a n T h e m . c o m Most Commonly Used Prescription Drugs
These days, television, magazines and even your mail is filled with ads promoting prescription drugs. But are you getting all of the facts? There are a variety of prescriptions available to you and some you may never have even heard about. Stay informed about your options, it can help you get control over your condition and your prescription costs.
The fol owing chart shows medications most commonly used by Anthem members and lists less expensive options for many of these drugs. Bring this list with you on your next physician’s visit and discuss the best therapeutic drug option with your doctor. If you don’t see your medication on the drug list, ask your physician or pharmacist if there is an appropriate alternative medication. •
Visit anthem.com for the most up-to-date information about Inclusion of a medication on the drug list is not a
your prescription medications. The site has tools you can use
guarantee of coverage. Some drugs on this list may not be covered by
to check potential drug interactions and learn more about lower
your plan. Please refer to your Certificate or Evidence of Coverage for
cost alternatives including generic and over-the-counter drugs.
coverage limitations and exclusions.Therapeutic Class Lower-Cost Alternatives
________________________________________________________________________________________________________________________________ Abilify
a Aciphex GERD, heartburn
Tier 2 - Prevacid, Protonix/ Tier 1 - omeprazole/ OTC - Prilosec
Tier 1 - glipizide (Glucotrol) metformin (Glucophage), glyburide
Tier 1 - amphetamine salt combo, methyliphenidate (Ritalin)
Tier 1 - fexofenadine, fluticasone nasal (Flonase), flunisolide nasal (Nasalide)
Tier 1 - lisinopril (Zestril), enalapril, benazepril
Tier 1 - temazepam (Restoril), triazolam (Halcion)
Tier 1 - glipizide (Glucontrol) metformin (Glucophage), glyburide
________________________________________________________________________________________________________________________________ Benicar HCT
Tier 1 - benazepril/HCTZ, enalapril/HCTZ, lisinopril/HCTZ
B Bisoprl/HCTZ Antihypertensive
________________________________________________________________________________________________________________________________ Cephalexin
c Ciprofloxacin
Tier 1 - fexofenadine, fluticasone nasal (Flonase), flunisolide nasal (Nasalide)
Therapeutic Class Lower-Cost Alternatives
________________________________________________________________________________________________________________________________ Concerta
Tier 1 - amphetamine combo, methyliphenidate (Ritalin)
c Coreg Antihypertensive
Tier 1 - atenolol, captopril, enalapril, lisinopril
Tier 1 - lovastatin (Mevacor)/ simvastatin (Zocor), pravastatin (Pravachol)
Tier 1 - amitriptyline (Elavil), bupropion (Wellbutrin),
________________________________________________________________________________________________________________________________ Depakote
D Diazepam Antianxiety agents
Tier 1 - atenolol, captopril, enalapril, lisinopril
Tier 1 - atenolol, captopril, enalapril, lisinopril
________________________________________________________________________________________________________________________________ Effexor XR
Tier 1 - amitriptyline (Elavil), bupropion (Wellbutrin),
Tier 1 - methotrexate, hydroxychloroquine
________________________________________________________________________________________________________________________________ Fexofenadine
F Flonase Allergies
Tier 1 - fluticasone nasal (Flonase), flunisolide nasal (Nasalide)
________________________________________________________________________________________________________________________________ Gabapentin
G Glimepiride Diabetic therapy
________________________________________________________________________________________________________________________________ Humalog
h Humira Antiarthritics
Tier 1 - methotrexate, hydroxychloroquine
Tier 1 - atenolol, captopril, enalapril, lisinopril
________________________________________________________________________________________________________________________________ Ibuprofen
I Imitrex Migraine headache therapy 2
________________________________________________________________________________________________________________________________ Kariva
K ________________________________________________________________________________________________________________________________ L Lantus Diabetic therapy
Tier 1 - amitriptyline (Elavil), bupropion (Wellbutrin),
Tier 1 - captopril/HCTZ, enalapril/HCTZ, lisinopril/HCTZ
________________________________________________________________________________________________________________________________ Medroxyprogesterone Glucocorticoids
m Metformin Diabetic therapy TieR 1 Lowest co-payment – Drugs offering the greatest value TieR 3 Highest co-payment – These are typically brand name drugs that
within a therapeutic class. Some of these are the generic equivalents of
do not have a generic equivalent. These also may be brand name drugs that
have no therapeutic equivalent, but are determined to be a third tier drug
solely based on cost. Drugs in this tier may cost more than equivalent drugs
TieR 2 Moderate co-payment – These can be brand name
on lower tiers or determined to be less efficient than equivalent drugs on
drugs which have a generic equivalent. Other drugs on this tier are
lower tiers by the Anthem Pharmacy and Therapeutics Committee.
the preferred drugs within a therapeutic class based on clinical
effectiveness and cost as determined by the Anthem Pharmacy and
Certain exclusions, limitations and prior authorization requirements may apply
to some drugs covered by the three-tier prescription drug benefit plan as
outlined in your member booklet or Evidence of Coverage. Therapeutic Class Lower-Cost Alternatives
________________________________________________________________________________________________________________________________ Nabumetone
n Naproxen Nonsteroidal anti-inflammatory 1
Tier 1 - fexofenadine, fluticasone nasal (Flonase), flunisolide nasal (Nasalide)
Tier 1 - fluticasone nasal (Flonase), flunisolide nasal (Nasalide)
Tier 2 - Prevacid, Protonix/ Tier 1 - omeprazole/ OTC - Prilosec
Tier 1 - diltiazem ER, nifedipeine ER, verapamil SR (Calan)
________________________________________________________________________________________________________________________________ Omeprazole
0 Omnicef Antibiotic
________________________________________________________________________________________________________________________________ Paroxetine
p Penicilln VK Antibiotic
Tier 1 - lovastatin (Mevacor)/ simvastatin (Zocor), pravastatin (Pravachol)
Tier 1 - estradiol (Estrace), estropipate (Ogen)
Tier 1 - estradiol (Estrace), estropipate (Ogen)
________________________________________________________________________________________________________________________________ Ranitidine
r Risperdal Ataractics-tranquilizers 2
________________________________________________________________________________________________________________________________ Seroquel
s Singulair
Tier 1 - amphetamine combo, methyliphenidate (Ritalin)
________________________________________________________________________________________________________________________________ Tamiflu
Tier 1 -amantidine (Symmetrel), rimantadine (Flumadine)
T Topamax Anticonvulsants
Tier 1 - atenolol, metoprolol (Lopressor)
Therapeutic Class Lower-Cost Alternatives
_____________________________________________________________________________________________________________________________ Tramadol HCL
T Trazodone Antidepressants
____________________________________________________________________________________________________________________________ Valtrex
V Verapamil Antihypertensive
Tier 1 - lovastatin (Mevacor)/ simvastatin (Zocor), pravastatin (Pravachol)
____________________________________________________________________________________________________________________________ Warfarin
w Wellbutrin XL Antidepressants
Tier 1 - amitriptyline (Elavil), bupropion (Wellbutrin),
____________________________________________________________________________________________________________________________ Yasmin 28
Y ____________________________________________________________________________________________________________________________ Z Zithromax Antibiotic
Tier 1 - prochlorperazine (Compazine), promethazine (Phenergan)
Tier 1 - amitriptyline (Elavil), bupropion (Wellbutrin),
Tier 1 - fexofenadine, fluticasone nasal (Flonase), flunisolide nasal (Nasalide)
Average 30-Day Cost for Common Drugs Did you know that the average Drug Name Average Cost 30-Day Rx American household spends $812 per year on prescription drugs?1
There are things you can do to reduce health care costs for you and your
family. The highest cost drugs are usually found on tier 3. Be sure to
ask your doctor about generic and lower tier alternatives to brand name
medications. Generic drugs are equally effective and typically less costly. Remember that using mail order may help you save money also. When
Trust Your Generics
you purchase more than a month’s worth of medications and supplies by
If you’ve ever wondered if generics are just as good as brands, rest
using the 90-day supply mail order option, you can save on maintenance
assured they are. The standards set by the Food and Drug Administration
require that generic drugs be chemically identical to their brand-name
1 Kashihara, D. and Carper, K. National Health Care Expenses in the U.S. Community Population,
counterparts and equal in safety, strength and effectiveness.
2002 Statistical Brief #61. December 2004. Agency for Healthcare Research and Quality, Rockville, MD
http://www.meps.ahrq.gov/papers/st61/stat61.pdf
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