Your Anthem prescription drug plan is a plan you can count on. The three-tier design covers nearly any prescription medica-
tion available on the market today. Typically, first Tier prescriptions are low-cost or generic drugs and Tiers 2 and 3 are brand-name drugs. You can expect to pay the most for medications on Tier 3.
Visit anthem.com for the most up-to-date information about your prescription medications. The site has tools you can use to
check potential drug interactions and learn more about lower-cost alternatives, including generic and over-the-counter drugs.
In some cases, lifestyle choices can impact the amount of health care needed, as well. Making a few changes, like stopping
smoking, losing weight or exercising more regularly may help alleviate the symptoms of some conditions. Talk to your doctorabout the lifestyle changes or drug alternatives that may be right for you. For a more complete list of alternative choices for a particular medication, log on to anthem.com and click on the Drug Listing from the Virginia member home page.
The following chart highlights the medications most commonly used by Anthem members and lists less expensive options for
Some drugs on this list may not be covered by your plan. Please refer to your benefit booklet for specific coverage on these drugs.
Tier 2 - Seroquel / Tier 1 - chlorpromazine
Anti-Ulcer Preps/Gastrointestinal Preps 3
Tier 2 - Prevacid, Protonix / OTC - Prilosec
Tier 1 - hydromorphone (Dilaudid), morphine
Tier 1 - glipizide (Glucotrol), metformin
Tier 1 - methylphenidate (Ritalin), amphetamine
Tier 2 - Flonase, Nasonex / Tier 1 - flunisolide
Tier 2 - Flonase, Nasonex / Tier 1 - flunisolide
Tier 1 - lisinopril (Zestril), captopril (Capoten)
Tier 1 - glipizide (Glucotrol), metformin
Tier 1 - triazolam (Halcion), temazopam (Restoril)
Tier 1- amoxicillin/clavulanate (Augmentin)
Tier 1 - glipizide (Glucotrol), metformin
Tier 1 - glipizide (Glucotrol), metformin
Tier 1 - naproxen (Naprosyn)/ OTC - ibuprofen
Tier 1 - cyclosporine (Imuran, Sandimmune)
Tier 1 - ipratropium (Atrovent), albuterol
Tier 1 - Methylphenidate (Ritalin), amphetamine
Tier 2 - Lipitor, Zocor / Tier 1 - lovastatin
Tier 2 - Effexor XR, Tier 1 - bupropion SR
Tier 1 - lisinopirl (Prinivil), fosinopril (Monopril)
Tier 1 - hydromorphone (Dilaudid), oxycodone
Tier 1 - amitriptyline (Elavil), bupropion SR
Tier 2 - Cuprimine / Tier 1 - sulfasalazine
All strengths except 12.5mg available generically
Glipizide ER Diabetic Therapy 2 Tier 1 - Glipizide ER (glucotrol XL)Humalog
Tier 2 - Cuprimine / Tier 1 - sulfasalazine
Tier 2 - Depakote / Tier 1 - carbamazepine
Tier 2 - Grifulvin V / Tier 1- ketoconazole (Nizoral)
Tier 1 - erythromycin (EES), ciprofloxacin (Cipro)
Tier 1 - citalopram (Celexa), fluvoxamine (Luvox)
Tier 1 - cholestyramine (Questran), lovastatin
Tier 2 - Flonase, Nasonex / Tier 1 - flunisolide
Anti-Ulcer Preps/Gastrointestinal Preps 3
Tier 1 - Omeprazole / Tier 2 - Prevacid, Protonix / OTC - Prilosec
Tier 1 - cholestyramine (Questran), lovastatin
Tier 1 - felodipine (Plendil), verapamil (Calan)
Anti-Ulcer Preps/Gastrointestinal Preps 1
Tier 2 - Lipitor, Zocor / Tier 1 - lovastatin
Tier 1 - estradiol (Estrace), estropipate (Ogen)
Anti-Ulcer Preps/Gastrointestinal Preps 2
Tier 1 - cyclosporine (Imuran, Sandimmune)
Anti-Ulcer Preps/Gastrointestinal Preps 2
OTC - Prilosec / Tier 2 - Prevacid / Tier 1 - Omeprazole
Anti-Ulcer Preps/Gastrointestinal Preps 1
Tier 1 - chlorpromazine (Thorazine), haloperidol
Tier 1 - chlorpromazine (Thorazine), haloperidol
Tier 2 - Dantrium / Tier 1 - diazepam (Valium)
Tier 1 - methylphenidate (Ritalin), amphetamine
Tier 1 - gabapentin (Neurontin), carbamazepine
Tier 1 - propranolol (Inderal), metoprolol (Lopressor)
Tier 2 - Depakote / Tier 1 - carbamazepine (Tegretol)
Tier 1 - lovastatin (Mevacor) / Tier 2 - Zocor; Lipitor
Tier 1 - cholestyramine (Questran), lovastatin
Tier 1 - fluoxetine (Prozac), paroxetine (Paxil)
Tier 1 - chlorpromazine (Thorazine), haloperidol
Tier 2 - Flonase, Nasonex / Tier 1 - Flunisolide
As you know, health insurance premiums rise to accommodate the rising cost of health care; prescription drugs account for abouta fifth of that cost.1 The average annual prescription drug expense for an American household is $812.1
There are things you can do to prevent or reduce unnecessary
Average 30-Day Cost for Common Drugs
increases in health care costs for your family. A good startingplace is to learn about the medications you are taking and
find out if you might be able to save money by switching toan equally effective, less costly drug.
The highest cost drugs usually are found on tier three. Be sure
to ask your doctor about generic and lower-tier alternatives to
brand-name medications. The best alternative may not be a pre-scription medication at all, but an over-the-counter version. You
may be able to reduce your out-of-pocket prescription drug costs by consulting with your doctor to find a lower-cost medication
Remember that using mail order may help you save moneyalso. When you purchase more than a month’s worth of
medications and supplies by using the 90-day supply mail
order option, you can save on maintenance medication costs.
1 Kashihara, D. and Carper, K. National Health Care Expenses in the U.S. CommunityPopulation, 2002 Statistical Brief #61. December 2004. Agency for Healthcare Research
and Quality, Rockville, MD. http://www.meps.ahrq.gov/papers/st61/stat61.pdf
Trust Your GenericsIf you've ever wondered if generics are just as good as brands, rest assured they are. The standards set by the Food and DrugAdministration require that generic drugs be chemically identical to their brand-name counterparts and equal in safety,strength and effectiveness.
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Virginia, Inc.
Anthem Blue Cross and Blue Shield and its affiliated HMOs, HealthKeepers, Inc., Peninsula Health Care, Inc. and Priority Health Care, Inc., are independent licensees of the Blue Cross and Blue Shield Association.
® Registered marks Blue Cross and Blue Shield Association.
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Your Anthem prescription drug plan is a plan you can count on. The three-tier design covers nearly any prescription medica-
tion available on the market today. Typically, first Tier prescriptions are low-cost or generic drugs and Tiers 2 and 3 are brand-name drugs. You can expect to pay the most for medications on Tier 3.