Does Maryland maintain a formulary for generic substitution?
Maryland follows the FDA_s _Orange Book_ of Generic Equivalents. A state formulary is not maintained. However, Maryland law provides that the Secretary of the Department of Health and Mental Hygiene may make additions or deletions to the Orange Book for the purpose of generic substitution. Currently, six (6) drugs may not be substituted even if an equivalent generic product is listed in the Orange Book. Those drugs are phenytoin extended release capsules, valproic acid, theophylline extended release, warfarin sodium, primidone, and carbamazepine. Teva_s Epitol, however may be substituted for Tegretol.
“Effective November 1, 2006, the Department eliminated the policy that prohibits substitution of certain drugs, thereby removing six drugs from the Maryland Drug Formulary of Equivalent Drug Products. The drugs are Carbamazepine Oral Tablets 200 mg; Phenytoin Sodium Extended Oral Capsules 100 mg; Valproic acid; Theophylline extended release; Warfarin sodium; and Primidone. The FDA has declared these drugs do have generic equivalents. Therefore, they no longer need to continue as nonsubstitutable narrow therapeutic index drugs in Maryland.
