Horizon Blue Cross Blue Shield of New Jersey is removing Rezulin from a preferred list of drugs covered under a minority of its health plans. In addition, Aetna U.S. Healthcare says that it also may remove the type 2 diabetes drug from its formulary by the end of the year.

According to an October 21 news wire report, Rezulin will still receive some coverage but will cost patients a higher copay under Horizon's formulary. Horizon will replace Rezulin with the type 2 drugs Actos and Avandia in its drug formulary.

"Based on the current literature, it appears that Actos and Avandia are safer," says Terry Leach, formulary director for Horizon Blue Cross in Newark.

Jennifer King, spokesperson for Aetna, says that Aetna will remove Rezulin from its formulary because it has the side effects of elevated liver enzymes which Actos and Avandia do not. According to King, Aetna members who use Rezulin without any side effects may no longer get coverage for the drug if it is removed from the formulary.

"There would always be exceptions made," says King. "Doctors could appeal if they want their patients on Rezulin."

Nationwide, Rezulin has been used by approximately 1.6 million people.