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Preferred Medication List–Alphabetical Guide

Effective January 1, 2020

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 clinically appropriate to treat your condition or maintain your health.

This Preferred Medication List (PML) was developed by Cougar Scripts, your plan sponsor’s pharmacy benefit manager, under the direction of a committee of doctors and pharmacists. All medications on this list are preferred by your plan.

Understanding Your Tiered Copays

Your pharmacy benefit plan has three tiers of medications that determine your costs (copays):

1st tier: Generics

Generics contain the same active ingredient as their brand-name equivalents and offer the same effectiveness and safety. Some generics use a brand name instead of a chemical name. Both have the lowest copay. Medications in this tier have a copay of $10 for a 30-day supply.

2nd tier: Preferred

Medications in this tier have been selected by your pharmacy benefits plan as preferred-brand medications. They have higher copays than generics but are less costly than nonpreferred medications on the third tier. Medications in this tier have a copay of $45 for a 30-day supply.

3rd tier: Nonpreferred

Because a generic version or a second-tier alternative is available, nonpreferred medications have higher copays and are not listed on the Preferred Medication List (PML). Medications in this tier have a copay of $100 for a 30-day supply.

Have your doctor consult this guide for the lowest-cost brand-name and generic medications available for your therapy. The generic and preferred medications here are listed alphabetically. Preferred-brand medications appear in UPPERCASE letters; generic medications appear in lowercase letters or with the first letter Uppercase. Some medications treat more than one condition. Check different categories for your medication.

All medications on the Preferred Medication List (PML) have been approved by the FDA.

Additional Information

Not all medications are listed in this Preferred Medication List (PML). Medication coverage and copays may vary from plan to plan. For more information specific to your plan, register on MyCougarScripts.com and click on Drug Costs and Coverage. For assistance, please call the Cougar Scripts Customer Care Center toll-free at 1-800-123-4567.

Please note

The Preferred Medication List (PML) is subject to change without notice.

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ACANYA

Acarbose

ACCU-CHEK LANCETS: FASTCLIX, MULTICLIX, SOFT TOUCH, SOFTCLIX

Acetaminophen/codeine

Acyclovir

Adapalene

ADCIRCA

ADVAIR DISKUS

Albuterol syrup, neb

Alendronate sodium

Aliskiren

Allopurinol

Alogliptin

ALPHAGAN P 0.1%

Alprazolam

ALREX

Ambrisentan

Amiodarone

AMITIZA

Amitriptyline

Amlodipine

...

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