Pharmacy Table

Small Group Standard Plans – benefits for cardiovascular drugs

Benefits for cardiovascular drugs provided under the outpatient prescription drug benefit

Certain generic drugs related to prevention and treatment of cardiovascular disease will be available for $0 cost-sharing, if covered on the health plan:

Condition	Medication Classes/Groups at Zero Cost-Sharing	$0 Cost Share Medications
Hypercholesterolemia	Cholesterol absorption inhibitors	ezetimibe tablets
Hypercholesterolemia	Statins	atorvastatin calcium tablets fluvastatin sodium capsules fluvastatin sodium ER tablets lovastatin tablets pitavastatin calcium tablets pravastatin sodium tablets rosuvastatin calcium tablets simvastatin tablets
Hypertension	Angiotensin-converting enzyme (ACE) inhibitors	benazepril hcl tablets captopril tablets enalapril maleate oral solution and tablets fosinopril sodium tablets lisinopril tablets moexipril hcl tablets perindopril erbumine tablets quinapril hcl tablets ramipril capsules trandolapril tablets
	Angiotensin receptor blockers	candesartan cilexetil tablets irbesartan tablets losartan potassium tablets olmesartan medoxomil tablets telmisartan tablets valsartan tablets
	Beta blockers	acebutolol hcl capsules atenolol tablets betaxolol hcl tablets bisoprolol fumarate tablets carvedilol phosphate ER capsules carvedilol tablets labetalol hcl tablets metoprolol succinate ER tablets metoprolol tartrate tablets nadolol tablets nebivolol hcl tablets pindolol tablets propranolol hcl ER capsules propranolol hcl oral solution and tablets sotalol hcl tablets timolol maleate tablets
	Calcium channel blockers	amlodipine besylate tablets cartia XT capsules diltiazem hcl ER capsules diltiazem hcl ER tablets diltiazem hcr tablets dilt-XR capsules felodipine ER tablets isradipine capsules matzim LA tablets nicardipine hcl capsules nifedipine capsules nifedipine ER tablets nimodipine capsules nisoldipine ER tablets taztia XT capsules tiadylt capsules verapamil hcl ER tablets verapamil hcl tablets
	Thiazide diuretics	chlorthalidone tablets hydrochlorothiazide tablets and capsules indapamide tablets metolazone tablets
Post-event care	Anticoagulants	dabigatran etexilate mesylate capsules jantoven tablets warfarin sodium tablets
	Aspirin (NSAIDs)	aspirin 81mg
	Beta blockers	acebutolol hcl capsules atenolol tablets betaxolol hcl tablets bisoprolol fumarate tablets carvedilol phosphate ER capsules carvedilol tablets labetalol hcl tablets metoprolol succinate ER tablets metoprolol tartrate tablets nadolol tablets nebivolol hcl tablets pindolol tablets propranolol hcl ER capsules propranolol hcl oral solution and tablets sotalol hcl tablets timolol maleate tablets
	Platelet inhibitors (Plavix)	clopidogrel bisulfate tablets
Tobacco use	Antidepressants (only Bupropion)	bupropion SR tablet
	Nicotine receptor partial agonist (Varenicline)	varenicline tartrate tablets
	Nicotine replacement therapies	nicotine gum, patch and lozenge