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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


ADAP MM 2023-21
December 20, 2023


TO:
ADAP Enrollment Workers

SUBJECT:
Removal of Medications from the ADAP Formulary


​ADAP MM 2023-21: Removal of Medications from the ADAP Formulary


​The following medications have been removed from the ADAP Formulary because they are no longer available from the manufacturer(s): 

Medication​ Brand Name Drug Class Date Removed from the ADAP Formulary
saquinavirInviraseAntiretroviral8/21/2023
delavirdineRescriptorAntiretroviral8/21/2023
fomivirsenVitraveneAntiviral 8/21/2023
interferon alfacon-1InfergenAntiviral1/20/2023
codeine w/ASAgenericAnalgesic8/21/2023
isoniazid/rifampinRifamateAntibiotics8/21/2023
ranitidine HCLZantacH₂ Blockers 8/21/2023
capreomycinCapastatAntibiotics8/21/2023
lamivudine/tenofovir disoproxil fumarate*TemixysAntiretroviral8/21/2023
interferon alfa-2bIntron-AImmunomodulators2/6/2023
interferon alfa-2aRoferon-AAntineoplastic Interferons 2/6/2023
ribavirin Rebetol Antiviral 2/6/2023
ribavirin/interferon alfa-2BRebetron Antiviral 2/6/2023
Peginterferon alfa-2BPeg-IntronInterferons 2/6/2023

* Temixys's version of lamivudine/tenofovir disoproxil fumarate has been removed, but other commercially available versions of the medication are still on the formulary.

† Several interferon products are no longer commercially available and have been removed, but Pegasys pegylated interferon alfa-2a is still on the formulary.

ADAP management requests that you share this information with your clinical leadership team and local prescribers. The ADAP drug formulary has been updated to reflect the removal of these medications. Access to the updated formulary is available at the following URL: https://cdph.magellanrx.com/member/documents.

If you have any questions regarding the removal of these medications from the ADAP formulary, please contact the OA Formulary Specialist, James Vo (James.Vo@cdph.ca.gov).

Thank you,

Joseph Lagrama Signature

Joseph Lagrama
ADAP Branch Chief
California Department of Public Health