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Select Preventive Prescription Drugs – Jan. 1, 2018

In addition to a healthy lifestyle, preventive can help you avoid some illnesses and conditions. Zimmer Biomet's medical options – Value HSA, Premium HSA and HRA – include preventive medications at no cost to participants enrolled in a medical option to support the goal of ongoing good health.

This list provides examples of commonly prescribed preventive medications. The medications are categorized based on the medical conditions that they are used to prevent. Select preventive prescription drugs shown in all capital letters are brand name drugs. All others are generic drugs.

This list is periodically reviewed and updated to ensure that the drugs listed meet the criteria for inclusion.

Anticoagulants/Antiplatelets (blood thinners) /dipyridamole Bivalirudin Clopidogrel Enoxaparin sodium Fondiparinux Heparin sodium (in vials) JANTOVEN Prasugrel Warfarin sodium

Antiemetics (for the prevention of and vomiting)* Aprepitant COMPRO Dimenhydrinate Granisetron Ondansetron Palonosetron PHENADOZ Prochlorperazine PROMETHEGAN Trimethobenzamide

Select preventive prescription drugs shown in all capital letters are brand-name drugs; all others are generic drugs. Last update: Sept. 29, 2017

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Antihypertensives – ACE Inhibitors (blood pressure lowering agents) with Benazepril Benazepril with Captopril Captopril with hydrochlorothiazide Enalapril Enalapril with hydrochlorothiazide Fosinopril Fosinopril wirh hydrochlorothiazide Lisinopril Lisinopril with hydrochlorothiazide Moexipril and Moexipril with hydrocholorothiazide Quinapril Quinapril with hydrochlorothiazide Ramipril Trandolapril Trandolapril/

Antimalarials (prevent malaria) Atovaquone/proguanil Chloroquine phosphate Hydroxychloroquine sulfate Mefloquin

Antiplatelets (prevent blood clots) Cilostazol Dipyridamole Eptifibatide Ticlopidine

Cholesterol-Lowering Agents, Atorvastatin and Atorvastatin/Amlodipine Fluvastatin Pravastatin Rosuvastatin

Contraceptives (prevent ) Medroxyprogesterone acetate All generic forms of birth control

Select preventive prescription drugs shown in all capital letters are brand-name drugs; all others are generic drugs. Last update: Sept. 29, 2017

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Osteoporosis Agents (prevent fractures) Alendronate ESSIAN EST Estradiol with Estrogen with Estropipate Ethinyl estradiol FORTICAL Ibandronate Pamidronate disodium Risedronate

Prenatal Vitamins (vitamins for pregnant women) All generic forms of prenatal vitamins

Prescription Vitamins All generic forms of children’s prescription vitamins with fluoride (consult your healthcare provider for strength)

Smoking Cessation Agents*

Vaccines All generic forms of vaccines

Weight Loss Agents** Diethlypropion Phendimetrazine Phentermine

Select preventive prescription drugs are those used to prevent certain health conditions, rather than to treat symptoms or conditions. For example, prenatal vitamins are considered preventive because they have been shown to be effective in preventing certain birth defects. However, Pepcid (Famotidine) is non-preventive because it treats the condition and symptoms of gastroesophageal reflux disease or GERD.

* There may be a limit on the quantity allowed per month or per year for certain drugs in this category. ** Prior authorization is required for these to drugs to be covered by the plan.

Antiestrogens (for prevention of recurrence of ) Anastrazole and SOLTAMOX

Select preventive prescription drugs shown in all capital letters are brand-name drugs; all others are generic drugs. Last update: Sept. 29, 2017

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Antihypertensives – Blockers (blood pressure lowering agents) Candesartan Candesartan-hydrochlorothiazide Irbesartan Irbesartan-hydrochlorothiazide Losartan Losartan-hydrochlorothiazide Olmesartan-hydrochlorothiazide Telmisartan-hydrochlorothiazide Valsartan-hydrochlorothiazide

Antihypertensives – Beta Blockers (blood pressure lowering agents) Acebutolol Atenolol Atenolol-chlorthalidone Bisoprolol with hydrochlorothiazide Labetalol Metoprolol Metoprolol with hydrochlorothiazide Nadolol Nadolol with bendroflumethiazide and Propranolol with hydrochlorothiazide Timolol Timolol with hydrochlorothiazide

Antihypertensives – Blockers (blood pressure lowering agents) Amlodipine, Amlodipine/benazeprilAmlodipine/valsartan, Amlodipine/telmisartan, Amlodipine/olmesartan and Amlodipine/olmesartan/hydrochlorothiazide Verapamil

Select preventive prescription drugs shown in all capital letters are brand-name drugs; all others are generic drugs. Last update: Sept. 29, 2017

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Antihypertensives – Miscellaneous (blood pressure lowering agents) Clonidine Clonidine-chlorthalidone Doxazosin Hydralazine Methyldopa Methyldopa-hydrochlorothiazide Prazosin Terazosin

Antihypertensives – Diuretics and related Diuretics (blood pressure lowering agents) Amiloride and Amiloride with hydrochlorothiazide Chlorothiazide Chlorthalidone Hydrochlorothiazide Inapamide Methylclothiazide Metolazone Spironolactone with hydrochlorothiazide Triamterene with hydrochlorothiazide

Cavities Chlorhexadine rinse Oralone paste Peridex liquid Periogard rinse Triamcinolone paste

Colonoscopy Preparation Gavilyte PEG-3350 and electrolytes solution Trilyte with flavor packets

Organ Transplant Medications Azathioprine Cyclosporine Gengraf Mycophenolate

Express Scripts, Inc. manages the benefit. All rights in the product names of all third-party products appearing here, whether or not appearing with the trademark symbol, belong exclusively to their respective owners.

Select preventive prescription drugs shown in all capital letters are brand-name drugs; all others are generic drugs. Last update: Sept. 29, 2017