• Ramipril, brand name Altace (Hoechst Marion Roussel)

• Trandolapril, brand name Mavik (Knoll Pharmaceuticals)

Alpha Blockers—Drugs that block receptors in arteries and smooth muscle. This action relaxes the blood vessels and leads to an increase in blood flow and a lower pressure for the control of hypertension. The action in the urinary tract enhances urinary flow in prostatic hypertrophy.

• Doxazosin, brand name Cardura (Pfizer)

• Prazosin, brand name Minipress (Pfizer)

• Terazosin, brand name Hytrin (Abbott)

Analgesic Drug—A drug for the control of pain.

Angiotensin II Receptor Blockers— Drugs for the treatment of high blood pressure that act to block the receptor for Angiotensin II, a blood-pressure-elevating substance.

• Losartan, brand names Hyzaar (Merck) and Cozaar (Merck)

• Irbesartan, brand name Avapro (Bristol Myers Squibb and Sanofi)

Antipyretic Drug—A drug for the control of fever.

Calcium Channel Blockers (CCBs)— Drugs that inhibit the movement of calcium through cellular membranes and cause blood vessels to relax thereby increasing flow and lowering blood pressure.

• Amlodipine, brand names Lotrel (Novartis) and Norvasc (Pfizer)

• Diltiazem, a generic CCB

• Felodipine, brand names Lexxel and Plendil, extended release (Astra)

Cyclooxygenase-2 (COX-2) Inhibitors—Drugs for the treatment of pain, arthritis, and primary dysmenorrhea that inhibit prostaglandin synthesis by inhibiting the enzyme cyclooxygenase-2.

• Celecoxib, brand name Celebrex (Pfizer)

• Refecoxib, brand name Vioxx (Merck)

Histamine₂ Receptor (H₂R) Blockers— Drugs for ulcers and acid reflux that diminish acid by blocking a receptor in the acid-producing system in the stomach.

• Cimetidine, brand name Tagamet (SmithKline Beecham), also OTC

• Famotidine, brand name Pepcid (Merck), also OTC

• Nizatidine, brand name Axid (Eli Lilly)

• Ranitidine, brand name Zantac (Glaxo Wellcome), also OTC

Hydroxymethylglutaryl Coenzyme A Reductase Inhibitors (HMG CoA RIs) —Drugs that inhibit a liver enzyme involved in the synthesis of cholesterol, thus reducing cholesterol levels and the risk of cardiovascular disease.

Front Matter (R1-R18)

Executive Summary (1-10)

Introduction (11-36)

Is the VA National Formulary Overly Restrictive and Does it Prevent Physicians from Meeting the Health Care Needs of Veterans? (37-71)

What are the Potential Costs to VA Health Care Associated with the National Formulary for Drugs? (72-119)

What are the Effects of the National Formulary and Related Policies on Quality of Care? (120-148)

How Does the VA National Formulary Compare with Private Insurance Formularies for Drugs and Devices and with Other Government Formularies? (149-182)

The VA National Formulary and Veterans Health Care (183-200)

References (201-216)

Acronyms (217-220)

Appendix A: Interim Report of the Committee on VA Pharmacy Formulary Analysis to the Department of Veterans Affairs and the Congress of the United States (221-226)

Appendix B: Academy of Managed Care Pharmacy's Managed Care Formulary and Pharmacy Benefit Design Survey (227-230)

Appendix C: Additional Cost Information (231-249)

Appendix D: Glossary (250-253)

Appendix E: Drug Classes and Drug Index (254-258)

Appendix F: Committee Biographies (259-262)