List of
Covered Drugs – Updated
January 21, 2008
Are You
Missing Your Chance To Save Money On Prescription Drugs?
>>>>>Prescription
Drugs as low as $3.75 for 30 tablets/capsules <<<<<
(Order
360 or more to get the best price)
Download and Print the
Enrollment Order Form here and fax or mail in with your prescription and
payment.
or call the helpdesk at 1-573-996-7894 to have one faxed or mailed to you.
(Scroll down
to see if your drug/strength is covered on list A, B, C, D, E, F or G)
TIP: Best cheapest program priced quantity to order is 360
tablets/capsules.
Medicines on PROGRAM LIST A would
end up costing $3.75 for 30 tablets/capsules + $5 shipping per order (not per
drug).
TIP 2: Pill
splitting could be a big cost-saver for Patients – Double the dose then cut
in half to cut your cost in half. Ask the doctor to prescribe a double
dose (for example, 100 mg tablets instead of 50 mg ones), then cut the pills in
half. Different doses of the same drug usually cost the same. So by splitting
the pills, consumers can effectively “buy one – get one free”. Most tablets
that have scores in them can easily be split, but not all medication is safe to
slice. Check with a doctor or pharmacist first.
This Patient
Assistance Program features TOP brand name
equivalent generic prescription drugs. Program is open to people of all ages nationwide and enrollment is free, whether you have
insurance or not. In some cases this program will be less expensive than your
prescription drug co-pay. Your cost depends on which program cost list
A, B, C, D, E, F, G, DS your medicine/strength is covered on, quantity ordered,
and a small shipping charge of $5 for each package (not per drug) shipped to
your home, office or trusted friend or family member.
This program was designed to help patients maximize their dollars spent on
prescriptions. Drugs on this list will be added or removed periodically as Drug
Manufacturer prices change. Only the EXACT DRUG STRENGTH on the list is
covered on this program. This list will be kept current with both NEW and
Deleted products. Please check it frequently for new additions. To download a
free Generic Medicine Program prescription assistance Order Enrollment Form,
click here. To access the Generic Medicine Program
Patient Assistance Program helpdesk by phone, you can call: 1-573-996-7894.
|
The program was developed
to maximize your dollars spent. Your cost depends on the number of pills you
buy, not on a monthly supply. |
|
|
Number
of |
Your
Cost |
|
90 |
$15.00 (*Equals $5
for 30 tabs) |
|
180 |
$25.00 |
|
270 |
$35.00 |
|
360 |
$45.00 = $45.00 =$3.75 for 30 tabs/caps |
The GENERIC
drugs listed here qualify for these prices:
|
Program minimum order requirement is 90
tablets/capsules to maximize savings for you.
|
|
How to Find
Your Medicine/Strength and Program Cost:
The covered medication list below is sorted alphabetically by generic drug
name and color coded. Check the list below to see if you find your
medication/strength. Then check to see what program it is covered on, and
then the cost/quantity. Example: For the medication “LOTENSIN”©, search for the generic name which is “BENAZEPRIL 10MG TAB”; it is covered on Program List A. If your medicine/strength is
on List A and you buy 360 tablets (Best Value) it would end up costing you $3.75
for 30 tablets/capsules. {Program List A color coded purple,
Program List B, Program List C, Program List D, Program List E, Program List
F, Program List G, and so on. |
||
|
For
Drug Covered On: |
Color
Code |
|
|
Program List A |
|
List
A equals $5 per month (30 qty) or LESS
depending on the quantity you order. |
|
Program List B |
|
List
B equals $7 per month (30 qty) or LESS
depending on the quantity you order. |
|
Program List C |
|
List C equals $9 per month (30 qty) or LESS depending on the quantity you order. |
|
Program List D |
|
List
D equals $12 per month (30 qty) or LESS
depending on the quantity you order. |
|
Program List E |
|
List E equals $14 per month (30 qty) or LESS depending on the quantity you order. |
|
Program List F |
|
List F equals $17 per month (30 qty) or LESS depending on the quantity you order. |
|
Program List G |
|
List G equals $19 per month (30 qty) or LESS depending on the quantity you order. |
|
Program List |
|
Program List USA GLOBAL = Click
Here to Download Order Form For any Medicine on USA GLOBAL List and call
1.573.996.3333 for a free current price quote |
TIP: To easily search for your medicine
use the shortcut keys and Press CTRL+F
(Press the CTRL “control key” and F key together, a little search window will
pop up
and you can type the name of your medicine and then click Find Next – it will
highlight
the closest text match you typed.)
|
Program List |
Generic Drug Name Available Only (sorted Alphabetically) |
BRAND NAME EQUIVALENT |
Minimum Order |
Best Value Order 360 Qty |
|
A |
ABC
PLUS LUTEIN/LYCOPINE TAB |
CENTRUM |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
Alternative |
Accupril
(Quinapril) Other cheaper alternatives…enalapril, lisinopril, benazepril,
captopril consult with your doctor. Remember, you will need a NEW
prescription for a covered alternative with a quantity of 90, 180, 270 or 360
faxed or mailed in with your order. |
|||
|
C |
ACEBUTOLOL
200MG CAP |
SECTRAL |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
ACEBUTOLOL
400MG CAP |
SECTRAL |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
|
A |
ACETAMINOPHIN
325MG TAB |
TYLENOL |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
D |
ACETAZOLAMIDE
250MG TAB |
DIAMOX |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
|
Actigall
Capsules |
Please
call 1-573-996-3333 for a free price quote |
||
|
A |
ACYCLOVIR
200MG CAP |
ZOVIRAX |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
ACYCLOVIR
400MG CAP |
ZOVIRAX |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
C |
ACYCLOVIR
800MG TAB |
ZOVIRAX |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
|
Adipex
P |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
B |
ADV
FORM PRENATAL Z TAB UD |
ZENATE |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
CARVEDILOL
3.125MG |
COREG |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
CARVEDILOL
6.25MG |
COREG |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
CARVEDILOL
12.5MG |
COREG |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
CARVEDILOL
25MG |
COREG |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
ALBUTEROL
INHALER |
PROVENTIL |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
ALBUTEROL
SULF 2MG TAB |
VENTOLIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
ALBUTEROL
SULF 4MG TAB |
VENTOLIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
|
Alesse |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
|
NIFEDIPINE
ER 90MG |
PROCARDIA XL |
$190 / 90 |
|
|
A |
ALLOPURINOL
100MG TAB |
ZYLOPRIM |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
ALLOPURINOL
300MG TAB |
ZYLOPRIM |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
ALOE
VERA 470MG CAPS |
ALOE
VERA |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
D |
AMANTADINE
100MG CAP |
SYMMETREL |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
|
Ambien
|
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
|
Ambien
CR |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
A |
AMIBID
DM 600/30MG TAB |
HUMIBID |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
AMIDRINE
CAP |
MIDRIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
E |
AMILORIDE
5MG TAB |
MIDAMOR |
$42 / 90 |
$141.00/360 =($11.75/30) |
|
A |
AMILORIDE
HCTZ 5/50 TAB |
MODURETI |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
10MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
ISOSOBIDE
DINTRATE 20MG |
ISORDIL |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
100MG TAB |
PHYLLOCONTIN,
TRUPHYLLINE |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
100MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
AMITRIPTYLINE
150MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
AMITRIPTYLINE
200MG TAB |
PHYLLOCONTIN,
TRUPHYLLINE |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
200MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
25MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
50MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
AMITRIPTYLINE
75MG TAB |
ELAVIL,
ENDEP, VANATRIP |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
F |
AMOXAPINE
50MG TAB |
ASENDIN |
$51 / 90 |
$177.00/360 =($14.25/30) |
|
B |
AMOXICILLIN
125MG CHEW TAB |
AMOXICOT,
AMOXIL |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
E |
AMOXICILLIN
200MG CHEW TAB |
AMOXICOT,
AMOXIL |
$42 / 90 |
$141.00/360 =($11.75/30) |
|
A |
AMOXICILLIN
250MG CAP |
AMOXICOT,
AMOXIL |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
E |
AMOXICILLIN
400MG CHEW TAB |
AMOXICOT,
AMOXIL |
$42 / 90 |
$141.00/360 =($11.75/30) |
|
A |
AMOXICILLIN
500MG CAP |
AMOXICOT,
AMOXIL |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
G |
AMOXICILLIN
875MG TAB |
AMOXICOT,
AMOXIL |
$57 / 90 |
$189.00/360 =($15.75/30) |
|
B |
AMOXIL
500MG CAP |
AMOXICOT,
AMOXIL |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
AMPICILLIN
250MG CAP |
POLYCILL |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
C |
AMPICILLIN
500MG CAP |
POLYCILL |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
D |
ANAGRELIDE
0.5MG CAP *PAY ATTN TO SCRIPT* |
AGRYLIN PAY ATTN TO 3MTS SUPPLY |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
D |
ANAGRELIDE
1MG CAP *PAY ATTN TO SCRIPT* |
AGRYLIN PAY ATTN TO 3MTS SUPPLY |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
D |
HYDROXYCHLOROQUINE 200MG TAB |
PLAQUENIL |
$36 / 90 |
$121.00/360 =($10.00/30) |
|
D |
ANEMAGEN
|
CHROMAGE |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
|
Antabuse |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
A |
APAP
500MG CAPLET |
TYLENOL |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
|
Apri |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
D |
ARMOUR
THYROID 120MG |
THYROID
TABLET |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
A |
ASPIRIN 325MG TAB |
BAYER |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
ASPIRIN
EC 325MG TAB |
BAYER |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
ASPIRIN
W COD 30MG TAB #3 (EMPRIN) |
controlled substance-only MI-IL-WI-IN-OH |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
ASPIRIN
W COD 60MG TAB #4 (EMPRIN) |
controlled substance-only MI-IL-WI-IN-OH |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
|
Astelin |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
A |
ASTRAGALUS
470MG CAPS |
ASTRAGALUS
|
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
ATENOLOL
100MG TAB |
TENORMIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
ZOLPIDEM
10MG TAB |
AMBIEN |
$21 / 90 |
$66.00/360 =(5.49/30) |
|
A |
ATENOLOL
25MG TAB |
TEMORMIN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
ATENOLOL
50MG TAB |
TEMORMIN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
ATENOLOL/CHLOR
100MG/25MG TAB |
TENORETIC |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
ATENOLOL/CHLOR
50MG/25MG TAB |
TENORETIC |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
|
Ativan
Tablets |
Click Here to Download Order Form |
Please
call 1-573-996-3333 for a free price quote |
|
|
D |
AMLODIPINE
10MG TAB |
NORVASC |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
D |
AMLODIPINE 5MG TAB |
NORVASC |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
Alternative |
Atorvastatin
Calcium (LIPITOR) Another cheaper alternative is Lovastatin 10mg which costs
$12.00/30 consult with your doctor. Remember, you will need a NEW prescription
for a covered alternative with a quantity of 90, 180, 270 or 360 faxed or
mailed in with your order. |
|||
|
D |
AZATHIOPRINE
50MG TAB |
IMURAN |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
C |
BACLOFEN
10MG TAB |
LIORESAL |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
E |
BACLOFEN
20MG TAB |
LIORESAL |
$42 / 90 |
$141.00/360 =($11.75/30) |
|
A |
BELLADONNA
ALKA/PB TAB |
DONNATAL |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
BENAZEPRIL
10MG TAB |
LOTENSIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
BENAZEPRIL
20MG TAB |
LOTENSIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
BENAZEPRIL
40MG TAB |
LOTENSIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
BENAZEPRIL
5MG TAB |
LOTENSIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
D |
BENAZEPRIL
HCT 20/12.5 TABLETS |
LOTENSIN
HCT |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
D |
BENAZEPRIL
HCT 20/25 TABLETS |
LOTENSIN
HCT |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
D |
BENAZEPRIL
HCT 5/6.25MG TABLETS |
LOTENSIN
HCT |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
D |
BENZONATATE
100MG CAP |
TESSALON |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
A |
BENZTROPINE
0.5MG TAB |
COGENTIN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
BENZTROPINE
1MG TAB |
COGENTIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
BENZTROPINE
2MG TAB |
COGENTIN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
E |
BETHANECHOL
10MG TAB |
DUVOID,
URECHOLINE |
$42 / 90 |
$141.00/360 =($11.75/30) |
|
D |
BETHANECHOL
5MG TAB |
DUVOID,
URECHOLINE |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
A |
BILBERRY
EXT 40MG CAP |
BILBERRY
EXT |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
BIOTIN
300MCG TAB |
BIOTIN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
BISOPROLOL/HCTZ
10/6.25 TAB |
ZIAC |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
BISOPROLOL/HCTZ
5/6.25 TAB |
ZIAC |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
H |
DESIPRAMINE
HCL 100MG TAB |
NORPRAMIN |
$69/90 |
|
|
G |
PROPRANOLOL
*ER 60MG TAB |
INDERAL
LA |
$87/90 |
|
|
|
METOPROLOL
SUCCINATE 100MG TAB |
TOPROL
XL |
$94 / 90 |
$189.00/360 =($15.75/30) |
|
G |
METOPROLOL
SUCCINATE 50MG TAB |
TOPROL
XL |
$57 / 90 |
$189.00/360 =($15.75/30) |
|
H |
PILOCARPINE
HCL 5MG TAB |
|
$69/90 |
|
|
H |
METOPROLOL
SUCCINATE 25MG TAB |
TOPROL
XL |
$69 / 90 |
|
|
H |
BROMFED
10/3/30 240ML |
|
$15 / 8oz |
|
|
D |
BROMPHENIRAMINE
AND PSEDOEPHEDRINE 12/120MG |
BROMFED
CAP |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
B |
BUMETANIDE
0.5MG TAB |
BUMEX |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
BUMETANIDE
1MG TAB |
BUMEX |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
C |
BUMETANIDE
2MG TAB |
BUMEX |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
C |
BENAZEPRIL
HCT 10/12.5 |
LOTENSIN
HCT |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
C |
BUPROPION
100MG TAB |
WELLBUTRIN |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
C |
BUPROPION
75MG TAB |
WELLBUTRIN |
$27 / 90 |
$87.00/360 =($7.25/30) |
|
A |
BUSPIRONE
10MG TAB |
BUSPAR |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
D |
BUSPIRONE
15MG TAB |
BUSPAR |
$36 / 90 |
$120.00/360 =($10.00/30) |
|
A |
BUSPIRONE
5MG TAB |
BUSPAR |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
BUTALBITAL/APAP
50/325/40 TAB |
FIORICET |
$21 / 90 |
$87.00/360 =($7.25/30) |
|
F |
BUTALBITAL/APAP/CAFFEINE
50/325/40 CAP |
ESGIC,
FIORICET |
$51 / 90 |
$177.00/360 =($14.25/30) |
|
F |
THEOPHYLLINE
ER 200MG CAP |
THEO-DUR |
$51 / 90 |
$177.00/300 =($14.25/30) |
|
B |
BUTALBITAL/APAP/CAFFEINE
50/500/40 TAB |
ESGICPLUS |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
|
TYLENOL
4 |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
BUTALBITAL/ASP/CAFFEINE
50MG CAP CONTROLLED |
FIORINAL |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
CALCARB
600 W/D 200MG TAB |
CALTRATE |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
CALCIUM
& MAGNESIUM TAB |
CALCIUM
& MAGNESUIM |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
CALCIUM
(CALCIUM 600 W/VIT D&SOY) |
CALCIUM
W/VIT D&SOY |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
B |
CALCIUM
(CORAL CALCIUM 1000MG CAP) |
CORAL
CALCIUM |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
CALCIUM
600 TABS |
CALTRATE |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
CALCIUM
600+D TABS |
CALTRATE |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
G |
CALCIUM
ACETATE (PHOSLO 667 MG GELCAPS) |
PHOSLO
GELCAPS |
$57 / 90 |
$189.00/360 =($15.75/30) |
|
B |
CALCIUM
CARB 1250MG TAB |
MAALOX |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
CALCIUM
CONC 600MG TAB |
CALCIUM
CONC |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
CALCIUM
MAGNESIUM ZINC TAB |
CALCIUM
MAGNESIUM ZINC |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
CAPTOPRIL
100MG TAB |
CAPOTEN |
$21 / 90 |
$66.00/360 =($5.49/30) |
|
A |
CAPTOPRIL
12.5MG TAB |
CAPOTEN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
CAPTOPRIL
25MG TAB |
CAPOTEN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
A |
CAPTOPRIL
50MG TAB |
CAPOTEN |
$15 / 90 |
$45.00/360 =($3.75/30) |
|
B |
CAPTOPRIL/HCTZ
25/15MG TAB |
CAPOZIDE |
$21 / 90 |
$66.00/360 =($5.49/30) |