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You can make the most of your pharmacy benefit plan and control your prescription medication costs by using this Preferred Medication List. Be sure to share this list with your doctor to select cost-effective medications that are clinical y appropriate to treat your condition or maintain your health.
This Preferred Medication List (PML) was developed by • Therapeutic categories are listed alphabetically in all Walgreens Health Initiatives, your plan sponsor's pharmacy UPPERCASE letters in black boxes. Therapeutic classes in benefit manager, under the direction of a committee of each category are printed in gray boxes.
doctors and pharmacists. All medications on this list are • Types of medications in each class are printed in italics. • Generic medications are listed in lowercase letters below the word generic. Brand-name generic medications have the first Your pharmacy benefit plan offers three categories- • Preferred-brand medications are listed in UPPERCASE letters or tiers-of medications that determine your costs (copays): • Some medications treat more than one condition. Check 1st tier: Generics. Generics contain the same active ingredient
different categories for your medication.
as their brand-name equivalents and offer the same effective-ness and safety. Some generics use a brand name instead of a All medications on the PML have been approved by the FDA. chemical name. Both have the lowest copay.
2nd tier: Preferred. Medications in this tier have been selected
Not all medications are listed in this PML. Medication by your pharmacy benefit plan as preferred-brand medica- coverage and copays may vary from plan to plan. For more tions. They have higher copays than generics but are less information specific to your plan, register on MyWHI.com costly than nonpreferred medications on the third tier.
and click on Drug costs & coverage. You can also access the 3rd tier: Nonpreferred. Because a generic version or a
alphabetical version at the above web site.
second-tier alternative is available, nonpreferred medications Please note: The PML is subject to change without notice.
have higher copays and are not listed on the PML.
For assistance, please call the Walgreens Customer Care Whenever possible, have your doctor consult this guide for the lowest-cost brand-name and generic medications available for your therapy. Some tips to keep in mind when using this guide: Walgreens Health Initiatives 2009 Preferred Medication List
Medication Categories Guide
Effective April 1, 2009
ANTIASTHMATICS
Nitrofuran Derivatives
Platelet Inhibitors
Bronchial Dilators
Antimalarial Agents
Penicillins
Miscellaneous
Antiparasitic and
Antiprotozoal Agents
CANCER THERAPY
Quinolones
Bronchial Dilator and
Antivirals
CARDIOVASCULAR
Glucocorticoid
Combinations
Blood Pressure Agents
Sulfonamides
Corticosteroid Inhaled
Medications
Tetracyclines
Leukotriene Receptor
Cephalosporins
Antagonists
Tuberculosis Agents
Mast Cell Stabilizers
Miscellaneous
ANTI-INFECTIVES
BLOOD FORMATION
AND COAGULATION
Antifungal Agents
Anticoagulants
Macrolides
Generic medications-listed in all lowercase letters or beginning with an Uppercase letter-are on tier 1. Walgreens Health Initiatives 2009 Preferred Medication List
Medication Categories Guide
Effective April 1, 2009
Cholesterol Agents
Antidepressants
Heart Rhythm
Stabilizers
Antipsychotics
Miscellaneous
Attention Deficit
CENTRAL NERVOUS
Hyperactivity Disorder
SYSTEM AGENTS
Antianxiety Agents
(ADHD) Agents
Alzheimer Agents
Diuretics
Anticonvulsants
Analgesics
Bipolar Agents
Migraine Agents
Antiparkinsonism
Agents
Generic medications-listed in all lowercase letters or beginning with an Uppercase letter-are on tier 1. Walgreens Health Initiatives 2009 Preferred Medication List
Medication Categories Guide
Effective April 1, 2009
Sleep Aids
Miscellaneous
Anti-Inflammatory
Agents-Eye
Diarrhea Agents
EYE, EAR, NOSE AND
THROAT AGENTS
Allergy and
Gastric Acid Secretion
Antihistamine Agents-
Reducers and
Eye
Ulcer Therapy Agents
COUGH, COLD AND
ALLERGY AGENTS
Glaucoma Agents
Antiallergy-
Blood Sugar
Antihistamine Agents
Diagnostics
Allergy Agents-Nose
Cough and Cold Agents
Antibiotics-Ear
Intestinal Motility
Stimulants
Nose and Ear Topical
Blood Sugar Increasing
Agents
Agents
Laxatives
Antibiotics-Eye
Insulins
Miscellaneous
GASTROINTESTINAL
Nausea Agents
Antispasmodics
DIABETIC AGENTS
AND MONITORING
Antidiabetic Agents-
Chronic Inflammatory
Oral
Antihistamines-
Bowel Disorder Agents
Nose
Pancreatic Enzymes
Generic medications-listed in all lowercase letters or beginning with an Uppercase letter-are on tier 1. Walgreens Health Initiatives 2009 Preferred Medication List
Medication Categories Guide
Effective April 1, 2009
Progestins
Miscellaneous
Miscellaneous
Testosterone
Antipsoriatic Agents
SKIN AND MUCOUS
MEMBRANE AGENTS
Thyroid Hormones
Acne Agents-Oral
Antivirals
HIV AGENTS
Acne and Vitamin A
Corticosteroids
Estrogenic Agents
Agents-Topical
and Combinations
HORMONES
Antidiuretic and
Vasopressor Hormones
Miscellaneous
Contraceptives
IMMUNE SYSTEM
MUSCULOSKELETAL
Antibiotics
Arthritis Agents
Glucocorticoids
Antifungals
Gout Agents
Osteoporosis Agents
Muscle Relaxants
Antineoplastics and
Immunosuppressants
Generic medications-listed in all lowercase letters or beginning with an Uppercase letter-are on tier 1. Walgreens Health Initiatives 2009 Preferred Medication List
Medication Categories Guide
Effective April 1, 2009
Miscellaneous
Electrolyte
Antihemophilic Factors
Hepatitis Agents
Replacements
Anti-Inflammatory
Electrolyte Stabilizers
Agents and DMARDs
UROLOGIC AGENTS
Benign Prostatic
Hypertrophy Agents
Antiparkinsonism
MISCELLANEOUS
Agents
Antiallergic and
Anaphylaxis Agents
Antivirals
Multiple Sclerosis
Agents
Blood Cell Stimulators
Dry Mouth-
Sjogren's Syndrome
Agents
Osteoporosis Agents
Myasthenia Gravis
Proteinase Inhibitors
Enzymes
Agents
Psoriasis Agents
Pulmonary Arterial
Hypertension Agents
Urinary pH Modifiers
Fertility Agents
Miscellaneous
Urinary Tract
Anesthetics and
Analgesics
Growth Hormones
SPECIALTY
PHARMACY
CATEGORIES
VITAMINS, MINERALS
AND ELECTROLYTES
Heparin and Related
Agents (LMWH)
Antibiotics
Generic medications-listed in all lowercase letters or beginning with an Uppercase letter-are on tier 1. Drug names are the property of their respective owners.

Source: http://hcgaz.net/pdf/resources/PPOFormulary.pdf

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