial infarctions (heart attacks). Qbrelis is the first oral liquid formulation of the angiotensin-converting enzyme (ACE) inhibitor, lisinopril. It will be available in a 150 mL bottle containing 1 mg/mL of lisinopril solution. Silvergate Pharmaceuticals has not released pricing information or an expected launch date. Full prescribing information can be found here.
MedWatch Update
Fluoroquinolone Antibiotics
The FDA is strengthening its previous safety warnings for systemic (oral and injected) fluoroquinolone (quinolone) antibiotics. Some patients taking or injecting a quinolone have experienced anaphylaxis (a severe allergic reaction), intestinal infections, nerve damage, ruptured tendons, seizures, vision loss and other rare, but serious, adverse effects. Because they can cause such often irreversible problems, oral and injected quinolones generally should be reserved only for severe infections, such as anthrax and plague. The risks of using quinolones are too great for them to be used routinely for patients with uncomplicated acute bronchial, sinus and urinary tract infections. An oral or injected quinolone should only be used for uncomplicated infections when all other treatment options have failed. The FDA is requiring revisions to boxed warnings, other label sections and patient Medication Guides for ciprofloxacin (Cipro®, generics) extended-release oral tablets, oral suspension, oral tablets and solution for injection; gemifloxacin (Factive®, generics) oral tablets; levofloxacin (Levaquin®, generics) oral solution, oral tablets and solution for injection; moxifloxacin (Avelox®, generics) oral tablets and solution for injection; and ofloxacin oral tablets. Patients, caregivers and healthcare providers should be alert for symptoms, such as arrhythmias, light sensitivity, numbness, rashes and weakness in the arms or legs, among patients using a systemic quinolone. The latest FDA Safety Communication along with information from prior warnings is available here.

 

29Jul
Express Scripts News Flash

Express Scripts News Flash

  • Express Scripts
  • Prescription   FSBP  

Adlyxin Approved for Diabetes

Sanofi has received approval from the U.S. Food and Drug Administration (FDA) for Adlyxin™ (lixisenatide). The drug is a glucagon-like peptide-1 (GLP-1) agonist for treating adults with type 2 diabetes; it is self-administered as a once-daily subcutaneous injection. The initial dose of Adlyxin is 10mcg once daily for 14 days and then increased to 20mcg daily. Prescribing information for Adlyxin is available on the company’s website here:

  • Brand (Generic) Name: Adlyxin™ (lixisenatide)
  • Manufacturer: Sanofi
  • Date Approved: July 28, 2016
  • Indication: To improve glycemic control, along with diet and exercise, for adults who have type 2 diabetes.
  • Dosage Forms Available: 50mcg/mL (green) and 100mcg/mL (burgundy) prefilled pens. The pens are designed to deliver fourteen doses of 10mcg and 20mcg per dose, respectively.
  • Launch Date: A launch date has not been established at this time.
  • Estimated Annual Cost: Pricing information is not yet available. However, Adlyxin is expected to be priced comparable to other available GLP-1 agonists at about,400 per year of therapy.
  • Type 2 diabetes is the most common form of the disease affecting about 29 million people in the US; it accounts for more than 90% of diabetes cases.
  • Adlyxin is a GLP-1 agonist that moderates blood glucose levels through several pathways, including slowing glucose absorption from the gut after meals, decreasing glucagon production and promoting insulin secretion from the pancreas.
  • Once available, Adlyxin will compete with other GLP-1 agonists, including once-weekly Bydureon® (exenatide e.r. – AstraZeneca), Tanzeum™ (albiglutide – GlaxoSmithKline) and Trulicity® (dulaglutide – Eli Lilly), once-daily Victoza® (liraglutide – Novo Nordisk) and twice-daily Byetta® (exenatide – AstraZeneca). All are administered via subcutaneous injection.
  • Sanofi’s fixed-dose combination of Adlyxin and Lantus® (insulin glargine - Sanofi) is also under FDA review. The FDA is expected to rule on the approval of this product in Aug. 2016.

 

27Jul
Express Scripts Clinical Matters News Flash

Express Scripts Clinical Matters News Flash

  • Express Scripts
  • FSBP  

Viekira XR Approved for Genotype 1 Hepatitis C

 

 

On July 25, 2016, the U.S. Food and Drug Administration (FDA) approved Viekira XR™, an extended-release formulation of dasabuvir/ombitasvir/paritaprevir/ritonavir tablets. It is indicated to treat adults who have chronic genotype 1 hepatitis C virus (HCV) infection. Dosing is three tablets taken once a day along with a meal. For patients who have genotype 1a HCV infection, Viekira XR will be used along with ribavirin. Recommended length of therapy for genotype 1a patients with compensated cirrhosis (Child-Pugh A) is 24 weeks; for genotype 1a patients without cirrhosis, treatment duration is 12 weeks. Patients with genotype 1b HCV infection without cirrhosis or compensated cirrhosis will take Viekira XR for 12 weeks and they will not need to use ribavirin. Patients with decompensated cirrhosis or severe liver conditions (Child-Pugh B or C) should not take it. AbbVie expects Viekira XR to be in pharmacies by the end of this week, but its cost has not yet been announced. Click here for complete prescribing information.

  • Brand (Generic) Name: Viekira XR™ (dasabuvir/ombitasvir/paritaprevir/ritonavir) extended-release tablets
  • Manufacturer: AbbVie
  • Date Approved: July 25, 2016
  • Indication: Treatment of adult patients with chronic hepatitis C virus (HCV) genotype 1 infection (along with ribavirin for patients with genotype 1a infection without cirrhosis or with compensated cirrhosis; as monotherapy for patients with genotype 1b infection without cirrhosis or with compensated cirrhosis)
  • Dosage Forms Available: Extended-release tablets each containing 200mg of dasabuvir, 8.33mg of ombitasvir, 50mg of paritaprevir and 33.33mg of ritonavir
  • Launch Date: July 29, 2016
  • Estimated Annual Cost: Pricing information is not available at this time.
  • Specialty Status: Viekira XR will be added to Express Scripts’ specialty drug list.
  • Approximately 3.2 million Americans have HCV infection, with genotype 1 accounting for nearly 75% of cases in the U.S.
  • Genotype 1a, which is more common in the U.S., is more difficult to treat than genotype 1b.
  • Viekira XR contains dasabuvir, a non-nucleoside polymerase inhibitor; ombitasvir, an NS5A inhibitor; and paritaprevir, a protease inhibitor that is boosted with ritonavir.
  • It will be dispensed in 28-day cartons, which will include four boxes that contain a one-week supply of daily dose packs.
  • A Medication Guide that supplies patient information will accompany each prescription filled.

AbbVie’s Viekira Pak™ was approved Dec. 19, 2014. It contains ombitasvir/paritaprevir/ritonavir tablets co-packaged with dasabuvir tablets. Not including ribavirin, the dosing regimen for Viekira Pak is three tablets in the morning and one tablet in the evening compared to three tablets once daily with Viekira XR

 

25Jul
Express Scripts Clinical News And Notes

Express Scripts Clinical News And Notes

  • Express Scripts
  • Benefit-Information   Prescription   FSBP  

Belviq XR Approved

The U.S. Food and Drug Administration (FDA) approved Arena and Eisai’s Belviq XR® (lorcaserin), 20mg extended-release tablets, on July 15, 2016. Belviq XR is a Schedule IV controlled substance known as a serotonin 2C receptor agonist. It is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in obese adults with a body mass index (BMI) of 30 kg/m2 or greater, or overweight adults with a BMI of 27 kg/m2 or greater who have at least one weight-related comorbid condition such as high blood pressure, type 2 diabetes or high cholesterol. The recommended dose is 20mg once daily. Immediate-release Belviq®, which is taken twice daily, has been on the U.S. market since June 2013. Click here for full prescribing information.

Additional Generics to Crestor Approved

On July 19, 2016, a judge rejected AstraZeneca’s request for an order to block FDA from approving additional generics to the company’s Crestor® (rosuvastatin). Following this ruling, the agency approved generics from eight additional manufacturers. Shipments from some of the manufacturers have already begun. In 2015, U.S. annual sales of Crestor were approximately.4 billion.

Generic to Nilandron Launched

On July 18, 2016, ANI Pharmaceuticals announced the FDA approval of its A-rated generic to Concordia Pharms’ Nilandron® (nilutamide) 150mg tablets. Nilandron is an anti-androgen therapy indicated for use in combination with surgical castration for the treatment of patients with metastatic prostate cancer (Stage D2). The recommended dose is 300mg once daily for 30 days followed by 150mg once daily. According to IMS Health, annual U.S. sales of Nilandron are approximately million. ANI launched its generic nilutamide tablets upon approval.

Generic to Zegerid and Zegerid OTC Launched

On July 18, Dr. Reddy’s announced the launch of A-rated generics to Zegerid® capsules. Zegerid contains omeprazole, a proton pump inhibitor (PPI), and sodium bicarbonate, an antacid. The medication is approved for the short-term treatment of stomach and duodenal ulcers, erosive esophagitis and heartburn associated with gastroesophageal reflux disease (GERD). Dr. Reddy’s omeprazole and sodium bicarbonate (20mg/1100mg and 40mg/1100mg) capsules are available in a 30 count bottle size. According to IMS Health, Zegerid had U.S. sales of approximately 6 million for the 12 months ending May 2016.

Perrigo also announced approval and launch of its store brand equivalent to Bayer’s Zegerid OTC® (omeprazole/sodium bicarbonate) 20mg/1100mg capsules. It will be packaged and marketed as a store brand or retailer owned brand label as a “value-priced” alternative to Zegerid OTC. Zegerid OTC is approved for the treatment of frequent heartburn. According to IMS Health, U.S. sales for Zegerid OTC were million for the 12 months ending June 2016.

Berinert Approved for Use in Children

FDA approved an extension to the indications of CSL Behring’s Berinert® [C1 esterase inhibitor (human)] on July 18, 2016. Previously indicated to treat hereditary angioedema (HAE) attacks in patients 12 years of age and older, it now also is approved to treat children younger than 12. Berinert has been available in the United States since 2009. Click here for full prescribing information.

Prezista Label Expanded

Janssen announced on July 18, 2016, that the FDA has expanded the use of Prezista® (darunavir) to include pregnant women with human immunodeficiency virus (HIV). The updated label is based on an analysis of women treated with Prezista during pregnancy and postpartum, and on results from prospective reports from the Antiretroviral Pregnancy Registry. The label recommends that pregnant women receive 600mg of Prezista with ritonavir 100mg twice daily.  Prezista was originally approved in 2006 to be used in combination with other antiretroviral drugs to treat HIV. Click here for complete prescribing information.

Namzaric – Widened Indication and New Strengths Approved

The indication for Namzaric®, an extended-release capsule containing memantine and donepezil, was broadened by FDA on July 18, 2016. In addition, FDA approved two new strengths for the drug, which is taken once daily to treat dementia associated with Alzheimer’s disease. It originally received FDA approval in December 2014 for patients taking both donepezil and memantine separately for moderate-to-severe Alzheimer’s-type dementia. Namzaric now is approved for patients taking only 10mg of donepezil per day. Allergan, which markets Namzaric in the U.S., announced that the new strengths (7mg memantine/10mg donepezil and 21mg memantine/10mg donepezil) will be released in September. They join 14mg memantine/10mg donepezil and 28mg memantine/10mg donepezil capsules that already are available. The recommended initial dose for patients transitioning from donepezil monotherapy is the lowest strength capsule, increasing incrementally by 7mg memantine per week up to a maintenance dose of one highest strength capsule per day. Click here for complete prescribing information. 

Oral Form of Relistor Approved

On July 19, 2016, FDA approved Relistor® (methylnaltrexone) oral tablets. Previously available only as a subcutaneous injection, Relistor is indicated to treat opioid-induced constipation (OIC) for adult palliative-care patients who are in late stage illnesses. It has an additional approval to treat OIC for adults with chronic pain that is not caused by cancer. Valeant Pharmaceuticals International plans to launch once-a-day Relistor tablets in the third quarter of this year. Click here for prescribing information.

Expanded Indication Approved for Synjardy

On July 20, 2016, FDA approved an expanded indication for Boehringer Ingelheim and Eli Lilly’s combination product Synjardy® (empagliflozin/metformin) to include treatment-naïve adults with type 2 diabetes. The Synjardy label was updated based upon results from a phase III study comparing the combination product to the individual components. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, was originally approved in 2014, while the combination product, Synjardy, was approved in 2015. Click here for full prescribing information.

MedWatch Update

Liquid Docusate

After Burkholderia cepacia (B. cepacia) bacteria were found in samples of Diocto Liquid (docusate sodium) oral solution that were tested by FDA and the Centers for Disease Control and Prevention (CDC), PharmaTech recalled all lots of Diocto on July 15, 2016. It was distributed under the Rugby® brand name. Although serious B. cepacia infections are fairly uncommon in the U.S., over 50 have been reported – mostly among patients in hospital intensive care units (ICUs) -- in the last several months. Oral docusate liquids, such as Diocto, are used widely in ICUs to help prevent constipation among patients who have limited mobility. Because other oral docusate solutions, suspensions and syrups may also contain B. cepacia, FDA and CDC are asking healthcare providers not to use any liquid docusate product until the source of the bacteria is found and eliminated. Other dosage forms of docusate (capsules, enemas and tablets) are not associated with B. cepacia contamination. Click here for more information about the PharmaTech recall.

Updated Patent Expiration Report Available

The Emerging Therapeutics Department has updated its patent expiration document. Click here for the updated patent expiration document.

 

19Jul
Express Scripts Clinical News And Notes

Express Scripts Clinical News And Notes

  • Express Scripts
  • FSBP  

New Once-Monthly Formulation of Repatha Approved

On July 11, 2016, Amgen announced U.S. Food and Drug Administration (FDA) approval of its Repatha® (evolocumab) Pushtronex™ system, a product to deliver a monthly single-dose of Repatha. The Pushtronex system is a hands-free, on-body infuser device designed to subcutaneously administer 420mg of Repatha as a single dose over nine minutes. Repatha also is available as 140mg single-use prefilled syringes and SureClick® autoinjectors. Prior to the Pushtronex system, the single monthly dose required injection with three 140mg syringes. Repatha is also approved with a dosing schedule of 140mg subcutaneously every two weeks. Amgen is expected to launch the Repatha Pushtronex system in early August 2016. Click here for full prescribing information.  

Expanded Indication for Dexilant

Takeda announced that on July 11, FDA approved an expanded indication for Dexilant® (dexlansoprazole), a proton pump inhibitor (PPI) for treating stomach acid-related disorders. Dexilant is now indicated for treating gastroesophageal reflux disease (GERD) and healing of erosive esophagitis (EE) in patients 12 years of age and older. Previously, it was indicated for use in individuals at least 17 years of age. Click here for full prescribing information.

Expanded Approval for Prevnar 13

On July 11, 2016, FDA approved a wider patient population for Pfizer’s pneumonia vaccine, Prevnar 13® (pneumococcal 13-valent conjugate vaccine [diphtheria CRM197 protein]). Previously approved by the FDA for adults age 50 and older and for children 6 weeks to 18 years old, Prevnar 13 now is indicated for all individuals over six weeks of age. It protects against 13 strains of Streptococcus pneumoniae (also called pneumococcus) bacteria, which are major causes of pneumonia and several other infections. Babies should receive doses of the vaccine at two months, four months and six months of age. A fourth dose should be given when the child is between 12 months and 15 months old. Children over age five, adolescents and adults need only one injection. Prevnar 13 is supplied in pre-filled, single-dose syringes for administration by a healthcare professional. Click here for complete prescribing information.

MedWatch Updates

Docusate Oral Solution, Oral Suspension and Syrup

As of July 14, 2016, the U.S. Centers for Disease Control and Prevention (CDC) had identified over 50 cases of Burkholderia cepacia complex (B. cepacia) bacterial infections in at least five states. Although harmless for most individuals, B. cepacia infections can be severe for patients who are immunocompromised or already seriously ill. Cystic fibrosis patients are especially prone to having lung infections caused by it. Most patients affected by the current outbreak were given a liquid form of the stool softener, docusate, while they were being treated at intensive care units (ICU) of several different hospitals. CDC and FDA believe that contaminated docusate liquid may be causing the infections. Other forms of docusate (oral capsules, oral tablets and rectal enemas) are not believed to be affected. CDC is asking healthcare providers not to give patients any liquid docusate products. All new cases of B. cepacia should be reported to public health officials and all liquid docusate that might be involved should be collected and saved to be tested for contamination. For more information, please click here. 

Alere INRatio

Alere, Inc. announced on July 11, 2016, that it is withdrawing from the U.S. market all of its INRatio® and INRatio®2 PT/INR monitoring systems. PT (prothrombin time) and INR (international normalized ratio) measure how long blood takes to clot. Target INR values for patients taking anticoagulant medications are between 2.0 and 3.0 INR units. Values above 4.5 units increase the risk of excessive bleeding. In December 2014, Alere advised that some systems under reported INR by up to 12.2 INR units when compared to plasma INR testing done by a laboratory. Readings for patients with several conditions, including anemia, cancer, end-stage kidney disease, acute or chronic infections and inflammatory disorders, were particularly likely to be incorrect. Nine serious adverse events related to using the systems prompted a recall at that time. Since then, Alere has worked with FDA to make changes that prevent the errors. However, no workable solution has been found and Alere has decided to discontinue the devices. It will inform providers and patients of alternative monitoring options as it phases out the INRatio line. For more information about the withdrawal, please click here.

Updated DrugWatch Document Available

The Emerging Therapeutics department has updated DrugWatch, a document that highlights near-term pipeline drugs as well as potential new generic opportunities. Click here for the updated DrugWatch document. 

 

 

13Jul
Express Scripts Clinical Matters News Flash

Express Scripts Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

On July 12, 2016, the U.S. Food and Drug Administration (FDA) approved Shire’s Xiidra™ (lifitegrast ophthalmic solution) 5% for treating the signs and symptoms of dry eye disease. The recommended dose is one drop in each eye administered twice daily, approximately 12 hours apart. Shire announced plans to launch Xiidra within the next few months (3rd quarter 2016). Click here for full prescribing information.

  • Brand (Generic) Name: Xiidra™ (lifitegrast ophthalmic solution) 5%
  • Manufacturer: Shire
  • Date Approved: July 12, 2016
  • Indication: Treatment of the signs and symptoms of dry eye disease
  • Dosage Forms Available: Xiidra will be available in foil pouches containing five 0.2mL single-use containers.
  • Launch Date: 3rd Quarter 2016
  • Estimated Annual Cost: Xiidra is expected to cost approximately,600 per year of therapy, similar to Restasis® (cyclosporine ophthalmic emulsion – Allergan).
  • Specialty Status: Lifitegrast is a lymphocyte function-associated antigen (LAF-1) antagonist. It works by down-regulating inflammation mediated by T lymphocytes, a type of white blood cell. Inflammation of the eye can cause a decrease in tear production, leading to dry eye disease.
  • Xiidra is a potential blockbuster medication. It will primarily compete with Allergan’s Restasis, a product with approximately.6 billion in annual sales. Restasis was originally approved in Dec. 2002 for increasing tear production in patients with dry eyes due to underlying ocular inflammation.
  • Xiidra was approved ahead of its July 22, 2016, PDUFA date. This is the second time Xiidra was under FDA review. It was issued a “complete response” letter in October 2015 as FDA requested additional data to support approval.  

 

11Jul
Express Scripst Clinical News and Notes

Express Scripst Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Syndros Oral Solution Approved

Insys Therapeutics received approval from the U.S. Food and Drug Administration (FDA) for Syndros™ (dronabinol) oral solution, a cannabinoid medication indicated to treat adults with anorexia associated with weight loss in patients with AIDS and nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments. The recommended doses and frequencies differ according to the condition being treated and the patient’s ability to tolerate the drug. Insys will launch Syndros after the Drug Enforcement Agency (DEA) completes its controlled substance scheduling review, likely in late 2016 or early 2017. Once available, it will compete with Marinol® (dronabinol capsules, CIII – Solvay/generics) for market share. Click here for full prescribing information. Express Scripts is currently evaluating the data around Syndros for a possible utilization management strategy.

 

Expanded Indication Approved for Xolair

On July 7, 2016, the FDA approved Genentech’s Xolair® (omalizumab) to treat moderate to severe allergic asthma in patients six years of age and older who are inadequately controlled with inhaled corticosteroids. Previously, Xolair was approved for this indication in patients 12 years of age and older. Xolair, a biologic drug that is administered by subcutaneous injection, has been on the market since 2003. It is also indicated to treat chronic idiopathic urticaria in patients 12 years of age and older who have symptoms despite treatment with an H1 antihistamine. Click here for full prescribing information.

 

Differin Gel Approved for Over-The-Counter Sale

The FDA announced on July 8, 2016, the approval of Differin Gel 0.1% (adapalene), a once-daily topical gel for over-the-counter (OTC) treatment of acne in people 12 years of age and older. Acne affects nearly 50 million people in the United States, and Differin Gel 0.1% is the first retinoid acne treatment available OTC. Differin Gel was originally approved in 1996 for patients 12 years of age and older with acne vulgaris. Galderma is planning to launch Differin Gel 0.1% OTC in the near future; however, at this time there is no specific launch date. Pricing is not yet known.

 

Generic to Fenoglide Available

Mylan announced the launch of its A-rated generics to Santarus' Fenoglide® (fenofibrate) 40mg and 120mg tablets. Fenoglide, a peroxisome proliferator receptor alpha (PPARα) activator, is indicated for use in combination with a low-cholesterol diet to help lower triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein B (apo B). Additionally, it may help to increase high-density lipoprotein (HDL) cholesterol, or “good” cholesterol. This marks the first launch of a true generic to Fenoglide. In June 2015, Globe Pharmaceuticals launched “authorized generics” to Fenoglide 40mg and 120mg tablets. Authorized generics are essentially brand drugs repackaged into generic-looking bottles and can compete as either brand or generics, depending on the market dynamics. For the 12 months ending on April 30, 2016, fenofibrate 40mg and 120mg tablets sales were approximately.3 million according to IMS Health.

 

5Jul
Express Scripts Clincial News and Notes

Express Scripts Clincial News and Notes

  • Express Scripts
  • FSBP   Prescription  

Humira Approved for Panuveitis

On June 30, 2016, AbbVie announced that the U.S. Food and Drug Administration (FDA) approved Humira® (adalimumab) for the treatment of non-infectious intermediate, posterior and panuveitis. In 2014, FDA granted Humira orphan drug designation for this indication. Uveitis is an inflammatory eye disease that can flare and impact vision. Uveitis is typically treated with corticosteroids. Recommended dosing of Humira for uveitis is 80mg, followed by 40mg every other week by subcutaneous injection. Humira is a tumor necrosis factor (TNF) inhibitor that was first approved in December 2002. It is also indicated to treat nine other inflammatory conditions including rheumatoid arthritis, juvenile idiopathic arthritis, psoriasis, ankylosing spondylitis, Crohn’s disease (in adults and children), ulcerative colitis, psoriasis and hidradenitis suppurativa. For full prescribing information click here.

Updated Hepatitis C Issues Document Available

The standard of care for treating chronic hepatitis C (CHC) is rapidly evolving. The Infectious Diseases Society of America (IDSA) and the American Association for the Study of Liver Diseases (AASLD) in collaboration with the International Antiviral Society-USA (IAS-USA) provides web-based, evidence-based, expert-derived recommendations for hepatitis C management. The guidance is a fluid document, updated as the treatment landscape evolves and new therapies are approved. This Issues Document is intended to describe current and pipeline medications for treating hepatitis C and how Express Scripts and Accredo can effectively manage the evolving market. Click here for the Hepatitis C Issues Document.

 

1Jul
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • Prescription   NonFEHB   All   Benefit-Information   Dental   Disability   FSBP   Health-Programs   Helpful-Links   NewMembers  

Greetings and Welcome to July 2016! That means summer is in full swing and we are enjoying the seasonal activities. As you travel and see the sites, you can take comfort in knowing AFSPA is Caring for your Health Worldwide®.

July is the month we celebrate Independence Day. The Fourth of July commemorates the adoption of the Declaration of Independence on July 4, 1776. Throughout the year, our members represent the United States and work to protect and promote the ideals embodied in our founding document. On this holiday, wherever you are in the world, I hope you can celebrate our country’s history and heritage.

Also, July is National Minority Mental Health Awareness Month. It is a time to focus on the importance of mental wellness and effective mental health care for everyone. It is also when we can make others aware of available resources. The Foreign Service Benefit Plan (FSBP) offers many benefits to address your mental health needs including Digital Coaching, Health Coaching, and myStrength™ - the online mental health support program. To learn more, see pages 83 – 86 of the Plan Brochure.

Lastly, I encourage you to maintain a healthy diet all year round. Attending summer barbeques and family reunions can invite temptations to eat unhealthy foods. But try to eat fruits and vegetables with every meal and snack. They can help your body fight off sickness. Plus, they can give you energy and help you stay at a healthy weight. When you do give into temptation, remember moderation is key.


Once again, please enjoy your friends and family on the Fourth of July. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

 

1Jul
Member Portal Outage

Member Portal Outage

  • Kyle Longton, Chief Operating Officer
  • Disability   All   Benefit-Information   Legal   Life-AD-D   fsbp411   Health-Programs   Prescription   in-network-provider   NonFEHB   Open-Season   FSBP   Helpful-Links   Immediate-Benefit   Dental   Long-Term-Care   Members-of-Household   NewMembers   Eligibility   Services   SLF   Travel   Overseas-Information  

AFSPA is experiencing an outage of its AFSPAconnect Member Portal. We are working to resolve the issue and will have it operational again as soon as possible. There may be periodic interruptions to the AFSPA.org site throughout the day as well. I anticipate that these will be temporary.

The outage also is affecting staff access to certain parts of our network. This may lead to a delay in response time to e-mails and a longer hold time for callers.

I apologize for the inconvenience and appreciate your patience.

-Kyle Longton

 

 

29Jun
Early Closing on July 1

Early Closing on July 1

  • Kyle Longton, COO
  • FSBP   All   fsbp411  

AFSPA will close at 3 pm EDT on Friday, July 1. We will remain closed through the Independence Day holiday on Monday, July 4. We will resume our normal business hours at 8:30 am EDT on Tuesday, July 5.

We wish all of our members and their families a safe and fun Independence Day!

 

28Jun

State of Emergency as a result of floods

  • Staff
  • FSBP   All  

The governors of West Virginia and Virginia have declared States of Emergency in the certain counties due to flooding. Express Script’s (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override select benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide ESI a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed.  The following counties are affected by this:
 

·         West Virginia impacted counties: Barbour, Boone, Braxton, Cabell, Calhoun, Clay, Doddridge, Fayette, Gilmer, Greenbrier, Harrison, Jackson, Kanawha, Lewis, Lincoln, Logan, Marion, Mason, McDowell, Mercer, Mingo, Monongalia, Momoe, Nicholas, Pendleton, Pleasants, Pocahontas, Preston, Putnam, Raleigh, Randolph, Ritchie, Roane, Summers, Taylor, Tucker, Tyler, Upshur, Wayne, Webster, Wetzel, Wirt, Wood, and Wyoming Counties.

·         Virginia impacted county: Alleghany

 

27Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Rayaldee Approved for Secondary Hyperparathyroidism

On June 17, 2016, OPKO Health received U.S. Food and Drug Administration (FDA) approval of Rayaldee® (calcifediol) extended-release capsules for the treatment of secondary hyperparathyroidism in adults with stage 3 or 4 chronic kidney disease and with serum total 25-hydroxyvitamin D levels less than 30ng/mL. The initial recommended dose is 30mcg once daily at bedtime, which can be increased to 60mcg after three months if intact parathyroid hormone is above the treatment goal. OPKO Health plans on launching Rayaldee in the second half of 2016; it will be available as 30mcg extended-release capsules. Click here for full prescribing information.

 

 

Avycaz Labeling Extended

On June 22, 2016, FDA approved Allergan’s request to add information from a Phase III study to the labeling for Avycaz® (ceftazidime/avibactam). It is an intravenous (IV) drug that includes two kinds of antibacterials; one is a cephalosporin and one a beta-lactamase inhibitor. Avycaz was first approved in February 2015 to be used after other antibacterial treatments had failed for patients with complicated urinary tract infections caused by certain bacteria. At the same time, Avycaz received FDA approval, in combination with metronidazole, to treat patients with complicated intra-abdominal infections that also are due to specific microorganisms. Based on the results of the study, Avycaz labeling now can include information about its effectiveness against more types of bacteria that cause complicated intra-abdominal infections. Click here for complete prescribing information.

 

20Jun
Express Scripts News and Notes

Express Scripts News and Notes

  • Express Scripts
  • FSBP   Prescription  

Vaxchora Vaccine Approved to Prevent Cholera

On June 10, 2016, the U.S. Food and Drug Administration (FDA) approved PaxVax’s Vaxchora™, a vaccine for prevention of cholera caused by serogroup O1 in adults age 18 through 65. Cholera is an acute intestinal infection characterized by diarrhea acquired by ingesting contaminated water or food. The majority of cases are associated with foreign travel to endemic areas where the water and food supply is contaminated. Vaxchora is the only vaccine approved in the U.S. for protection against cholera. It will be supplied as an oral, single-dose, live attenuated vaccine that should be administered at least 10 days before travel to a cholera-affected area. The vaccine is expected to be available in the third quarter of 2016. Click here for full prescribing information. 

 

 

Gonitro Approved for Angina Pectoris

Espero Pharmaceuticals received FDA approval for Gonitro™ (nitroglycerin) sublingual powder for the acute relief of an attack or prophylaxis of angina pectoris (chest pain) due to coronary artery disease. It will be available as packets, each containing 400mcg of nitroglycerin. The recommended dose is one or two packets under the tongue at the onset of an angina attack. One additional packet can be administered every 5 minutes as needed, not to exceed three packets within a 15 minute period. If chest pain persists after the administration of three packets, the patient should seek medical attention. Gonitro can also be used to prevent chest pain prior to engaging in activities that could provoke an acute angina attack. It represents another treatment option for the estimated eight million Americans who suffer with stabile angina due to coronary artery disease. Espero plans on launching Gonitro during the second half of 2016. Click here for full prescribing information.

 

New Strength for Orfadin

A higher strength of Sobi’s Orfadin® (nitisinone) was approved by FDA on June 15, 2016. It is indicated for the treatment of Hereditary Tyrosinaemia type-1 (HT-1), a rare and progressive disease that results in potentially fatal liver and kidney complications. Orfadin was initially approved in 2002. The new 20mg capsule is expected to launch in September 2016. The drug is also available as 2mg, 5mg, and 10mg capsules, and as a 4mg/mL oral suspension. Click here for full prescribing information.

 

Glassia Approved for Self-Infusion

On June 15, 2016, Shire and Kamada announced that FDA approved Glassia for self-infusion at home after appropriate training. Glassia, which was originally approved in 2010, is an alpha1-proteinase inhibitor to treat the chronic, genetic disorder alpha1-antitrypsin (AAT) deficiency. AAT deficiency can lead to the destruction of lung tissue and cause chronic lung disease such as emphysema. The recommended dose of Glassia is 60mg/kg administered by intravenous infusion once weekly. Click here for full prescribing information.

 

MedWatch Updates

Zecuity

Updating a safety notice that it issued earlier in June, FDA announced on June 10, 2016, that Teva Pharmaceuticals temporarily is suspending marketing, sales and distribution of Zecuity® (sumatriptan iontophoretic transdermal system) patches. Since Zecuity was launched in the U.S about 10 months ago, FDA and Teva have received multiple reports of reactions – primarily burns and scars – at the sites where patches have been applied. While they jointly investigate the adverse reactions, Teva recommends that patients stop using Zecuity, dispose of any unused patches they may have and request a different migraine drug from their physicians. Providers not only should stop prescribing Zecuity, they should advise patients to stop using it, as well. Patients who may have had reactions should be evaluated by their doctors. Those with injuries caused by Zecuity should file a MedWatch report with FDA. MedWatch forms may be requested by phone at 800.332.1088 or click here to download.

 

Teva Migraine Support Solutions can provide instructions regarding disposal of unused patches at 855.932.8489. Click here for the updated FDA notice regarding the Zecuity marketing suspension.

 

Invokana/Farxiga
Following up on another previous Safety Communication, FDA announced on June 13, 2016, that it is requiring stronger warnings for the sodium-glucose cotransporter-2 (SGLT2) inhibitors, Invokana® (canagliflozin), Farxiga™ (dapagliflozin) and their combination products, Invokamet® (canagliflozin/metformin) and Xigduo™ XR (dapagliflozin/metformin extended release). All four are indicated to treat type 2 diabetes. Over about two and one-half years, FDA verified at least 100 cases of acute kidney injury (AKI) among patients taking one of the drugs. Most recovered at least partly after the drug was stopped, but four patients died and several others had to undergo dialysis. Labeling for the drugs now includes advice for patients to report any signs of AKI, such as decreased urine output or swollen legs, to their doctors. Prescribers are cautioned to assess kidney functioning before prescribing one of the drugs and then to reassess patients regularly, watching for any possible AKI symptoms. Click here for more information.

 

13Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Byvalson Approved to Treat High Blood Pressure

Byvalson™ (nebivolol/valsartan) was approved by the U.S. Food and Drug Administration (FDA) on Jun. 3, 2016. It is indicated for lowering high blood pressure. Each tablet contains 5mg of a beta blocker (nebivolol) and 80mg of valsartan, an angiotensin II receptor blocker (ARB). Taken once daily, Byvalson can be used either as first-line treatment or for patients whose high blood pressure is not managed adequately by taking either nebivolol or valsartan alone. It also may be taken along with drugs from other classes, such as diuretics. Labeling for Byvalson has a boxed warning against using it during pregnancy because the ARB component may cause fetal death or birth defects that could include bone, kidney or lung damage. The manufacturer, Allergan, plans to release Byvalson during the second half of 2016. Click here for full prescribing information.

 

 

Express Scripts is currently investigating the data around Byvalson for a possible utilization management strategy.

 

New Formulation of Jetrea Approved

ThromboGenics NV received FDA approval for a new formulation of its already approved drug Jetrea® (ocreplasmin) for the treatment of vitreomacular adhesion (VMA). The new formulation of Jetrea will come as an already-diluted version, eliminating the previously required preparatory dilution steps prior to injection. Jetrea was originally approved in 2012 for the treatment of VMA. Jetrea is administered by intravitreal (eye) injection as a one-time dose. It is the only pharmacological treatment approved for treatment of VMA. ThromboGenics plans to launch the new formulation in the first half of 2017. Click here for full prescribing information.

 

Generic to Dofetilide Capsules Launched

Mayne Pharma announced the launch of its generic alternative to Pfizer’s Tikosyn® (dofetilide) 125mcg, 250mcg and 500mcg capsules. The company was granted 180 days of generic exclusivity.  Tikosyn is an anti-arrhythmic agent used to prevent irregular heartbeats, including atrial fibrillation and atrial flutter. According to IMS health, annual U.S. sales of Tikosyn are approximately 0 million.  

 

Updated DrugWatch Document Available

The Emerging Therapeutics department has updated DrugWatch, a document that highlights near-term pipeline drugs as well as potential new generic opportunities. Click here for the updated DrugWatch document. 

 

6Jun
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Jentadueto XR Approved for Type II Diabetes

The U.S. Food and Drug Administration (FDA) approved Boehringer Ingelheim and Eli Lilly’s Jentadueto® XR on May 31, 2016. The product is a once-daily fixed dose combination of the dipeptidyl peptidase-4 (DDP-4) inhibitor, Tradjenta® (linagliptin), and extended-release metformin. Jentadueto XR is approved for use in adult patients with type 2 diabetes where treatment with both linagliptin and extended-release metformin is appropriate. It will be available in two strengths (linagliptin/metformin e.r.) 5mg/1000mg and 2.5mg/1000mg. Boehringer Ingelheim and Lilly plan on launching Jentadueto XR in mid-to-late July. Click here for complete prescribing information.

 

Juvéderm Volbella XC Approved

On June 1, 2016, Allergan announced the FDA approval of Juvéderm Volbella® XC for use in lip augmentation and for correction of perioral lines (lines around the lips) in adults 21 years of age and older. Juvéderm Volbella XC contains a hyaluronic acid gel formulation that is designed to add volume to the lips and soften perioral lines. Allergan plans on launching Juvéderm Volbella XC in October 2016. Click here for more information.

 

Generic to Doryx 50mg Delayed-Release Tablets Launched

Mylan announced the launch of its A-rated generic alternative to Mayne Pharma’s Doryx® (doxycycline hyclate delayed-release) 50mg tablets. The company was granted 180 days of generic exclusivity preventing FDA from approving additional generics to this strength until November 2016. Doryx is a tetracycline antibiotic that is used for a variety of conditions including acne, respiratory tract infections and sexually transmitted infections. According to IMS Health, annual U.S. sales of Doryx 50mg tablets are approximately.8 million.

 

Expanded Teflaro Indication Approved

On May 31, 2016, Allergan received approval from the FDA for Teflaro® (ceftaroline fosamil) as a treatment for acute bacterial skin and skin structure infections (ABSSSI) and community-acquired bacterial pneumonia (CABP) for patients aged 2 months to younger than 18 years. Teflaro was first approved as a treatment for ABSSSI and CABP for adults in October 2010. Teflaro is the only cephalosporin antibiotic with activity against methacillin-resistant Staphylococcus aureus (MRSA) in ABSSSI. Click here for full prescribing information.

 

MedWatch Update

Zecuity

In a Drug Safety Communication released Jun. 2, 2016, FDA warned of possibly severe side effects from using Zecuity® (sumatriptan iontophoretic transdermal system – Teva Pharmaceuticals). Introduced in the United States last September to treat migraine headaches, Zecuity uses a weak electric current to deliver sumatriptan through the skin. FDA has received numerous reports from patients who have suffered burns or who have scars, some apparently permanent, from the patches, even though they were used according to directions. While it analyzes available data further, FDA advises a patient who uses a Zecuity patch and who has pain at the place where the patch is applied to take it off at once and contact a healthcare provider. The disposable patches, which each include batteries, should not get wet during use. Patients also are reminded to use each Zecuity patch for only four hours or less. Some patients may need to ask their prescribers about changing to another migraine medication.

 

2Jun
Express Scripts Clinical Matters News Flash

Express Scripts Clinical Matters News Flash

  • Express Scripts
  • Prescription   FSBP  

Generic Nuvigil Launched

 

Mylan announced the launch of its AB-rated generic to Cephalon's Nuvigil® (armodafinil) 50mg, 150mg and 250mg tablets. The drug, a stimulant medication, is approved to treat sleepiness from narcolepsy, sleep apnea, or night shift work. Mylan was granted 180 days of generic exclusivity for these strengths of Nuvigil, preventing FDA from approving additional generics until December 2016.

  • Brand (Generic) Name: Nuvigil® (armodafinil - Cephalon)
  • Generic Manufacturer: Mylan
  • Launch Date:  June 1, 2016
  • Indication: To improve wakefulness in adult patients with excessive sleepiness associated with obstructive sleep apnea, narcolepsy, or shift work disorder.
  • Dosage Forms Available: 50mg, 150mg and 250mg tablets
  • Annual U.S. Sales: 9.7 million for the most recent 12 months ending in March 2016 according to IMS Health.
  • Later today, Allergan is expected to announce the launch of its AB-rated generic to Nuvigil 200mg tablets with 180 days of generic exclusivity.
  • Nuvigil is a single isomer follow-on to the company’s Provigil® (modafinil). Generics to Provigil became available in March 2012. 

 

1Jun
Express Scripts Clinical Matters News Flash

Express Scripts Clinical Matters News Flash

  • Express Scripts
  • Prescription   FSBP  

Ocaliva Approved for Primary Biliary Cholangitis

 

On May 27, 2016, the U.S. Food and Drug Administration (FDA) approved Intercept Pharmaceuticals’ Ocaliva™ (obeticholic acid). Ocaliva is indicated to treat primary biliary cholangitis (PBC), a slowly progressing autoimmune liver disease caused by the destruction of bile ducts. Ocaliva stimulates farnesoid X receptors (FXR), which helps to limit the production of bile acids and also increases bile flow out of the liver. It is indicated for adult patients whose PBC has not improved adequately after at least one year of treatment with ursodeoxycholic acid (UDCA). Recommended dosing is 5mg once daily along with UDCA or by itself for patients who cannot take UDCA. Intercept plans on launching Ocaliva in early June. It will be available through a limited network of specialty pharmacies that includes Accredo. Complete prescribing information for Ocaliva is at: https://ocaliva.com/ocaliva_pi.pdf.

  • Brand (Generic) Name: Ocaliva™ (obeticholic acid)
  • Manufacturer: Intercept Pharmaceuticals
  • Date Approved: May 27, 2016
  • Indication: To treat primary biliary cholangitis (PBC) in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA, or as monotherapy in adults unable to tolerate UDCA
  • Dosage Forms Available: 5mg and 10mg oral tablets
  • Launch Date: By June 8, 2016
  • Estimated Annual Cost: Based on wholesale acquisition cost (WAC), Ocaliva will cost approximately,400 per year.
  • Specialty Status: Ocaliva will be added to Express Scripts’ Specialty drug list.
  • Previously called primary biliary cirrhosis, PBC is an inflammatory autoimmune condition that destroys bile ducts. As a result, bile gradually accumulates in the liver, eventually causing irreversible liver damage. PBC is a major cause for liver transplants.
  • PBC affects only a small number of U.S. patients, but its onset is gradual, so most patients typically are not diagnosed with it until after the age of 35. Between 75% and 90% of patients are women.
  • Until the approval of Ocaliva, the only drug FDA approved to treat PBC was ursodeoxycholic acid (UDCA). In the United States, UDCA has the generic name ursodiol and the brand names Actigall® (300mg capsules – Actavis) and Urso Forte® (500mg tablets – Actavis).
  • Obeticholic acid is also a breakthrough therapy for the treatment of nonalcoholic steatohepatitis (NASH) in patients with liver fibrosis. Approval for this expanded indication is expected in 2018.

Zinbryta Approved for Multiple Sclerosis

The U.S. Food and Drug Administration (FDA) approved Biogen and AbbVie’s Zinbryta™ (daclizumab) on May 27, 2016. It is indicated for treating adults who have relapsing forms of multiple sclerosis (MS). However, it should generally be reserved for patients who have had an inadequate response to two or more drugs for treating MS. The recommended dose is 150mg given by subcutaneous injection once every four weeks. Zinbryta was approved with a Risk Evaluation and Mitigation Strategy (REMS), which includes required monthly liver function tests and a restricted distribution program. AbbVie plans on launching Zinbryta within a few weeks. It will be available through a limited network of specialty pharmacies that includes Accredo. Full prescribing information can be found at: https://www.zinbryta.com/.

  • Brand (Generic) Name: Zinbryta™ (daclizumab)
  • Manufacturer: Biogen and AbbVie
  • Date Approved: May 27, 2016
  • Indication: To treat adult patients with relapsing forms of multiple sclerosis (MS) who have had an inadequate response to two or more MS therapies
  • Dosage Forms Available:  Self-administered autoinjector containing 150mg of Zinbryta for subcutaneous administration
  • Launch Date: AbbVie plans on launching Zinbryta within a few weeks.
  • Estimated Annual Cost: Pricing information is not yet available.
  • Specialty Status: Zinbryta will be added to Express Scripts’ specialty drug list.
  • MS is an autoimmune condition that destroys myelin sheaths (protective coverings on nerve cells in the brain and spinal cord). About two-thirds of patients are women and most patients are diagnosed between 20 years and 50 years of age.
  • The most common form, relapsing-remitting MS (RRMS), affects about 85% of about 400,000 Americans who have the disease. Patients with RRMS have periods of active symptoms alternating with remissions? periods of little or no disease activity.
  • An intravenous (IV) form of daclizumab, under the brand name of Zenapax®, was previously on the market for preventing the rejection of kidney transplants. However, it was withdrawn from the U.S. market in 2009 because of low sales.
  • Zinbryta is an interleukin-2 receptor blocking antibody that helps to reduce T-cell overactivity in patients with MS.
  • Zinbryta’s labeling has a boxed warning, highlighting the potential for autoimmune liver damage or other immune-related conditions. Patients using it will need liver function testing on a monthly basis.
  • Zinbryta’s prescribers, dispensing pharmacies and patients all will be authorized under a Risk Evaluation and Mitigation Strategy (REMS). 

 

1Jun
FROM THE CEO

FROM THE CEO

  • Paula S. Jakub, RHU
  • FSBP   All  

Welcome to Summer 2016! In many parts of the world, this means transitioning from cooler weather to warmer weather. Please use sunscreen while enjoying the nice weather. There are many dangers that come from too much sun exposure including premature aging, sunburn, and skin cancer. The World Post reports that globally, skin cancer is the fifth most common cancer for men and seventh for women. Sunscreen shields your skin from the risk of various types of skin cancer. Please use it throughout the summer season.

By now, you should have seen the Spring AFSPA in Action Newsletter in your mailbox. We have received wonderful feedback about the first ever spring newsletter. The two sections that I hope you pay special attention to are Living Well Together and AFSPA Listens. On pages 6 and 7, members can learn how to match specific health conditions to FSBP services. It explains FSBP programs and how they can meet your individual needs. Then, COO Kyle Longton responds to member questions and concerns on page 10. The article explains our handling of some of your most difficult situations. Because it is so important for us to respond to our members’ issues, I have asked Kyle to make this a permanent section in our newsletter going forward. 

Also, please be advised we have deployed security enhancements to the claims processing in the Member Portal. FSBP members will no longer see a hyperlink in your secure Member Portal. You now will see a link that allows you to download the claims you would like to see. In order to view the claims, you must be logged into your secure Member Portal. If you attempt to go to a hyperlink for a claim, without being logged in, you will be presented with an error message. Then you will be redirected to the login page. The same happens if you copy and paste into a different browser. Please call a Health Benefits Officer if you have any questions about any of the new security enhancements. Our goal is to keep your information safe.

Lastly, summertime means summer travel. Whether you travel domestically or internationally, you may want to consider a travel insurance plan. Please also consider this insurance plan for visiting family members, especially those who visit you overseas.  Many commercial health plans and even Medicare, do not provide coverage for service received overseas. A travel insurance plan can provide assistance such as: an emergency cash advance, luggage tracking, referrals to physicians and hospitals, payment for medical claims, emergency evacuation, repatriation of remains, or something as simple as information regarding the weather. AFSPA offers a 24-hour global assistance and travel insurance policy through Travel Assistance International. If you travel frequently, you can purchase the plan on an annual basis or on a per trip basis. See the full description of services that are provided as well as an application on the AIP section of AFSPA’s website.  

We hope your family stays safe and healthy this summer. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

31May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  

Buprenorphine Implant Approved

On May 26, 2016, the U.S. Food and Drug Administration (FDA) announced it had approved Probuphine® (buprenorphine) implant for subdermal administration, CIII, as maintenance treatment of opioid dependence. Four small Probuphine rods are implanted under the skin inside the upper arm by a healthcare provider who is trained and certified. The rods must be removed after six months or if they shift, cause irritation or become infected. Unlike the sublingual and buccal forms of buprenorphine that currently are available, Probuphine releases drug slowly over six months. Patients eligible for using it will have to be stabilized on low or moderate doses (no more than 8mg per day) of sublingual or buccal buprenorphine. The manufacturers, Titan Pharmaceuticals and Braeburn Pharmaceuticals, have not shared pricing details, but have indicated that Probuphine will cost less than,000 per implantation. The companies plan on launching the drug this summer. The product labeling contains a boxed warning cautioning about possible nerve damage caused by the implants, as well as about potential movements of the rods after implantation. Complete prescribing information is at:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/204442Orig1s000lbl.pdf

 

 

Flucelvax Quadrivalent Approved

On May 24, 2016, the U.S. Food and Drug Administration (FDA) approved Flucelvax Quadrivalent™ (influenza virus vaccine) suspension for intramuscular injection as active immunization against the two strains of influenza A as well as the two strains of influenza B that are included in the vaccine. The quadrivalent formula is the first four-strain cell structure-derived inactivated influenza vaccine for adults and children over 4 years of age. The manufacturer, Seqirus, plans to launch the new vaccine in time for the 2016-2017 flu season. Complete prescribing information for Flucelvax Quadrivalent is available at:

http://flu.seqirus.com/flucelvax/about-flucelvax.html

 

Expanded Invokamet Indication Approved

The FDA approved a new indication for Invokamet® (canagliflozin/metformin - Janssen) on May 24, 2016. It is now approved for use as a first-line treatment of adults with type 2 diabetes. Previously, it was approved for use in patients not adequately managed by treatment with canagliflozin, metformin or both. Canagliflozin, approved under the brand name of Invokana®, was the first glucose co-transporter 2 (SGLT2) inhibitor to receive FDA approval. SGLT2 inhibitors decrease glucose reabsorption in the kidneys causing more glucose to be excreted in urine. Metformin works primarily by reducing glucose production in the liver. Full prescribing information can be found at: www.Invokamet.com

 

Generic to Doryx 200mg Delayed-Release Tablets Launched

Mylan announced FDA approval and launch of its A-rated generic alternative to Mayne Pharma’s Doryx® (doxycycline hyclate delayed-release) 200mg tablets. The company was also granted 180 days of generic exclusivity preventing FDA from approving additional generics to this strength until March 2017. Doryx contains a tetracycline antibiotic that is used for a variety of conditions including acne, respiratory tract infections and sexually transmitted infections. According to IMS Health, annual U.S. sales of Doryx 200mg tablets are approximately 2 million.

 

MedWatch Updates

Ketoconazole

FDA is reminding clinicians not to prescribe ketoconazole tablets for common skin, fingernail or toe nail infections. Ketoconazole is an antifungal drug that should not be used as the first treatment for any fungal infection. It is intended to be reserved for severe fungal infections after other treatments have failed. Although FDA issued a warning and required labeling changes for oral ketoconazole in 2013, it still is being prescribed frequently for non-life-threatening infections, despite not being approved to treat them. Taking ketoconazole has been associated with damage to the adrenal glands, liver or both. At least one recent death also has been attributed to its use. Additionally, oral ketoconazole has major interactions with numerous other drugs, which include antibiotics in the erythromycin class, some antidepressants and antipsychotics, some cholesterol-lowering drugs known as statins and some medications for migraine headaches (triptans). Ketoconazole’s topical forms (cream, foam, gel and shampoo) are not included in FDA’s warning because they are not absorbed very extensively into the body. More information about the warning is at:

http://www.fda.gov/Drugs/DrugSafety/ucm500597.htm.

 

Methadone/Buprenorphine
In a Drug Safety Communication released on May 26, 2016, FDA restated cautions about the risk of neonatal opioid withdrawal syndrome (NOWS) among babies whose mothers used methadone or buprenorphine while pregnant. Both drugs are used, along with counseling, to treat dependence on opioids (also called opioid use disorder). Although they are recommended during pregnancy, both are opioids that may cause NOWS. As part of a broader Opioids Action Plan, FDA is reinforcing and clarifying labeling for opioid products. The Warnings and Precautions part of labels for methadone and buprenorphine products used to treat dependence will be required to indicate the risk of NOWS. FDA’s full notice is at:

http://www.fda.gov/Drugs/DrugSafety/ucm503630.htm.

 

27May
Express Scripts Clinical Matters News Flash

Express Scripts Clinical Matters News Flash

  • Express Scripts
  • FSBP   Prescription  

Afstyla Approved for Hemophilia A

 

On May 26, 2016, CSL Behring received approval from the U.S. Food and Drug Administration (FDA) for Afstyla® [antihemophilic factor (recombinant), single chain] to prevent bleeds as well as to manage bleeding episodes and to control bleeding associated with surgical or dental procedures. Dosing and dose frequency depend on the patient’s age and weight, and on whether the dose is for prevention or for treating an acute bleed. For routine prophylaxis, most patients will require an intravenous infusion two to three times per week. CSL Behring plans on launching Afstyla early this summer. It will be available through a limited network of specialty pharmacies that includes Accredo. Complete prescribing information is at: www.afstyla.com

 

  • Brand (Generic) Name: Afstyla® [antihemophilic factor (recombinant), single chain]
  • Manufacturer: CSL Behring
  • Date Approved: May 26, 2016
  • Indication: To treat and control bleeding episodes, to manage perioperative bleeding and to reduce the frequency of bleeding episodes in adults and children with hemophilia A.
  • Dosage Forms Available: Single-use vials containing 250 international units (IUs), 500IUs, 1,000IUs, 2,000IUs or 3,000IUs of powdered Afstyla.
  • Launch Date: CSL Behring plans on launching Afstyla early this summer.
  • Estimated Annual Cost: Pricing information is not yet available.
  • Specialty Status: Afstyla will be added to Express Scripts’ specialty drug list.
  • Hemophilia A is a rare, chronic, genetic bleeding disorder affecting approximately 16,000 adults and children in the United States. It is caused from insufficient clotting Factor VIII activity, which is a protein in the blood that controls bleeding. Patients with hemophilia A experience bleeding episodes that cause pain, irreversible joint damage and life-threatening hemorrhages.
  • Afstyla is a stabilized, single chain recombinant Factor VIII concentrate. Currently available products consist of both a heavy and a light chain which, under certain conditions, may dissociate leading to the formation of hemostatically inactive compounds.
  • Several recombinant Factor VIII products already are on the U.S. market. They include Advate (Baxalta), Helixate® FS (CSL Behring), Kogenate FS (Bayer), Kovaltry® (Bayer), Novoeight® (Novo Nordisk), Recombinate (Baxalta) and Xyntha® Solofuse® (Wyeth Biopharma). Two other long-acting products, Adynovate [antihemophilic Factor (Recombinant), PEGylated] and Eloctate [antihemophilic Factor (Recombinant), Fc Fusion Protein] are also available. Other Factor VIII products on the market are derived from human plasma and some also include von Willebrand factor.

 

23May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

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Opdivo Approved for Hodgkin Lymphoma

On May 17, 2016, Bristol-Myers Squibb’s Opdivo® (nivolumab) gained approval from the U.S. Food and Drug Administration (FDA) for treating classical Hodgkin Lymphoma (cHL) that has relapsed or progressed after autologous hematopoietic stem cell transplantation and post-transplantation Adcetris® (brentuximab vedotin – Seattle Genetics). The recommended dose is 3mg/kg administered as an intravenous infusion over 60 minutes every 2 weeks until disease progression or unacceptable toxicity. Opdivo injection is a human programmed death receptor-1 (PD-1) immune checkpoint inhibitor that was first approved by FDA in December 2014. It is also indicated to treat certain patients with advanced melanoma, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC). Complete prescribing information for Opdivo can be found at:

http://packageinserts.bms.com/pi/pi_opdivo.pdf

 

Lenvima Approved for Kidney Cancer

Eisai announced on May 16, 2016, that the FDA has approved Lenvima® (lenvatinib) for treating patients with advanced renal cell carcinoma (aRCC) in combination with Afinitor® (everolimus – Novartis) following prior anti-angiogenic therapy. Lenvima is an oral multiple receptor tyrosine kinase inhibitor. It was first approved on February 13, 2015, for the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC). The recommended dose for RCC is 18mg of Lenvima in combination with 5mg of Afinitor, once daily.  Full prescribing information is available at:

http://www.lenvima.com/pdfs/prescribing-information.pdf. 

 

MedWatch Update

Invokana/Invokamet
In a Drug Safety Communication dated May 18, 2016, FDA is warning that Janssen’s Invokana® (canagliflozin) and Invokamet® (canagliflozin/metformin) may be associated with an increased risk for foot, leg and toe amputations among patients using them. Although FDA does not have enough information to draw solid conclusions, mid-term results from an ongoing clinical study showed that more patients taking canagliflozin needed amputations than patients taking an inactive placebo. A second study did not find the same risk, however. Patients in the first trial have been treated for an average of four and one-half years; patients in the second one only have been treated for nine months, on average. Canagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that treats type 2 diabetes. FDA is not requesting label changes, at this time, but it will evaluate additional information from the trials. Patients are being warned to let their healthcare professionals know right away about any unusual infections, numbness, pain or sores involving their feet or legs. Prescribers are advised to monitor canagliflozin patients carefully for any signs of foot or leg problems. A separate alert was issued last year to caution about increased fracture risks and possible decreased bone mineral density from the use of canagliflozin. Along with other drugs in its class, it also may be linked with ketoacidosis (a potentially dangerous buildup of fatty acids in the blood) and urinary tract infections. The most recent FDA notice is at: http://www.fda.gov/downloads/Drugs/DrugSafety/UCM501749.pdf

 

Updated DrugWatch Document Available

The Emerging Therapeutics department has updated DrugWatch, a document that highlights near-term pipeline drugs as well as potential new generic opportunities.  Click here for the updated DrugWatch document.

 

19May
Express Scripts Clinical Matters News Flash: Tecentriq Approved for Bladder Cancer

Express Scripts Clinical Matters News Flash: Tecentriq Approved for Bladder Cancer

  • Express Scripts
  • FSBP   Prescription  

On May 18, 2016, Genentech received approval from the U.S. Food and Drug Administration (FDA) for Tecentriq™ (atezolizumab) for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who have disease progression during or following platinum-based chemotherapy, or whose disease has worsened within 12 months of receiving platinum-based chemotherapy before surgery (neoadjuvant) or after surgery (adjuvant). The recommended dose of Tecentriq is 1200mg as an intravenous infusion over 60 minutes every 3 weeks. Genentech plans on launching Tecentriq within 1-2 weeks. It will be available through a limited network of specialty pharmacies that includes Accredo. Full prescribing information can be found at: http://www.gene.com/download/pdf/tecentriq_prescribing.pdf

  • Brand (Generic) Name: Tecentriq™ (atezolizumab)
  • Manufacturer: Genentech
  • Date Approved: May 18, 2016
  • Indication: Treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who have disease progression during or following platinum-based chemotherapy, or whose disease has worsened within 12 months of receiving platinum-based chemotherapy before surgery (neoadjuvant) or after surgery (adjuvant).
  • Dosage Forms Available: 1200 mg/20 mL (60 mg/mL) solution in single-dose vials
  • Launch Date: Tecentriq is expected to be available by June 1, 2016.
  • Estimated Annual Cost: Pricing information is not yet available; however, it is expected to cost approximately 0,000 per year.
  • Specialty Status:Tecentriq will be added to Express Scripts’ specialty drug list.
  • Each year in the U.S., approximately 76,000 patients are diagnosed with bladder cancer. Urothelial carcinoma is the most common type of bladder cancer; it can also be found in the renal pelvis, ureter and urethra.
  • Tecentriq is a programmed death receptor-ligand 1 (PD-L1)-blocking antibody. It is an immunotherapy that helps the body’s immune system attack cancer cells.
  • Merck’s Keytruda® (pembrolizumab) and Bristol-Myers Squibb’s Opdivo® (nivolumab) are PD-1 blocking antibodies that are currently available on the market. Tecentriq is the first PD-1/PD-L1-blocking antibody to gain FDA approval for bladder cancer.
  • Tecentriq is a breakthrough therapy that was granted accelerated approval. It was approved almost 4 months ahead of its FDA action date of September 12, 2016.
  • FDA approval was based on a Phase II trial in patients with locally advanced or metastatic urothelial carcinoma. The study showed that Tecentriq shrank tumors in 27 percent of patients with mUC whose disease had medium and high levels of PD-L1 expression and worsened after initial treatment. Genentech is conducting a confirmatory Phase III trial to verify that the drug provides a clinical benefit in these patients.
  • Tecentriq is also a breakthrough therapy for the second-line treatment of patients with locally advanced or metastatic PD-L1+ non-small cell lung cancer. Approval for this expanded indication is expected by October 19, 2016.

 

 

16May
Express Scripts Clinial News and Notes

Express Scripts Clinial News and Notes

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  • Prescription   FSBP  

New Indication for Vibativ

Vibativ® (telavancin – Theravance Biopharma), an antibacterial drug, received a new indication from the U.S. Food and Drug Administration (FDA) on May 6, 2016. It originally was approved in 2009 to treat adult patients who have complicated skin and skin structure infections. In 2013, Vibativ was approved as an alternative to vancomycin for treating hospital-acquired or ventilator-associated pneumonia that is caused by Staphylococcus aureus (S. aureus) and that does not respond to other antibacterial drugs. It now has an additional indication for S. aureus bacteremia (S. aureus bacteria in the blood) among patients using it for one of its other indications. It is infused intravenously once a day with doses based on the patient’s body weight. A boxed warning on its label cautions that it should not be administered to patients who have decreased kidney function or to women who are pregnant. Its complete prescribing information is at:

http://www.vibativ.com/pdf/PrescribingInformation.pdf    

  

Labeling Expansion for Imbruvica

AbbVie and Janssen Biotech announced on May 9, 2016, that labeling for Imbruvica® (ibrutinib) can include additional information on results from two clinical trials. It already had FDA approvals for treating Mantle call lymphoma (MCL) and Waldenström’s macroglobulinemia. In March, it got a new indication as initial therapy for patients with chronic lymphocytic leukemia (CLL). This week, FDA approved another use – for treating small lymphocytic lymphoma (SLL). Additionally, in combination with bendamustine and rituximab, Imbruvica can be used, after one or more previous treatments, for patients whose CLL or SLL either came back or did not respond to previous therapy. Imbruvica, an oral Bruton’s tyrosine kinase inhibitor, is taken once a day at varying doses depending on the condition being treated. Full prescribing information for Imbruvica is at:

http://www.imbruvica.com/

 

MedWatch Update

Olanzapine

On May 10, 2016, FDA released a Drug Safety Communication to caution that using the drug olanzapine has been associated with a rare, but potentially very severe adverse reaction. Since it was first approved 20 years ago, a few patients using olanzapine have developed drug reaction with eosinophilia and systemic symptoms (DRESS). Usually beginning with a rash, fever and swelling in the face, lymph nodes or both, DRESS is characterized by increased numbers of eosinophils, which are white blood cells involved with regulating inflammation and immune function. DRESS can cause inflammation throughout the body. Among the olanzapine-related cases reported to FDA, one patient died; 22 others suffered serious heart, kidney, liver, lung or other internal organ damage. Dosing does not appear to be a major factor -- doses as low as 5mg caused DRESS for some of the affected patients. The average time to onset of symptoms was slightly less than three weeks after olanzapine was started. An antipsychotic medication that is used to treat bipolar disorder and schizophrenia, olanzapine is available as generics and it also is sold under the brand names Symbyax® (fluoxetine/olanzapine) and Zyprexa®. It has both oral and injectable forms. Presently, DRESS has no specific treatment other than discontinuation of the drug that is causing it. FDA now requires manufacturers to put a warning about the possibility of DRESS on the labels of all products that contain olanzapine. Patients are advised to get medical attention right away if they get a fever or rash while taking it. Doctors who suspect a patient might have DRESS should stop olanzapine immediately. FDA’s complete warning is at: http://www.fda.gov/Drugs/DrugSafety/ucm499441.htm.


Fluoroquinolone Antibiotics

In a Drug Safety Communication issued on May 12, 2016, FDA recommended limiting the use of antibacterial drugs in the fluoroquinolone (quinolone) class. FDA has determined that the risks of using quinolones for patients with uncomplicated bronchial, sinus and urinary tract infections are not justified when alternative therapies are available. Among their very serious possible side effects are anaphylaxis (a severe allergic reaction), intestinal infections, nerve damage, ruptured tendons, seizures and vision loss. Although reports of serious side effects are uncommon, the problems can cause permanent impairment or even death. The affected drugs are ciprofloxacin (Cipro®, generics), gemifloxacin (Factive®, generics), levofloxacin (Levaquin®, generics), moxifloxacin (Avelox®, generics), and ofloxacin. Labeling for all injected and oral quinolones now will include information on their possible risks. Ophthalmic (eye drop) and otic (ear drop) quinolones do not have the same chance of adverse effects, so they will not have a warning. FDA encourages patients using an oral or injected quinolone to read the Medication Guide that comes with each drug fill. They should immediately tell a healthcare provider about symptoms such as changes in heartbeats; numbness, pain or weakness in the arms or legs; rashes; sensitivity to light; and unusual responses to temperature or touch. Prescribers should make sure that patients are aware of what to report. When possible, a different drug should be prescribed to treat uncomplicated bacterial infections, especially for any patient who may have had previous problems with a quinolone. More information on the FDA Safety Communication may be found at: http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm.

 

9May
Express Scripts - Clinical News and Notes

Express Scripts - Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

Akovaz Approved to Treat Low Blood Pressure during Surgery. 
On April 29, 2016, Flamel Technologies received approval from the U.S. Food and Drug Administration (FDA) for Akovaz™ (ephedrine sulfate) for the treatment of clinically significant low blood pressure (hypotension) occurring in the setting of anesthesia (during surgery). Akovaz will be supplied as 50mg/mL single-use vials. The recommended dose of 5mg to 10mg should be given as an intravenous bolus after it is diluted. Akovaz contains ephedrine sulfate, an alpha- and beta-adrenergic agonist and a norephinephrine-releasing agent that increases blood pressure. While ephedrine sulfate has been used for many years, Akovaz is the first ephedrine sulfate product to gain FDA approval. Flamel Technologies plans on launching Akovaz in the third quarter of 2016. Full prescribing information can be found at: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208289s000lbl.pdf  
Fycompa Oral Solution Approved
Eisai received FDA approval for Fycompa® (perampanel) CIII oral suspension. The new formulation is bioequivalent and interchangeable with the company’s Fycompa tablets, which were originally approved in October 2012. It is approved for the treatment of partial-onset seizures with or without secondarily generalized seizures, and primary generalized tonic-clonic seizures in patients with epilepsy 12 years of age and older. Fycopma oral suspension is expected to be available in June 2016. Full prescribing information can be found at: www.fycompa.com  
MedWatch Updates
Brintellix Name Change
FDA has given Takeda Pharmaceuticals and Lundbeck Pharmaceuticals approval to change the brand name of their antidepressant, Brintellix® (vortioxetine). More than 50 prescribing and dispensing mix-ups involving Brintellix and an antiplatelet drug, Brilinta® (ticagrelor), have been reported since Brintellix was introduced in September 2013. To end confusion between the similar names, Brintellix is being re-named Trintellix. It will look the same – pink (5mg), yellow (10mg) or orange (20mg) tear-drop-shaped tablets; and directions for its use will not change. However, beginning in June, bottles of newly manufactured tablets will be labeled with the new brand name and a new National Drug Code (NDC) number assigned by FDA. For a few months, pharmacies may have bottles with both brand names in stock. AstraZeneca’s Brilinta will continue to be made as round, yellow tablets imprinted with “90” and a “T”. It is used to prevent heart attacks and strokes for patients who have acute coronary syndrome or who previously have had a heart attack. To assure that the drug is correct, FDA advises prescribers to include the generic name of the drug and the condition it is being used to treat on the prescription form or electronic transmission. Dispensing pharmacists and patients should check each prescription to be sure it is filled with the right drug. FDA’s Drug Safety Communication is at: http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm.  
Aripiprazole
In a Drug Safety Communication issued on May 3, 2016, FDA is cautioning about uncontrollable behaviors that rarely may be associated with taking aripiprazole. Available as generics and with the brand names Abilify® and Aristada™ (aripiprazole lauroxil), aripiprazole is an antipsychotic medication used to treat a number of psychological conditions including autistic irritability, bipolar disorder, schizophrenia and Tourette’s syndrome. It also may be used with other drugs to treat depression. Feeling compelled to gamble already is listed as an uncommon side effect on its labeling. Now, FDA has identified other compulsions, such as overpowering cravings to eat, shop or engage in sexual activity, that also could result from taking aripiprazole. Most of the affected patients did not exhibit compulsive tendencies before starting treatment -- and decreasing or stopping aripiprazole eliminated the compulsions, as well. FDA will require manufacturers to include a warning about the possibility of these additional compulsions on the labeling and in the patient Medication Guides for all aripiprazole products. Prescribers, patients and caregivers should be alert for uncharacteristic compulsive behaviors. More detailed information on FDA’s action is at: http://www.fda.gov/Drugs/DrugSafety/ucm498662.htm   
Updated Biosimilars Issues Document Available
The Emerging Therapeutics department has updated the Biosimilars Issues Document to note the approval of Inflectra™ (infliximab-dyyb – Celltrion / Pfizer) and to describe FDA’s draft guidance on biosimilar labeling. Click here for the updated Biosimilars Issues document.

 

3May
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • Prescription   FSBP  
Bevespi Aerosphere Approved for COPD
AstraZeneca received approval on April 25, 2016, from the U.S. Food and Drug Administration (FDA) for Bevespi Aerosphere™ (glycopyrrolate/formoterol fumarate) inhalation aerosol. It is a combination of a long-acting muscarinic antagonist (LAMA) and a long-acting beta-2 agonist (LABA) for use as maintenance treatment for chronic obstructive pulmonary disease (COPD). The recommended dose is two oral inhalations (each containing 9mcg of glycopyrrolate and 4.8mcg of formoterol fumarate) in the morning and two in the evening. As with all LABA-containing drugs, labeling for Bevespi Aerosphere carries a boxed warning that it increases the chance of death among asthma patients, so it should not be used to treat asthma. It uses a proprietary new formulation technique, Co-Suspension™ Technology, that is intended to keep the drug mix consistent both within the inhaler device and in the lungs. When launched, it will compete with Anoro® Ellipta® (umeclidinium/vilanterol – GlaxoSmithKline), Stiolto™ Respimat® (tiotropium/olodaterol – Boehringer Ingelheim) and Utibron™ Neohaler® (indacaterol/glycopyrrolate – Novartis). Bevespi Aerosphere is expected to launch during the second half of 2016. Pricing information is not yet available. Its complete prescribing information is available at: www.Bevespi.com  
Abuse-Deterrent Xtampza ER Approved
The FDA approved Collegium Pharmaceutical’s Xtampza™ ER (oxycodone) extended-release capsules on April 26, 2016. Xtampza ER is a C-II opioid indicated for use as twice-daily treatment of chronic, severe pain that needs constant opioid therapy and that has not been controlled by other treatment. Xtampza ER will launch around the middle of the year as 10mg, 15mg, 20mg, 30mg and 40mg capsules. Using a new method, the opioid is mixed with wax and fatty acids to form microspheres that each contain active drug. The wax keeps the opioid from being dissolved and injected; it also prevents rapid release of the oxycodone if the capsules are mashed. Both the potential for abuse and the risk of overdosing are reduced significantly. Additionally, capsules can be opened to sprinkle on soft foods and then given to patients who cannot swallow whole capsules. Xtampza ER and all other opioids approved in the U.S. still must have a boxed warning about their potential for abuse and misuse. Their labeling also cautions about accidentally taking them, serious breathing problems that may occur with their use and addiction among babies whose mothers use opioids while pregnant. Prescribing information for Xtampza is posted at: http://www.collegiumpharma.com/uploads/downloads/Xtampza-ER-Full-Prescribing-Information.pdf.   
Oral Solution Approved for Orfadin  
On April 22, 2016, the FDA approved a 4mg/mL oral solution formulation of Orfadin® (nitisinone), which is made by Swedish Orphan Biovitrum AB (Sobi™). Used along with diet limitations, it treats a very rare genetic disease known as hereditary tyrosinaemia type-1 (HT-1). Individuals who have HT-1 cannot utilize tyrosine, an amino acid, so impurities accumulate in their blood. Serious, and even fatal, kidney, liver and nerve damage can result. HT-1 affects only a few hundred patients – mainly children. Orfadin blocks an enzyme to prevent the buildup of tyrosine by-products. Because Orfadin doses are determined by the patient’s weight, doses change frequently. A liquid form of the drug makes both dosing and dose adjustments easier. Previously, Orfadin was available only in 2mg, 5mg and 10mg capsules that had to be mixed with water for children who could not swallow them. Orfadin Oral Suspension, 4mg/mL will be released in August 2016. Prescribing information is at: http://www.raretx.com/insert/Orfadin%20Package%20Insert.pdf  
Expanded ProAir RespiClick Indication Approved
On April 28, 2016, the FDA approved an expanded indication for Teva’s ProAir® RespiClick (albuterol sulfate) inhalation powder for the treatment and prevention of bronchospasms in children 4 to 11 years old with reversible obstructive airway disease and for the prevention of exercise-induced bronchospasms. ProAir RespiClick was approved in March 2015 with the same indications for patients at least 12 years of age. Full prescribing information can be found at: www.myproair.com  
Nuplazid Approved for Parkinson’s Disease Psychosis
On April 29, 2016, the FDA approved Acadia Pharmaceuticals’ Nuplazid™ (pimavanserin) for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis. The recommended dose is 34mg (two 17mg tablets) once daily. Acadia plans on launching Nuplazid by the end of May. It will be available through a limited network of specialty pharmacies that includes Accredo. Full prescribing information can be found at: https://www.nuplazid.com/.  
Generic Crestor Launched
Allergan has announced the launch of the first AB-rated generic to AstraZeneca’s Crestor® (rosuvastatin calcium) in the United States. Under terms of a settlement, Allergan was allowed to introduce its generic to the U.S. market 67 days before Crestor’s patent expires on Jul. 8, 2016. Other generics are expected to launch after this patent expires in July.  
MedWatch Updates
Fluconazole
On April 26, 2016, FDA posted a Safety Alert about the use of oral fluconazole by women who are pregnant. Fluconazole is an antifungal drug frequently taken on one day, as a 150mg tablet, to treat vaginal yeast infections. In higher doses and for longer periods, it also prevents and treats some types of meningitis, pneumonia and other systemic infections that are caused by several different fungal organisms. Labeling for oral fluconazole, available as generics and under the Pfizer brand name, Diflucan®, already has a warning that it should not be used long-term or in high doses for pregnant women because it can cause birth defects such as weakened bones, cleft palate and heart disease. The low, single-tablet dose is thought less likely to cause problems with fetal development. A recent study, however, found a possible increase in the risk of miscarriage when only one or two 150mg doses were used. While FDA is evaluating the study and other relevant information, it advises that topical rather than oral antifungal products be used to treat vaginal yeast infections during pregnancy. FDA’s warning is at:  http://www.fda.gov/Drugs/DrugSafety/ucm497482.htm.    

Updated DrugWatch Document Available
The Emerging Therapeutics department has updated DrugWatch, a document that highlights near-term pipeline drugs as well as potential new generic opportunities. Click here for the DrugWatch document  

 

26Apr
Cabometyx Approved for Kidney Cancer

Cabometyx Approved for Kidney Cancer

  • Express Scripts - Clinical Matters News Flash
  • Prescription   FSBP  
On April 25, 2016, Exelixis received approval from the U.S. Food and Drug Administration (FDA) for Cabometyx™ (cabozantinib) for the treatment of patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy. The recommended dose is 60mg once daily. Exelixis plans on launching Cabometyx within two weeks. It will be available through a limited network of specialty pharmacies that includes Accredo. Full prescribing information can be found at: https://hcp.cabometyx.com/downloads/CABOMETYXUSPI.pdf  
  • Brand (Generic) Name: Cabometyx™ (cabozantinib)
  • Manufacturer: Exelixis, Inc.
  • Date Approved: April 25, 2016
  • Indication: Treatment of patients with advanced renal cell carcinoma who have received prior anti-angiogenic therapy
  • Dosage Forms Available: 20mg, 40mg and 60mg tablets
  • Launch Date: By May 9, 2016
  • Estimated Annual Cost: Cabometyx is expected to cost approximately 5,000 per year.
  • Specialty Status: Cabometyx will be added to Express Scripts’ specialty drug list.
  • According to the American Cancer Society, approximately 63,000 new cases of kidney cancer will be diagnosed among American adults in 2016. About 90% will be RCC and an estimated 17,000 RCC patients will need secondary treatment after an anti-angiogenic drug. Nearly all RCC patients are older than 45 years, with men around twice as likely to have RCC as women.
  • Cabometyx interferes with the activity of several receptor tyrosine kinases, proteins which promote the growth and spread of tumors.
  • In clinical trials, overall survival for RCC patients taking Cabometyx was about five months longer than for patients taking the comparator drug, Afinitor® (everolimus – Novartis). Progression-free survival was nearly twice as long (7.4 months vs. 3.8 months). Objective response rate, a measure of tumor size decrease, was 21% for Cabometyx and 5% for Afinitor.
With the brand name Cometriq®, cabozantinib initially was FDA approved in November 2012, for treating metastatic medullary thyroid cancer (MTC). Although both are oral medications, Cabometyx tablets and Cometriq capsules are not interchangeable. 

 

25Apr
Express Scripts Clinical News and Notes

Express Scripts Clinical News and Notes

  • Express Scripts
  • FSBP   Prescription  

MedWatch Update

FDA Approvals Withdrawn for Certain Drugs and Indications

Through a notice published in the Federal Register on April 18, 2016, FDA formally revoked its approval for two drugs that combined a statin with another cholesterol-lowering drug. Stating that reducing triglycerides or increasing high-density lipoprotein cholesterol (HDL-C) has not been proven to decrease cardiovascular risk, FDA rescinded approvals for Advicor® (lovastatin/ niacin extended release/) and Simcor® (simvastatin/niacin extended release). Neither drug has been distributed since the end of 2015; and their manufacturer, AbbVie, voluntarily stopped production of both earlier in 2015. More information on the FDA’s action is available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-08887.pdf.     

In a related move, FDA also withdrew approvals of indications for use with a statin from AbbVie’s Niaspan® (niacin) extended-release tablets, Trilipix® (fenofibric acid) delayed-release capsules and their respective generics. AbbVie had revised its prescribing information for both Niaspan and Trilipix in April 2015 to eliminate the rescinded indications. It notified prescribers, pharmacies and patients of the revision at that time. Many generic manufacturers have changed their prescribing information, as well. Both drugs have multiple other indications that have not been affected and both will continue to be marketed in the U.S. Information about the changes is at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-08887.pdf.

 

9May

AFSPA Image Usage

  • Nne-Nne Abanobi
  • All  

As a reminder, AFSPA routinely takes photos at its events. Members and guests should notify the photographer if they want to restrict the use of their names and/or images. Without notification, you are permitting AFSPA to publish your image(s) on its websites, newsletters, marketing materials, etc. 

 

1May
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • FSBP   All  
Greetings and welcome to May 2016! The American Foreign Service Protective Association (AFSPA) is devoted to meeting the needs of the Foreign Service community. We strive “to provide unparalleled service that our unique worldwide membership requires.” This is not just our mission statement, but it is how we approach the work we do every day at AFSPA. Thank you for trusting us with your lives and your health. We do not take it for granted.

To begin, the annual Public Service Recognition Week is happening May 1-7, 2016. This is a time in which government service at the Federal and other levels is recognized. The key messages for the week are: “government workers are doing important work that positively affects all of us every day; the government needs people like you to address the incredible challenges our nation is facing; public servants deserve thanks for working diligently on our behalf; and government service is public service.” I agree with these statements; I witness your commitment to our country throughout my travels and here at home.  Thank you for your solid service, especially during these trying times. 

As you approach the age of 65, many questions arise about your health benefits and the role that Medicare plays. It is important to us to make the transition easier for you, which is why we developed a new publication: Medicare and the Foreign Service Benefit Plan: Putting it Together. This simple six-panel brochure provides detailed information on how to sign up for Medicare and how Medicare works with FSBP. It outlines the four parts of Medicare and even includes helpful links at the end. Click here to view the entire booklet. In addition, you can view my video presentation about Medicare. Click here to view the video. I am sure you will find the content useful and valuable.

Lastly, for the first time the Senior Living Foundation (SLF) is one of the sponsors of this year’s Foreign Affairs Day, happening on Friday, May 6, 2016. The event serves as a homecoming for retirees from the State Department and provides them with an opportunity to engage with active officers and learn about current developments at State. SLF has participated in Foreign Affairs Day for many years. Please visit the SLF website at www.slfoundation.org for event pictures and more information about the Foundation.

Please enjoy your Memorial Day holiday, as we remember those who have died serving in our country’s armed forces. We honor those who have given their lives for our freedom. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

27Apr

Express Scripts Update - Website and Systems Operating Normally

  • Kyle Longton, COO
  • All   FSBP   Prescription  
As of late yesterday evening, all Express Scripts systems - including the website and the mobile site - are operating normally.

I apologize for any inconvenience you may have experienced during this outage. Thank you for your patience.

 

26Apr
Update on Express Scripts Systems

Update on Express Scripts Systems

  • Kyle Longton, COO
  • Prescription   FSBP   All  
At 2 pm EDT, we received confirmation that applications used by Express Scripts' Patient Care Advocates to assist members when they call are back up and running.

The team at Express Scripts is still working to bring the member website back to full functionality. We hope to have more information soon.

Thank you for your patience.

 

26Apr
Express Scripts Website and Systems Temporarily Down

Express Scripts Website and Systems Temporarily Down

  • Kyle Longton, COO
  • FSBP   All  
This morning, we received notification from our partners at Express Scripts that they are experiencing technical issues. The issues are affecting the Express Scripts website as well as the systems used by Patient Care Advocates answering member telephone calls. Express Scripts is working to correct the problems as quickly as possible.

We ask your patience while the fixes are underway. Check back here for updates.

 

14Apr

Venclexta Approved for Lymphocytic Leukemia

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Flash, 12 April 2016.pdf

 

14Apr

AFSPA Closing 3:00P.M. EDT – 4/14/16

  • Staff
  • All  

AFSPA will be closing at 3:00P.M. EDT on Thursday, April 14, 2016. We apologize for the inconvenience. We will resume normal business hours on Friday, April 15, at 8:30 A.M. EDT.
You may submit claims via our secure Member Portal at any time, by going to: https://secure.myafspa.org.

We look forward to serving you on Friday, April 15, 2016.

Thank you.

 

4Apr

Clinical Matters News & Notes Release

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Matters News & Notes Release, 28 March 2016.pdf

 

2Apr

Member Portal Scheduled Maintenance

  • Staff
  • FSBP   All  
Please be advised that on April 3, 2016 Member Portal ( https://secure.myafspa.org/) may be unavailable from 
7:00 pm-12:00 am EDT as it will be undergoing maintenance. 

We apologize for the inconvenience

 

1Apr
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   FSBP  
Greetings and Welcome to Spring 2016! What a privilege and a responsibility it is to play a role in serving almost 60,000 FSBP members and the thousands of others who are members of our other programs and the Association every day. I am grateful for the trust that each person places in our health plan and other programs.

April is designated as National Minority Health Month. This annual event sets aside time to raise awareness about the health disparities that affect racial and ethnic minorities. This year's theme is Prevention is Power: Taking Action for Health Equity. It emphasizes the role of prevention in reducing health disparities. FSBP offers many programs aimed specifically at preventing serious medical conditions. Healthy Actions like Digital Coaching address unique health challenges such as cholesterol management, stress management, and even weight control. FSBP recognizes that everyone should have the chance to live a healthy life, regardless of who they are and where they live. Click here to learn more about National Minority Health Month from the U.S. Department of Health and Human Services.

World Immunization Week, a global public health initiative to raise awareness and increase rates of immunization against vaccine-preventable diseases around the world,  takes place each year during the last week of April. Immunizations can protect against 25 different infectious agents or diseases, from infancy to old age, including measles, pertussis, polio, and tetanus. Under FSBP’s Preventive care benefits, the plan covers adult routine immunizations (including administration) endorsed by the Centers for Disease Control and Prevention (CDC) per their Recommended Adult Immunization Schedule by Vaccine and Age Group. For children, FSBP covers childhood immunizations recommended by the American Academy of Pediatrics for members under age 22. For both adults and children, FSBP covers travel immunizations recommended by the CDC. This is a great time to make sure you and your family members are up-to-date on all immunizations.

We want to thank you for sending feedback about AFSPA’s new website. Many of you like the brighter colors and the fresh pictures. However, we realize that some members encountered issues when searching for specific information. We are working to reorganize and streamline the content. In addition, we are adding a “Help” button option to provide members and visitors with a guided tour through the website and its features. Our goal is to make the website as user friendly as possible. Enhancing the AFSPA site is an ongoing initiative. Please continue to offer feedback. We want to make the overall experience better for you.

Over the last few years, AFSPA has evolved and expanded. We have an outstanding team in place, including a strong, experienced leadership team. AFSPA has built a solid foundation for growth and is well positioned to continue growing. We recognize our current members have been affected and may have experienced longer wait times and longer claims processing times as we go through our “growing pains.” We apologize for any inconveniences and thank you for your patience. Please trust that we are taking steps to improve our services. AFSPA has hired and trained additional staff in recent months. We will continue to examine how we can better provide the unparalleled service you expect.

By the way, have you joined our Facebook page yet? We are building a strong community of AFSPA members. You should get in on the conversation too.

As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

31Mar

AFSPA Closing 4:00 P.M. EDT - 3/31/16

  • Staff
  • FSBP   All  

Due to unforeseen circumstances, AFSPA will close at 4:00P.M. EDT on Thursday, March 31, 2016. We apologize for the inconvenience. We will resume normal business hours on Friday, April 1, at 8:30 A.M. EDT. You may submit claims via our secure Member Portal at any time, by going to: https://secure.myafspa.org. We look forward to serving you on Friday, April 1, 2016. Thank you for your patience and cooperation.

 

30Mar

Families of U.S. Personnel Will Be Evacuated from Turkey

  • Staff
  • FSBP   All  
The Foreign Service Benefit Plan (FSBP) has been advised that the Department of State and the Department of Defense will evacuate almost all family members from their facilities in Turkey.  They have cited security concerns as the campaign against the Islamic State continues.   

As with other relocations of FSBP members, we request members to advise us of temporary and/or permanent relocations. We want to continue uninterrupted delivery of your medications and handle your claims appropriately.  

We ask that you contact Express Script’s (ESI, the Plan’s Pharmacy Benefit Manager) Member Services at 1 800 497-4641 and keep them apprised of your current mailing address to assure proper delivery of medication.  

In addition, you may contact the Plan directly to update your information:

  • Through our secure Internet connection at: https://secure.myafspa.org
  • By phone at 1 202 833-4910 and asking to speak to our Member Quality Services Department; or
  • By fax at 1 202 833-4918. 
The FSBP continues to monitor situations that require keeping lines of communication open with those of you who could be affected by the disruption of medicine delivery and/or claim information.

 

29Mar

OPM Selects New FSAFEDS Contractor

  • Staff
  • fsbp411   FSBP   All  

The Office of Personnel Management (OPM) has selected WageWorks, Inc. as the new Federal Flexible Spending Account Program (FSAFEDS) contractor.   
www.wageworks.com/about/news/press-releases/march-2016/united-states-office-of-personnel-management-chooses-wageworks-to-administer-flexible-spending-account-program  
The effective day of the contract was March 1, 2016.  Transition activities are underway and will continue until WageWorks, Inc. assumes full administration of FSAFEDS in the Fall. This change will have no impact on enrollee balances, contributions or eligible expenses.  
More information will be provided as the transition progresses.  
Please send any questions and/or comments to [email protected]

 

24Mar

Clinical Matters News & Notes Release

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Matters News & Notes Release, 21 March 2016.pdf

 

24Mar

Kovaltry Approved for Hemophilia A

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash,17 March 2016.pdf

 

24Mar

Clinical Matters News & Notes Release

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Matters News & Notes Release,14 March 2016.pdf

 

15Mar

AFSPA Closed Wednesday, March 16, 2016!

  • Staff
  • All  
Due to an unprecedented regional emergency, the Washington Metropolitan Area Transit Authority (WMATA) is suspending transportation services for the Washington DC area on Wednesday, March 16, 2016. Please see the official message from WMATA below:

“The Metrorail system will close at its normal time tonight (midnight) and remain closed until 5 a.m. Thursday. All six Metrorail lines and all 91 stations will be closed on Wednesday.” 

This incident led AFSPA to make the decision to close the office during this time period.
Our partners at Aetna will be accepting all member calls during AFSPA’s regular business hours of 8:30A.M. to 4:30P.M. (EST). Please anticipate longer wait times due to this unforeseen emergency.

AFSPA is expected to reopen on Thursday, March 17, 2016 at 8:30A.M. (EST). Please check our website for the most up-to-date information.

Thank you for your patience. We look forward to serving you on Thursday, March 17, 2016.

 

9Mar

Idelvion Approved for Hemophilia B

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Flash, 8 March 2016.pdf

 

9Mar

Clinical Matters News & Notes Release

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Matters News & Notes Release, 7 March 2016.pdf

 

7Mar
AFSPA is now offering a new CIGNA Global Disability Plan!

AFSPA is now offering a new CIGNA Global Disability Plan!

  • Staff
  • All   Disability  

We now offer a Disability Income Protection Plan that does not require a health application to enroll. This is your opportunity to fill in your income protection gap. Cigna Global Health Benefits offers a 2-year & a 5-year benefit option, covers maternity that begins after the effective date, covers war and terrorism, and covers you stateside and overseas. To learn more, call 202-833-4910 or visit www.afspa.org/disability. Sign up today!

 

1Mar
FROM THE CEO

FROM THE CEO

  • Paula S. Jakub, RHU
  • All  
Welcome to March 2016! The season of Spring means new beginnings. A new emphasis for Spring 2016 is the establishment of a Facebook page for the American Foreign Service Protective Association. We wanted to utilize social media to tell more stories, to offer more resources, and to continue strengthening the AFSPA community. With Facebook's one billion worldwide members, it made sense to pursue this popular communication platform. Our members will have access to the information no matter where they are located. Please click here to join the AFSPA Facebook page. You will receive regular updates and learn how we strive to offer you the unparalleled service you expect from us.

As mentioned last month, AFSPA now has a New Disability Income Protection Plan, underwritten by CIGNA. AFSPA began offering this additional Disability Plan in February 2016. Enrollment does not require a health application. The plan covers war, terrorism, and maternity (whose inception begins after the effective date). For more information, call AFSPA at 202-833-4910 or visit www.afspa.org/disability. Your enrollment is guaranteed so consider joining now. AFSPA continues to offer the existing long term disability plan from Lloyds of London, which offers a unique Lump Sum Payment feature. It is important for members to have choices that best suits their needs.

Lastly, March is National Nutrition Month. It focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. This would be a great time to explore the Mediterranean Wellness Program offered to all FSBP members. The eight week interactive online program gives you access to a registered dietician. It also offers a support manual with information to help manage your weight. If you didn’t know, the Mediterranean Wellness Program counts as a Healthy Action for those completing the Simple Steps to Living Well Together Program. So start your path to better eating and earning a incentive credit today. Please refer to the 2016 FSBP Brochure to explore the many other programs that can help members with nutrition goals, including our Weight Management Program, Health Coaching Program and TherapEase Cuisine, just to name a few.  

We hope your family has a happy and healthy Spring. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

1Mar

Clinical Matters News & Notes Release

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Matters News & Notes Release, 29 February 2016.pdf

 

1Mar

Clinical Matters News & Notes Release

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Matters News & Notes Release, 17 February 2016.pdf

 

1Mar

Generic Glumetza Launched

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 2 February 2016.pdf

 

22Feb
Did you forget to enroll in a Dental Plan?

Did you forget to enroll in a Dental Plan?

  • Staff
  • Dental  

Learn more about AFSPA’s Dental Plans! AFSPA offers four different dental plans to meet the needs of our worldwide membership.  This includes a true international plan that covers any dentist worldwide. AFSPA’s dental plans have no open enrollment period and cover unmarried dependents up to age 26. There are over 600,000 in-network providers throughout the United States. Call or e-mail us at (202) 833-4910 or [email protected] to enroll today!

 

12Feb

Generic Gleevec Launched

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 1 February 2016.pdf

 

12Feb

Zepatier Approved for Hepatitis C

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 29 January 2016.pdf

 

4Feb

Aetna update on Zika Virus

  • Staff
  • fsbp411   All   FSBP  

Outbreaks of the Zika virus infection in Central and South America have authorities investigating a potential link between the virus in pregnant women and microcephaly – abnormal smallness of the head – and other poor outcomes in babies. - For more information click here.

 

2Feb
FROM THE CEO

FROM THE CEO

  • Staff
  • All  
Greetings from the nation’s capital! We experienced this winter’s first major snow storm last month. We followed the guidance of the Office of Personnel Management and closed our office for several days while the region cleaned up and recovered from the devastating blizzard. I apologize for any interruptions in customer service and thank you for your patience. You can find the latest information on closures, unexpected delays, or early dismissals affecting our office on the newsfeed on www.afspa.org.

The Protective Association prides itself for checking the current insurance marketplace to determine if we are offering the programs that address our members’ current and future needs. We are happy to announce a New Disability Income Protection Plan, underwritten by CIGNA. AFSPA is offering this additional Disability Plan starting February 2016. Enrollment does not require a health application. Plus the plan covers war, terrorism, and pregnancy (when inception begins after the effective date). There are options for a 2-year and a 5-year benefit period. For more information, call AFSPA at 202-833-4910 or visit our website www.afspa.org, under Ancillary Insurance Programs. Your enrollment is guaranteed. We will continue to offer the popular existing long term disability plan, which offers a unique Lump Sum Payment feature.  We feel it is important for members to have choices that best suits their individual needs.

I am also pleased to announce the success of the new the Foreign Service Benefit Plan’s (FSBP) Simple Steps to Living Well Together Program. Over 700 members have completed Step One: the Health Risk Assessment (HRA) during the month of January. This also means over 700 members have earned a 0 gift card. The HRA is like an interview you take online or over the phone. You share information about your health habits and history. When completed, you receive a personalized health summary that can help you understand your individual health needs. This information can assist you in setting meaningful goals for yourself.  You can choose from the many programs offered by FSBP that can help you meet those goals. The 0 gift card reward arrives a few weeks after you submit your HRA and select your preferred reward. It is that simple!  

Lastly, February is American Heart Month. According to the American Heart Association, cardiovascular disease — including heart disease, stroke, and high blood pressure — is responsible for one out of every three deaths. It is the No. 1 killer of American women and men, and it is a leading cause of serious illness and disability. If you have high blood pressure, I encourage you to take steps to control it. Make sure to complete your routine physical examination, which FSBP covers at 100% when you visit an in-network provider or a provider outside the U.S. Monitoring your blood pressure is the best form of prevention. Click here to learn how the Centers for Disease Control and Prevention (CDC) suggests you take better care of your heart.

We hope your family stays safe, warm, and healthy this winter. As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,
Paula S. Jakub

 

1Feb

WHO Declares International Emergency Regarding Zika Virus

  • Staff
  • FSBP   fsbp411   All  

The World Health Organization has declared an international emergency over the spread of the Zika virus, which is linked to birth defects in the Americas.  For more information and guidance, please click here.

 

1Feb

IRS Forms 1095-B and 1095-C Information

  • Staff
  • fsbp411   FSBP  
Beginning in 2016, Foreign Service Benefit Plan (FSBP) enrollees will receive the IRS Form 1095-B from the American Foreign Service Protective Association, underwriter for the FSBP, showing that you were covered under the FSBP. If you have questions about the information on IRS Form 1095-B, or about lost or incorrect forms, you should contact us at (202) 833-4910 or at: [email protected]. Please do not contact OPM, your employing agency, or your retirement office about IRS Form 1095-B. OPM and the agencies will not be able to answer questions about the information on IRS Form 1095-B. It is our responsibility to make corrections to and answer questions about IRS Form 1095-B.

Federal employees also will receive the IRS Form 1095-C regarding their offer of health coverage from their employing agency. You should direct your inquiries related to IRS 1095-C Form to your employing agency. Annuitants who were employed a portion of the year will receive an IRS Form 1095-C also from your former employer. Otherwise, annuitants will not receive this form.

Click here for "Health Care Coverage Forms for Federal Employees Health Benefits - Fast Facts".

Click here for "Health Care Coverage Forms for Annuitants - Fast Facts".

 

25Jan
AFSPA Closed Today

AFSPA Closed Today

  • Kyle Longton, Chief Operating Officer
  • All  
Following an historic blizzard, much of the Washington metro region remains buried in snow. AFSPA is following the direction of the Federal government and will remain closed on Monday, January 25.

We will continue to follow the government's lead and assess our ability to open. My colleagues and I look forward to serving you when we re-open. In the meantime, I encourage you to explore the website for answers to your questions and information about our programs.

 

22Jan

Clinical Matters News & Notes Release

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Matters News & Notes Release,18 January 2016.pdf

 

22Jan
AFSPA Closing at 10:45 today

AFSPA Closing at 10:45 today

  • Kyle Longton, COO
  • All  
The most recent forecasts for the Washington, DC metro region indicate that snow will begin to fall in the early afternoon. To allow our staff time to get home safely, we will close our office and shut down the phones at 10:45 am today. We will monitor conditions and follow the Federal government's operating decision next week.

For providers trying to reach the Foreign Service Benefit Plan, our provider call center is closed today due to inclement weather that has already reached that location.

All of us on staff at AFSPA wish all of our members - particularly those in the path of this storm - a safe weekend.

- Kyle Longton

 

21Jan
Planned Early Closing

Planned Early Closing

  • Kyle Longton, COO
  • All  
The Washington, DC metro area is expecting a major weather event on Friday and Saturday, January 22 and 23. Meteorologists are predicting blizzard conditions resulting in up to two feet of snow.

The Federal government will decide on its operating status on Friday morning. If the Federal government closes for the day, AFSPA will also close. If the Federal government is open, AFSPA will make every effort to open on time. We will close our office no later than 12:30pm. I will announce any changes via our website and answering service. The early closure will allow AFSPA staff members to travel home safely before the worst of the storm arrives.

Thank you for your understanding. I wish the best to all AFSPA members around the world who are facing inclement weather.

- Kyle Longton, COO

 

19Jan

Military Treatment Facilities (MTFs)

  • Staff
  • fsbp411   FSBP  

Many Military Treatment Facilities (MTFs) are no longer doing third party billing (submitting the claims to insurance providers and accepting payment from them).  Instead, they will provide you an invoice with claim information and require you to pay the bill.  In order to process a claim, the Plan needs key pieces of information.  It is important that you send us all of the pages of the invoice.  For example, we are finding that the diagnoses do not appear on the invoice until the second or third page of the invoice.  The Plan will pay benefits for covered services to the member and not the MTF, provided we have sufficient information to process the claim.  Paying the MTF will be the member’s responsibility.  In addition, some MTFs are billing for services that were rendered beyond the Plan’s timely filing limit.  If that happens, please submit your claim as soon as you receive it so that we can review for processing.

 

1Jan
From the CEO

From the CEO

  • Paula S. Jakub, RHU
  • All   Health-Programs   FSBP   Dental  
Happy New Year and Welcome to 2016! At this time of year, we usually make resolutions related to improving our health. This could include quitting smoking, losing weight, or developing a regular exercise routine. Let the Foreign Service Benefit Plan (FSBP) assist you with your goals. We have redesigned our wellness program, Simple Steps to Living Well Together, to help you identify your health risks and achieve your health goals. The best part is…you earn rewards along the way. Click here to learn about the complete program and the three simple steps to better health.

As you know, Open Season for the Federal Employees Health Benefits program officially ended December 14, 2015.  We want to welcome all our new FSBP members. It is an honor to be your chosen health plan. Please become familiar with all the great benefits and programs that now are available to you.. And after a long holiday season, a good way to begin is to  utilize your massage therapy benefits to relieve the additional stress. As a reminder, we cover 40 visits per year, up to per visit. That is over three massages each month. January is a great time to get started.

Did you forget to sign up for dental insurance during the Federal Open Season? AFSPA offers dental plans that you can join at any time. Our Cigna HMO plan has no claim forms, no calendar year deductible  or maximums and no waiting periods. Our Cigna PPO plan also does not have a calendar year deductible and provides access to over 200,000 in-network providers nationwide.  You also have the flexibility of using an out-of-network dentist.  Both these dental plans cover your unmarried dependents up to age 26. This is a great time to explore dental insurance through AFSPA. Click here to choose one of our four popular dental plans.  

In 2016, AFSPA will continue to make improvements as well. Please look for more changes especially as AFSPA explores social media. We are striving to build a community and give you a forum to have open conversations. The first venture will be the launching of our Facebook page in early 2016. Look for more details coming soon.

Once again, I wish you a prosperous New Year. As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health,

Paula S. Jakub

 

30Dec

Happy New Year!

  • Staff
  • All  
AFSPA will close at 4:30 pm on Thursday, December 31, and will be closed all day on Friday, January 1. We will resume our normal business hours at 8:30 am on Monday, January 4.

We wish all of our members a happy and healthy New Year.

 

29Dec

Zurampic Approved for Gout

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Flash, 23 December 2015.pdf

 

28Dec

Bendeka Approved for Chronic lymphocytic leukemia (CLL) and Indolent B-cell non-Hodgkin lymphoma

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 9 December 2015.pdf

 

23Dec

Vonvendi Approved for von Willebrand Disease

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Flash, 10 December 2015.pdf

 

23Dec

Kanuma Approved for Lysosomal Acid Lipase Deficiency

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 8 December 2015.pdf

 

23Dec

AFSPA is closing early for Christmas

  • Staff
  • All  
Please be advised AFSPA will be closing early for Christmas on Thursday, December 24th at 12:00 P.M. Our offices will remain closed on Friday, December 25th, 2015. We will resume regular business hours on Monday December 28th, 2015.

Happy Holidays!

 

18Dec
AFSPA is closing early today

AFSPA is closing early today

  • Staff
  • All  
Please be advised that our offices will be closing at 11:15 A.M. today Friday, December 18th, 2015.

We will resume regular business hours on Monday, December 21st, 2015.

Thank you.

 

17Dec

A guide to the Aexcel specialist performance designation

  • Staff
  • FSBP  
A guide to the Aexcel specialist performance designation

Aexcel is our designation for high-performing specialty doctors and doctor groups in 12 medical specialty areas:

  • Cardiology
  • Obstetrics and gynecology
  • Cardiothoracic surgery
  • Orthopedics
  • Gastroenterology
  • Otolaryngology/ENT
  • General surgery
  • Plastic surgery
  • Neurology
  • Urology
  • Neurosurgery
  • Vascular surgery
        
    Doctors with the Aexcel specialist designation have met added standards for volume, clinical performance and efficiency.  We evaluate these doctors using specific standards and based on the results, we give them the Aexcel specialty designation.  

    How do you find a doctor with the Aexcel specialty designation?  Visit http://fsbp.coventryhealthcare.com, Select “Locate a Provider” and enter your initial search criteria (e.g. zip, city/county, state, name or specialty).  After preliminary results are returned, under “Narrow Your Results” in left margin select “Show Only Aexcel Providers”.  You also can scroll through initial results for blue star next to provider’s name.

    Evaluation Standards  

    First, we evaluate volume.  We identify doctors who have managed at least 20 episodes of care for Aetna members over the past 3 years.  An episode of care is defined as all services provided to a patient with a medical problem within a specific period of time across a continuum of care in an integrated system. For example, a hip implant, months of chemotherapy, treatment for a chronic eye infection or foot surgery.  

    Second, we evaluate the doctors’ clinical performance.  We use five categories of measures.  Doctors must meet standards in one of five categories: use of technology; Alignment with Institutes of Quality® (IOQ); Certification by an external entity such as the National Committee for Quality Assurance (NCQA); Performance based improvement model; or Claim based measures.  

    The third and final factor we look at is efficiency.   To do so, we examine what these doctors charge Aetna members for services and how many and what types of services they perform.  We consider all costs of care including inpatient, outpatient, diagnostic, laboratory and pharmacy claims.  There are some doctors who care for more patients with chronic or complex conditions in a given time period.  To make sure we are comparing apples to apples, we use risk-adjustment factors like age, gender and disease risk.  This way, we are able to evaluate all doctors on a level playing field by comparing their services for patients with similar conditions.    

    What if a specialist does not have a blue star:  This does not mean the doctor does not provide quality services.  It could be that we do not have enough information available to evaluate a particular doctor or the doctor’s specialty is not one of the 12 specialty categories. 

    The blue star identifies doctors who have earned the Aexcel specialty designation. These are doctors you might want to consider for specialty care.  However, Aexcel information is only a guide.  There are many ways to evaluate doctor practices.  You should talk with your primary care doctor and the specialist you are considering before making a decision.   Please note that ratings have a chance for error.  An Aexcel designation is not a guarantee of service quality or treatment outcome. Therefore, they should not be the only reason for choosing a specialty doctor.

 

16Dec

Clinical Matters News & Notes Release

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Matters News & Notes Release, 14 December 2015.pdf

 

7Dec

AFSPA in Action Newsletter

  • Staff
  • All  

Read the latest AFSPA news in our AFSPA in Action Fall Newsletter!
AFSPA in Action Fall Newsletter.pdf

 

2Dec

Clinical Matters News & Notes Release

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Matters News & Notes Release, 30 November 2015.pdf

 

1Dec
FROM THE CEO

FROM THE CEO

  • Paula S. Jakub
  • All  
December marks the end of another year and begins a time of reflection. Every year at this time, I think about how lucky we are at AFSPA to serve such an exceptional group of people. Thank you for giving us the opportunity to work with you this year.

Holidays bring family and friends together to celebrate traditions and spread good cheer. They also bring lots of opportunities for socializing, eating, and drinking. Even the most disciplined of us struggle with temptation during the holiday season. Stay physically active during the holidays. Make your focus on fun and not just on food. Also, be sure to manage your stress levels. Find a balance between work, home, and play. Get support from family and friends, when needed. Keep a relaxed and positive outlook. Above all, get proper sleep. These are just a few holiday tips to support your efforts for health and safety this season. See a full list of recommendations from the Centers for Disease Control and Prevention at http://www.cdc.gov/family/holiday/.

On another note, December 1 marks World AIDS Day. This annual day of reflection is an opportunity for people worldwide to unite in the fight against HIV. Government and health officials, non-governmental organizations, and individuals around the world observe the day. Activities often include education on AIDS prevention and control. The day shows support for people living with HIV and commemorates the people who have died.
Lastly, it is not too early to start thinking about resolutions for 2016. One of our most precious gifts is good health. I hope you have begun considering small changes in your lifestyle that will have a positive effect on the way your feel in 2016.  We have revamped the Wellness Benefits in the FSBP. If you already are a member of the Plan, please take a look at our Simple Steps to Living Well Together Program that helps you identify your health risks and achieve your health goals.
If you are not enrolled in the FSBP, please consider the FSBP for 2016. Open Season doesn’t end until December 14th, so it’s not too late to give yourself a present for 2016 – the gift of the support you need to achieve your 2016 health goals.

In summary, the holidays are a great opportunity to enjoy time with family and friends, to celebrate life, to be grateful, and to assess what is important. But they are also a wonderful time to appreciate the gift of health. I hope you and all family and friends have a lovely holiday season filled with joy and meaning.    

To Your Health,  
Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

30Nov

Portrazza Approved for Lung Cancer

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 25 November 2015.pdf

 

25Nov
AFSPA is closing early

AFSPA is closing early

  • Staff
  • All  
Please be advised we will be closing our offices early on Wednesday, November 25, 2015.
Our offices will close at 2:00P.M. EST. and will remain closed through the weekend. 

We will resume normal business hours on Monday, November 30, 2015. 

Happy Holidays! 

 

18Nov

Darzalex Approved for Multiple Myeloma

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash,18 November 2015.pdf

 

17Nov

Adynovate Approved for Hemophilia A

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Flash, 17 November 2015.pdf

 

16Nov

Clinical Matters News & Notes Release

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Matters News & Notes Release, 16 November 2015.pdf

 

10Nov

Cotellic Approved for Advanced Melanoma

  • Staff
  • Prescription   FSBP  

This is an Express Scripts Clinical Flash,10 November 2015.pdf

 

6Nov

Genvoya Approved for HIV

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 6 November 2015.pdf

 

5Nov

NUCULA Approved for Severe Asthma

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Flash, 5 November 2015

 

4Nov

Clinical Matters News & Notes Release

  • Staff
  • FSBP   Prescription  

This is an Express Scripts Clinical Matters News & Notes Release, 4 November 2015

 

6Nov
Welcome to the new AFSPA Website!

Welcome to the new AFSPA Website!

  • Paula S. Jakub
  • All  
Welcome to the new AFSPA Website! After months of planning and preparation, we are pleased to unveil the site to our loyal members. You will find freshly organized content partnered with more pictures and colors that are pleasing to the eye. Of course, we want AFSPA members to continue using the site as a resource. We built the site using a more secure structure to ensure continued access for our members and avoid interruption in service. In addition, we streamlined the presentation of the content, improved the contact forms and search function, and combined the news updates into a single feed. Our goal was to present a website that is easier – and even enjoyable – for members to use.

You can learn important health benefit information as well as more about our ancillary services including dental, disability, and others. This website is more interactive and allows us to hear directly from you. We want to know your thoughts on the new site and your overall experience with AFSPA. You can use the feedback features within the website (at the bottom of the home page, under Resources) or email [email protected].

Thank you for visiting and exploring the new AFSPA site! 

 

1Nov
From the CEO

From the CEO

  • Paula S. Jakub
  • All  
Welcome to November 2015!

As the year comes to an end, this season makes us focus on planning and preparation for the upcoming year. The Federal Employee Benefits Open Season is fast approaching, which is a great time to take a look at all your benefits.

In addition to reviewing the choices for your health plans, review your dental choices and consider adding dental coverage from AFSPA. AFSPA sponsors four different dental plans. Our plans are designed to provide options to fit how you use dental care. This includes a PPO plan that provides out-of-network benefits, two dental HMO plans that could lower your out-of-pocket expense even more. We also offer an international plan designed exclusively for our overseas members, offering the higher benefit level for treatment abroad. In addition to premiums that are competitive with FEDVIP, our plans provide the necessary flexibility for our members who transfer to/from overseas throughout the entire year and not just during an Open Season/QLE. We encourage you to take a look at our services. Many of you trust us with your medical health care, why not trust us with your dental health care too?

Recently, I have received many questions about the new Self Plus One enrollment type. For those who do not know, Self Plus One is a new enrollment type in the FEHB Program that allows you to cover yourself and one eligible family member you designate to be covered. You will be able to select the Self Plus One enrollment beginning this Open Season. You will want to pay special attention to the benefits and rates in the Foreign Service Benefit Plan (FSBP).

We develop our rates based on the population for each enrollment type in our Plan. Due to demographics, utilization of medical services, and medical costs, the premiums for the Self Plus One and Self and Family are similar. Many plans increased the Self and Family premium substantially to make room for the Self Plus One rate. If you compare the 2015 Self and Family rate to the 2016 Self Plus One rate of many plans in the FEHB Program, you will see that there is a considerable increase. The 2016 Self and Family rate is higher yet, in most cases, to make room for the Self Plus One rate. So, while it seems there should be a break in the Self Plus One premium, in reality, the right amount of premium still is needed to cover the outgoing claims, regardless of the enrollment type.

Please keep in mind: If you are a two person family, you do not have to enroll in Self Plus One. You may remain in Self and Family. Therefore, our focus was on the Self and Family rate, which affects the majority of FSBP enrollees. On another note, Open Season begins November 9, 2015. As you know, the AFSPA staff travel to various regions of the globe in preparation for Open Season. Any direct hire Federal employee who is enrolled or is eligible to enroll in any plan under the FEHB Program can attend these briefings, which are focused on general information to explain your Federal benefits and Open Season opportunities. This year’s topics include the Changes in 2016, How Health Care Reform Affects You, and the new Self Plus One Premium – available in 2016. Please plan to attend and bring your questions. See the November schedule below (subject to change – check with your local HR office):

November 2 – Yongsan Army Base, US Army Corps of Engineers, FED Compound, East Gate Club, Building S-87, 9:30am

November 2 – Yongsan Army Base, South Post Chapel, Overflow Room, 9:30am & 1pm

November 2 – Yongsan Army Base, Seoul American Elementary School, Library, 3pm

November 2 – Yongsan Army Base, Seoul Middle/High School, Auditorium, 4pm

November 3 – Osan Air Base, Building 936, Room 214, 1:30pm

November 3 – Osan Air Base, Osan American Elementary School, Library, 3pm

November 4 – Camp Humphreys, Community Fitness Center, Super Gym, 11am & 1pm

November 4 – Camp Humphreys, Camp Humphreys High School, Library, 3:30pm

November 4 – U.S. Consulate General Sao Paulo, Buzios Conference Room, 2:30pm

November 5 – U.S. Embassy Seoul, 1st Floor Conference Room, 9am

November 6 – U.S. Embassy Brasilia, Amazonas Conference Room, 9:30am

November 9 – American Institute Taiwan, Auditorium, 2pm

November 10 – U.S. Embassy Bogota, Florida Room, 2:30pm

November 10 – Camp Walker, Camp Walker Chapel, 9am

November 10 – Camp George, Daegu Elementary School, 2:30pm

November 10 – Camp Walker, Daegu High School, 3:15pm

November 12 – Kadena Air Base, Kadena High School, Library, 4pm

November 12 – U.S. Embassy Lima, Multipurpose Room, 1pm

November 12 – Misawa Air Base, Sollars Elementary School, Library, 3pm

November 13 – Kadena Air Base, Schilling Center, Large Conference Room, 9:30am

November 16 – Kadena Air Base, Schilling Center, Large Conference Room, 9:30am

November 16 – Kadena Air Base, Lester Middle School, Library, 4pm

November 16 – Yokosuka Naval Base, Building A-20, Classroom, 10:30am & 12pm

November 16 – Yokosuka Naval Base, Sullivan School Complex, Multi-Purpose Room, 3pm

November 16 – U.S. Embassy Port Au Prince, Multi-Purpose Room, 2pm

November 17 – Naval Air Facility Atsugi, Classroom 216, Building 949, 10am & 12pm

November 17 – Naval Air Facility Atsugi, Shirley Lanham Elementary, Library, 2:45pm

November 18 – U.S. Embassy Mexico City, Conference Room, 2pm

November 18 – Yokota Air Base, Mendel Elementary, Training Room, 3pm

November 19 – Camp Zama, Training Room, 1pm

November 19 – Camp Zama, Community Club, Garden Room, 3:30pm

November 20 – U.S. Embassy Tokyo, Management Conference Room, 3rd Floor, 9am

We hope to see you at one of our Open Season Briefings.By the way, Happy Thanksgiving! This year, as you celebrate this truly American holiday, thank your body by maintaining a healthy diet during the traditional gatherings. Reduce your salt intake, control your portions, and load your plate with vegetables.

As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU 
CEO, AFSPA 
Executive Director, Senior Living Foundation

 

19Oct
FSBP Announces 2016 Benefits and Premiums

FSBP Announces 2016 Benefits and Premiums

  • Staff
  • FSBP  
At a time when the Federal Employees Health Benefits Program has announced average enrollee premium increases of 7.4% (with some of the popular plans increasing even more), we are pleased to announce that we have increased only modestly in comparison. The Foreign Service Benefit Plan (FSBP) Self Only premium went up only 5% and our Self and Family premium went up only 5.4%.

Above is a chart showing our enrollees’ share of our premiums for 2016.

Starting in 2016, FEHB enrollees will be able to enroll in the new Self Plus One enrollment type. We announced information about the new Self Plus One enrollment type on our website on several occasions and in our Health Newsletter that we mailed to members recently. OPM has mandated that Self Plus One enrollment codes end in 3 for plans with one option.As with all FEHB plan premiums, OPM must approve them. You will notice that the enrollee’s share of the Self Plus One premium is slightly higher than the enrollee’s share of the Self and Family premium. We realize this sounds counter-intuitive but there are good reasons for this:

  • We develop our rates based on the population for each enrollment type in our Plan. Due to demographics, utilization of medical services, and medical costs, the premiums for the Self Plus One and Self and Family are similar. Because the government contribution for Self Plus One enrollments is smaller than the government contribution for Self and Family enrollments, Self plus One enrollees will pay a higher enrollee contribution than Self and Family enrollees.
  • If you are a two person family, you do not have to enroll in Self Plus One. You may remain in Self and Family. Therefore, our focus was on the Self and Family rate, which affects the majority of FSBP

 

13Oct
ESI System Down Time Planned

ESI System Down Time Planned

  • Staff
  • All  
On October 18, Express Scripts (ESI - the FOREIGN SERVICE BENEFIT PLAN'S pharmacy benefit manager) is relocating to new state-of-the-art data center facilities. In order to complete the data center relocation, ESI is planning system down time that will occur on Oct. 18, between 2 a.m. ET and 9 a.m. Eastern Time. ESI selected the date and time for the relocation that would have the least amount of impact on clients and members. Potential areas of impact and plans in place to notify users of system maintenance are: Eligibility: Prescriptions will not process during the down time window. Retail pharmacies will be notified in advance to minimize member impact and ensure access to care is not compromised. Pharmacies may use their discretion based on patient need to fill the prescription and process once the system is back up, provide a limited supply or ask the patient to come back once the system is back up.
  • Coverage review: All systems will be unavailable but messaging will be placed on all sites informing users of down time. Phone call and fax volume is expected to be low. Plans to increase staffing resources are in place to complete requests once the system is back up as quickly as possible.
  • Contact centers: Patient care advocates will be unable to assist callers during this time. Information will be included in messaging alerting patients of down time due to system maintenance.
  • Member Website and mobile app: These sites will not be accessible during this time. Messaging will be displayed on all websites prior to the outage, during the outage and post outage once all systems are running as normal.

 

1Oct
From the CEO

From the CEO

  • Paula S. Jakub
  • All  
Welcome to Fall 2015!
In many parts of the world, this means transitioning from warm weather to cold weather. Please make sure to wear layers of clothing to protect your body. You and your family may want to consider getting a flu shot as well. A flu vaccine is needed every season for two reasons. First, the body's immune response from vaccination declines over time and an annual vaccine is needed for optimal protection. Second, because flu viruses are changing constantly, the formulation of the flu vaccine is reviewed each year and sometimes updated to keep up with changing flu viruses. For the best protection, every family member over the age of six months should get vaccinated annually. The Foreign Service Benefit Plan covers flu shots at 100% when using an in-network provider or an overseas provider.

If you have not heard yet, AFSPA moved to a new location on Monday, September 14, 2015. The address is 1620 L Street NW, Suite 800, Washington, DC 20036. The new office provides ample space for our growing staff and some necessary additions including dedicated space to meet with members and training space. If you are in the DC area, please stop by to see us. We welcome visitors during our normal business hours of Monday through Friday, 8:30am to 4:30pm, Eastern Standard Time. Please see the pictures of the new building in our upcoming Fall (AFSPA in Action) newsletter.
Open Season is fast approaching. This year, the open enrollment period is from November 9 to December 14, 2015. The AFSPA staff always travel to various regions of the globe in preparation for Open Season. Any direct hire Federal employee who is enrolled or is eligible to enroll in any plan under the Federal Employees Health Benefits (FEHB) Program can attend. This year?s topics include the Changes in 2016, How Health Care Reform Affects You, and the new Self Plus One Premium - available in 2016. Please plan to attend and bring your questions. See the October schedule below (subject to change - check with local HR offices):

October 8 - US Embassy, Brussels, HR Conference Room - 9am
October 8 - Brussels American School, Sterrebeck Library - 2:30pm
October 9 - US Embassy, Brussels, JAS 2nd Floor Conference Room - 9:30am
October 13 - Alconbury Middle/High School, Library - 3pm
October 14 - Lakenheath High School, Library - 4pm
October 14 - USAG Grafenwoehr, Civilian Personnel Advisory Center Unit 28130 - 11am
October 14 - Paris Embassy - 11:30am
October 14 - Grafenwoehr - Netzaberg Elementary School Unit 28130, Room E2.124 - 3:15pm
October 15 - US Embassy, London, Ben Franklin Room - 10:30am
October 15 - Hohenfels Civilian Personnel Advisory Center Conference Room, Bldg. 33 - 1pm
October 15 - Hohenfels Elementary School, Media Center - 3:30pm
October 16 - Vilsek, Rose Barracks, Building 535 - 11am
October 19 - Ramstein, USAFE Conference Center Gebaude 525, Flugplatz. Jefferson Ave., Bldg 525 - 1pm
October 19 - Ramstein High School, Library - 3:30pm
October 19 - Vicenza Army Base, Vicenza High School Library - 4pm
October 20 - Kaiserslautern, Panzer Kaserne Building 3029, Room 104 - 9am
October 20 - Kaiserslautern, Panzer Kaserne Building 3029, Room 104 - 11am
October 20 - Kaiserslautern, Pulaski Barracks Info Center, Ktown Middle/High School -? 9am
October 20 - Aviano Air Force Base, Base Theatre (Area F) - 1:30pm
October 21 - Stuttgart, Germany - AFRICOM - Building 3313, Room 115-116 - 9am
October 21 - Stuttgart, Germany - Patch Barracks - Theater - 11:30am
October 21 - Stuttgart, Germany - Stuttgart High School - 4pm
October 22 - Rome Embassy, Conference Room - 10am
October 22 - Wiesbaden, Building 1032, Room 2 - 11am
October 22 - Wiesbaden Middle School, Info Center - 4pm
October 23 - Frankfurt Consulate, Flag Room - 1pm
October 27 - Naples Navy Base, CAPO Theater - 9am
October 27 - Naples Elementary, Media Center - 2:45pm

We hope to see you at one of our Open Season Briefings.By the way, Happy Halloween! Here is a health tip: Set an expiration date for your candy, such as seven days after the holiday. You can throw it out or consider donating it to a food pantry or organization that sends treats to troops overseas. This health tip comes directly from the Cleveland Clinic.As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health, 

Paula S. Jakub, RHU
CEO, AFSPA 
Executive Director, Senior Living Foundation

 

8Oct
Travel in Style

Travel in Style

  • Staff
  • Travel  
Whether you're traveling with your family or you have planned excursions for your retirement years, it is important to consider a solid travel insurance plan. While no one wants to think anything would happen while vacationing, it is always better to be prepared rather than to be surprised.

AFSPA offers the Travel Assistance International travel policy that fills in the blanks where your health insurance may not cover. For example, repatriation of remains to your family, emergency medical evacuation, pre-trip assistance, emergency cash advances, and many more services are included in this policy.

A standard travel insurance policy contains many different sections of coverage, not all of which everyone needs, but for most people a standard travel insurance policy will cover all the unexpected events that can occur while away from home.

All travel insurance services are available 7 days a week, 24 hours a day. Help is only a telephone call away! For more information, contact us at (202) 833-4910 or call Travel Assistance International at 1 (800) 821-2828.

 

8Oct
Choosing a Dental Office

Choosing a Dental Office

  • Staff
  • Dental  
Many people do not know who to select for their dental provider, therefore, they just don't! Anxiety is a strong emotion we experience when it comes to deciding to go to the dentist or not.There are several ways to approach selecting a dentist. When you are searching for a dentist, the American Dental Association (ADA) offers these suggestions:
  • Ask family, friends, neighbors, or co-workers for their recommendations.
  • Ask your family doctor or local pharmacist.
  • If you are moving, ask your current dentist to make a recommendation.
  • Contact your local or state dental society. The ADA provides a list of local and state dental societies on its web site, www.ada.org. Your local and state dental societies also may be listed in the telephone directory under 'dentists' or 'associations.
The ADA suggests calling or visiting more than one dentist before selecting one.

 

8Oct
The Need to Plan

The Need to Plan

  • Staff
  • Long-Term-Care  
Planning for the future is something we do daily, whether we are aware of it or not. We plan for dinner, for doctor/dental appointments, and even for the occasional vacation.

Planning for your later years, in regards to retirement and healthcare needs, should be considered as well. Think a Long Term Care plan at age 40 and above. This is important, as we are healthier in our forties and the premiums are lower. Applicants over the age 50 may have acquired health issues and the premium rates are much higher. Whatever age you decide to purchase a Long Term Care plan, it is important  to make an educated decision. Call (202) 833-4910 for more information. You will be happy you did!

 

8Oct
Renting your house?

Renting your house?

  • Staff
  • Legal  
Own a home? If you are assigned overseas, learn your rights as it relates to renting your home. Tenant-landlord issues can be especially challenging when you are abroad.

One option is to hire a management firm to handle your property issues while you are out of the country. They will act on your behalf regarding maintenance of your property, collection of rent, and any other emergency issues that may occur. To select a reputable management company, you may want to contact a real estate attorney. They can offer guidance in the selection of an adequate service.

For real estate and a variety of other legal matters, AFSPA has several law firms that have specialties to assist members with whatever situation comes their way. Call (202) 833-4910 for more information.

 

8Oct
Insuring Dependent Adults

Insuring Dependent Adults

  • Staff
  • Members-of-Household  
Are you getting ready for your next assignment overseas? Do you have a dependent adult (either a child over age 26 or a parent) that will be joining you at your new post? If so, consider the Reside or Reside Prime travel medical plans to provide coverage for the period of time they are with you overseas. These plans are also for significant others that are in need of medical insurance that will accompany you.

We provide you with the complete outlines of coverage, premium rates, and applications. Once submitted, applications will be considered within two business days by the program administrator, Seven Corners. For more information, please call (202) 833-4910.

 

8Oct
Disability Insurance: The Overlooked Benefit

Disability Insurance: The Overlooked Benefit

  • Staff
  • Disability  
'A penny saved is a penny earned.' Many have heard that saying but most of us do not practice it. If we are realistic, we know anything can happen at any time to threaten our health and financial well-being. If you are unable to work, do not spend your savings - purchase a disability plan. The coverage will help to support  you and your family adequately.

Purchase a disability policy to prevent financial difficulty when illness or injury occurs. This investment will be more than its weight in gold. For just a few dollars a month, a disability plan will provide a new sense of security. You will know you can continue to take care of yourself and your family, even if your employer pays a limited portion of your salary.

Proper planning is key!

 

8Oct
Live in the Moment

Live in the Moment

  • Staff
  • Life-AD-D  
Life insurance is not only for the future, but also for the present. A life insurance policy will assist your family with covering mortgage, every day bills, and education expenses after a spouse has passed away. Did you know it also can provide a?living benefit??

Our term life insurance plan provides an Accelerated Benefit Option. This allows early access to benefits that would eventually be paid at death. You can use the benefit in any way you wish? to pay medical bills, hire home health aides, or prepay funeral expenses. This benefit is payable to you if you are diagnosed with a terminal illness and have a life expectancy of nine months or less. This benefit will pay 50% of your coverage amount up to,000. The balance of your benefit (if any) will be paid after your death.

Be aware how your insurance plan can work for you when you need it. If you have questions, please call (202) 833-4910 or email [email protected]

 

8Oct

Term Life Insurance for per pay period

  • Staff
  • Immediate-Benefit  
Are you willing to forfeit buying soda once every two weeks? Are you willing to spend that saved toward an all-important term life insurance benefit? That is all that the Immediate Benefit Plan cost, per pay period!

This insurance plan provides,000 of coverage (,500, if you are over age 70) within two days after AFSPA is notified of your passing. It is payable to your designated beneficiary to cover those immediate costs such as funeral expenses, mortgage, and medical bills.

Applying for this term life insurance plan is easy. Just go to https://www.afspa.org/aip_detail.cfm?page=Immediate-Benefit and follow the instructions under secure enrollment. The brochure outlining coverage is available online.

 

21Sep
A New Home for AFSPA

A New Home for AFSPA

  • Staff
  • All  
After more than two decades in our previous location, AFSPA opened its new office at 1620 L Street NW, Suite 800, in Washington, DC on September 14, 2015. The location convenient to four Metro lines and in the heart of the DC's Golden Triangle enables us to remain accessible to the membership. The new office provides ample space for our growing staff and some necessary additions including dedicated space to meet with members and training space.

As we look to the future, this move will allow us to continue to provide the unparalleled service that our unique, worldwide membership requires.

 

11Sep

AFSPA IS MOVING!

  • Staff
  • All  

We will be moving to our new office located at 1620 L Street NW, Suite 800, Washington DC, 20036-5629. Our phones will be down from 1pm (EST) today and will be back up at 1pm (EST) on Monday, September 14. Your access to the Member Portal will not be interrupted and we will respond to any correspondence after 1pm on Monday. We apologize for any inconvenience.

 

1Sep
From the CEO

From the CEO

  • Paula S. Jakub
  • All  
Traditionally, we mark September, and specifically Labor Day, as the end of summer. Children and adults make major adjustments around this time of year. As kids head back to school, they will need help transitioning into their regular fall routine. This is also a good time to visit the pediatrician and the dentist to ensure a successful and healthy school year.

Along the same lines, please make sure your children are up-to-date on vaccines before sending them back to school. According to the Centers for Disease Control and Prevention (CDC), school-age children, from preschoolers to college students, need vaccines. Making sure that your child is vaccinated can be one of the most important things you do as a parent.  This affects your child?s long-term health?as well as the health of their friends, classmates, and others in your community. The Foreign Service Benefit Plan (FSBP) covers childhood immunizations recommended by the American Academy of Pediatrics for members under age 22. We also cover travel immunizations recommended by the CDC at 100% of the Plan allowance.

Did you move over the summer? If so, please let us know. As you prepare to leave one post for another, please send us your new address. Your employing agency does not notify the FSBP when you change your contact information. Please remember to send us a note with your updated mailing address, telephone number(s), and email address. You also can update your contact information via the Member Portal. To access the Member Portal, click on the AFSPAconnect link in the top right-hand corner, log in, and edit your information in the Member Profile section.  We want to be sure you receive your reimbursement checks and member communications in a timely manner. Please tell us if you change locations so we can stay in touch.

Lastly, September is National Cholesterol Education Month. This is a good time to get your blood cholesterol checked and take steps to lower it if it is high. The National Cholesterol Education Program (NCEP) recommends that adults age 20 years or older have their cholesterol checked every 5 years. Children, young adults and older Americans can have high cholesterol. Preventive guidelines for cholesterol screening differ, but experts agree on the need to screen adults who have other risk factors for coronary heart disease? obesity, smoking, high blood pressure, diabetes, and family history. This is a great time to get your cholesterol checked and to learn how to prevent high cholesterol in the future. FSBP covers a blood cholesterol and/or lipid panel/profile per person, per calendar year at 100% of Plan allowance. See more preventative care information in our upcoming Health Newsletter.

And speaking of the newsletter, please look out for our Health Newsletter in your mailbox. It is redesigned and restructured to better meet your needs. Let us know what you think of the new format by emailing[email protected]

As always, thank you for your trust and for giving us the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation

 

1Aug
Message from the CEO

Message from the CEO

  • Paula S. Jakub, RHU
  • All  

Greetings and Welcome to August 2016! That means summer is winding down and a new school year is coming quickly. This is a good time to visit the pediatrician and the dentist to ensure a successful and healthy school year.

Along the same lines, please make sure your children are up-to-date on vaccines before sending them back to school. According to the Centers for Disease Control and Prevention, all school-age children need vaccines. The Foreign Service Benefit Plan (FSBP) covers immunizations recommended by the American Academy of Pediatrics at 100% when obtained at an in-network provider or providers outside the 50 Untied States. Having your child vaccinated can be important as it can affect their long-term health.

FSBP is seeking accreditation through the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC). The surveyors will be onsite August 17 -19, 2016. We voluntarily requested this survey as a means of assisting our own efforts to improve the quality of health care and member services. FSBP has been preparing for the accreditation process for over a year. We are confident that our health plan will be evaluated favorably. Seeking this accreditation status is part of our ongoing “Commitment to Service” to you.

Lastly, have you moved? If so, please let us know. As you prepare to leave one post for another, please send us your new address. Your employing agency does not notify FSBP when you change your contact information. Please send a note with your updated mailing address, telephone number(s), and email address. You also can change your contact information via the Member Portal.

Look for your Summer Newsletter in the mail. It highlights AFSPA’s activities, services, and new programs, provides information on prescription drugs and offers suggestions on avoiding “ransomware” attacks. We also share some tips on how to manage stress effectively.

As always, thank you for your trust and for giving AFSPA the opportunity to serve you.

To Your Health,

Paula S. Jakub, RHU
CEO, AFSPA
Executive Director, Senior Living Foundation


Source: https://www.afspa.org/news.cfm


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