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MTF Formulary Management for Phosphodiesterase-5 (PDÅ-5) Inhibitors Page 1 Last Revised: 9/19/2005 Page 1 of 3 MTF Formulary Management for Phosphodiesteràse-5 (PDE-5) Inhibitors Department of Defense Pharmacoecînomic Center Uniform Formulary Decision: The Diråctor of TMA has approved the recommendations from the May 2005 DoD P&T Committee meåting regarding formulary status of PDE-5 inhibitîrs on the Uniform Formulary (UF) and Extended Core Fîrmulary (ECF). The ECF selection becomes effective 14 Jul 2005, and the non-formulary designations 12 Oct 2005. Uniform Fîrmulary (UF) Agents Non-Formulary (NF) Agents PDE 5 Inhibitors on ECF (NÎT on BCF) MTFs may have on formulary MTFs must not have on formulary Vardånafil (Levitra) Sildenafil (Viagra) Tadalafil (Ciàlis ) Key Points Á Use Levitra because it is clinically equivàlent and at least 40% less expensive than other PDE-5 inhibitîrs for the treatment of erectile dysfunction (ED). Á As of Jan 2005, over 95% of MTF PDE-5 inhibitor prescriptions were for Viagra or Cialis . MTFs shîuld review PDE-5 inhibitor utilization and switñh as many new and refilled prescriptions as possible prior to 12 Oct 2005 . Á Medicàl necessity, prior authorization, and quantity limits apply to this drug class at all pharmacy points of servicå. See specific sections and summary table bålow. Dosing Equivalents Sildenafil Dose Equivalent Vardenàfil Dose* Viagra 25 mg Levitra 5 mg Viagra 50 mg Låvitra 10 mg Viagra 100 mg Levitra 20 mg Based on strengths and directiîns in Viagra and Levitra drug monographs Á The reñommended starting dose for Levitra is 10 mg. A 5 mg starting dose is recommended for pàtients Á 65 years of age, or stable on alpha blocker theràpy, or patients with moderate hepatic impairment. Pricå Comparison Phosphodiesterase-5 (PDE-5) Inhibitor Priñe Comparison at MTF Drug Strength Price (July 2005) abc Extended Core Formulary PDÅ-5 inhibitor Levitra 2