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Discount Pharmacy
Prescription Guide
For additional benefit information, please reference the small color book also
included in this package.
PARTIAL LIST OF PARTICIPATING PHARMACY CHAINS

ABCO Pharmacy

Fry’s Food & Drug
ACME Markets
Furrs Supermarkets
Pathmark Stores
Allen’s Drugtown
Genovese
PharmHouse
Giant Eagle
PriceCostco
Giant Foods
Grand Union
Quick Chek Food Stores
Green Drug Stores
Randall’s
Gresham Drug
Raley’s Drug Center
Harvest Drug
Rinderer’s Drug
Hi School Pharmacy
Hook’s-Super X
Sav-More Drug Stores
Brookshire
Horizon Pharmacies
Save Mart
Brookshire Brothers
Schnuck’s Market
Bruno’s
Joel N’ Jerry’s
Seaway Foods
Buehler’s Foods
Sedano’s
Buffalo Pharmacies
Kare Drugs
City Pharmacies
Kash-n-Karry
Shop N’ Save
Keltsch Brothers
Shoprite
Kerr Drugs
Smith’s Food/Drug
Kessel Pharmacies
Smitty’s
Dahl’s
Keystone Medicine
Snyder Drugs
King Kullen
Star Markets
Delchamps
King Soopers
Dierbergs
Kinney Drugs
Klingensmith’s
The Great A & P
Discount Drug Mart
The RX Place
Dominick’s Finer Foods
Lambda Apothecary
The Pharm
Downeast Pharmacies
Lehman Drugs
Thrifty Pharmacies
Drug Emporium
Longs Drug Stores
Thrifty White
Drug Mart
Lucky Pharmacy
Thriftway
Duane Reade
May’s Drug
Tom Thumb
Eagle Pharmacies
Medco Drug
United Drug
Medic Discount
USA Drugs
Edgehill
Fagen Pharmacies
Walgreens
Family Care Pharmacies
Weis Markets
Family Drug/Care Plus
Marills Drug
Winn Dixie
Fischer Pharmacies
Navarro Discount Drug
Fred’s
Nelson’s Drug Stores
Plus thousands of
Fred Meyer
No-Frills Pharmacy
independents nationwide
Tiered-Pricing Pharmacy Program Terms and Conditions

This Prescribing Guide includes most, but not all, therapeutic classes of prescription drugs and is subject
to change without notice. This list is reviewed each month by NBpharmacy. Doctors are encouraged to
review the Prescribing Guide and utilize it when prescribing medications so members will receive the
best drug at the most cost effective rate.
The Prescribing Guide is not intended to interfere with the physician’s independent medical judgment in
regard to the patient physician relationship. The final choice of the specific drug therapy for an
individual patient rests solely with the prescriber. This Prescribing Guide has been developed to assist
physicians with their prescribing decision and to maximize the member’s savings. As always, the
physician should thoroughly evaluate, select and direct the use of medicinal agents.
Dear Member:

Please review this Prescribing Guide with your physician at the time the prescription is written. The
Prescribing Guide is a summary of the most commonly prescribed medications and includes both brand
name and generic medications. (Your Rx benefit has no limitations and includes ALL drugs available
through a prescription.) The Prescribing Guide includes a price coding system. The price coding
system will provide you and your physician with a general idea of what your out-of-pocket expense will
be when you fill the prescription at one of our many participating pharmacy providers.
Dear Physician:

Please refer to the price coding system included in this Prescribing Guide when selecting a drug therapy
for your patient. There are no limitations as to the drug you can prescribe for the patient. This is a
prescription discount benefit and the member is responsible for 100% of our discounted cost at the time
the prescription is filled. The Prescribing Guide is not intended as a substitute for your professional
judgment; however, when you prescribe according to the coding system out-of-pocket expense may be
lowered for your patient. When applicable, generic prescribing offers the patient greater savings.
Out-of-Pocket Coding
Pharmacy discounts are not insurance and are not intended as a substitute for insurance.
Tiered-Pricing Pharmacy Program Benefit Summary
The Tiered-Pricing Pharmacy Program is designed to save our members money, as well as educate our
members on the various prescription drug options available to them. This Prescribing Guide segments
brand name and generic drugs into three price classifications making it easier for members to consult
with their physician to find the most effective medication at the lowest cost.
The three tiered pricing structure includes:
Tier I Preferred brand and generic drugs available for $10 or less for the scheduled
quantity and dose
Tier II Preferred brand and generic drugs available for $20 or less for the scheduled
quantity and dose
Tier III Preferred brand and generic drugs available for $40 or less for the scheduled
quantity or dose For maximum savings, members should bring this booklet with them to the physician’s office and ask their doctor to prescribe medication within the first two tiers when possible. Many times, members will be able to save money by switching to a generic equivalent. The NBpharmacy program includes all aspects of our member’s prescription needs, and is easy to use. Members simply present the identification card, along with the prescription(s), to the pharmacist at one of our participating pharmacy providers. Please do not call the pharmacy for price quotes. They cannot give a quote over the telephone. Please bring a check, cash or credit card to the pharmacy in order to pay the lower of the pharmacy’s usual & customary price (U&C) or our discounted price at the time of purchase. If members would like help locating a pharmacy on the NBpharmacy program, or have any questions about the NBpharmacy program they can call the toll-free number on the back of their card. If for some reason the pharmacy has a question regarding the NBpharmacy program, members can have them call the toll-free number on the back of the card and we will give them the information they need over the phone. Prices and drug tier position are subject to change without notice. Frequently Asked Questions
Q: Where can I use the Tiered-Pricing Pharmacy card? A: The Tiered-Pricing Pharmacy card is accepted at participating pharmacies throughout the United States. The network includes pharmacy chains such as: Medicine Shoppe, Rite Aid, Eckerd, Walgreens and more as well as thousands of independent pharmacies nationwide. Pharmacy locations can be obtained by contacting customer service toll-free at 1-800-800-7616. If a neighborhood pharmacy is not already participating in the network, please have them call 1-800-800-7616. We will send them information about how they can participate in the network so that you can take advantage of the savings at your pharmacy of choice. Q: What if my pharmacy doesn’t recognize the card? A: Pharmacies may not be familiar with every prescription program in which they participate. If the pharmacist does not recognize your Tiered-Pricing Pharmacy card or if you encounter a problem at the pharmacy DO NOT leave without having the pharmacy call the toll-free number printed on the back of the card. Q: How much will I pay for my prescriptions? A: Your booklet includes a listing of the most commonly prescribed medications for both brand and generic drugs. These medications have been broken into payment tiers of $10, $20 and $40 levels. In each category, you will pay the listed tier price or less, but you will never pay more than the price listed in each tier. For drugs not listed in one of the tiers, members pay our contracted discount price or the pharmacy’s usual and customary price (U&C), whichever is less. Q: What is my average discount on drugs not listed in one of the tiers? A: All members receive an average discount of approximately 16% on non-tiered brand name and generic drugs. There is not a guaranteed percentage savings on every prescription purchase. The price depends upon the pharmacy and the type and quantity of drugs purchased. Pharmacies, just like other retail stores, compete against each other and may have special prices on some products. When this happens, we cannot discount the pharmacy’s already low price, but a member will benefit from the pharmacy’s special pricing. THE MEMBER ALWAYS RECEIVES THE CONTRACT PRICE OR THE PHARMACY’S PRICE, WHICHEVER IS LESS. Q: What is a generic drug? A: Once a patent on a brand name drug expires, other drug companies may make a generic version of the drug with the approval of the Food and Drug Administration (FDA). The FDA’s standards for quality are the same for all manufacturers. This means the generic drug must contain the same active ingredients as the name brand whose patent has expired, and that it is as safe, potent and effective. Frequently Asked Questions (cont.)
Q: How can I keep my prescription drug costs down? A: The use of generic prescription drugs, whenever available, is the most cost effective. Discuss your prescription options with your doctor and ask whether a less expensive alternative would be as effective for your ailment or condition. Q: How will I know if there is a generic equivalent available? A: Simply ask your local pharmacist or call Customer Service to find out about generic equivalents for your prescription. Also, ask your doctor to prescribe generics whenever possible and appropriate. Q: What is the difference between brand and generic drugs? A: The brand name is the trade name under which the product is advertised and sold. Initially, brand drugs are protected by patents. The patents enable the developing manufacturer to recoup the research and development costs incurred in bringing the drug to market for a predetermined number of years. Once a patent expires, other companies may manufacture a generic equivalent, provided they follow stringent FDA regulations for safety. Generic drugs are drugs for which the patent has expired, allowing other manufacturers to produce and distribute the product under a generic name. Generics are essentially a chemical copy of their brand name equivalents. The color or shape may be different, but the active ingredients must be the same for both. The preferred drug list contains only FDA approved generic medications. Q: Will I save money on every brand drug prescription? A: NBPharmacy members are guaranteed to pay the lower of our contracted rate of the pharmacy’s U&C. In most cases, NBpharmacy’s contract rate will save members approximately 16% depending on the drug type (brand or generic) and which pharmacy location the member chooses to fill the prescription. Our participating pharmacy network is comprised of different types of pharmacies, including national chains and independent locations. Consequently, each pharmacy has different buying habits when it comes to purchasing their drug inventory and setting their U&C. Therefore, there may be instances, particularly for certain heavily marketed brand name drugs that a participating pharmacy sets their U&C lower than our contracted rate to attract more customers. In this instance the member will always pay the lowest price at the time of purchase. Q: How do I contact the mail service pharmacy? A: Members can order a 90-day supply of medication through our convenient mail order pharmacy service and have it delivered to their home. Our mail order provider processes and ships all completed within 48 hours. Prescription drug orders are shipped free of charge. An easy mail order form is provided in your fulfillment kit.
See listing of participating pharmacies near you in the back of the small color book included in
this kit or call 1-800-800-7616 for assistance in locating a provider.

Acidifying Agents
Adamantanes
Adrenals
Alpha-Adrenergic Blocking Agents
Aminoglycosides
Ammonia Detoxicants
Androgens
Angiotensin-Converting Enzyme Inhibitors
Antacids And Adsorbents
Anthelmintics
Antiallergic Agents
Antiarrhythmic Agents
Antibacterials (Eent)
Antibacterials (Skin & Mucous Membrane)
Anticoagulants
Antidepressants
Antidiarrhea Agents
Antiflatulents
Antihistamines (Gi Drugs)
Anti-Infectives (Skin & Mucous Membrane)
Anti-Inflammatory Agents (Eent)
Antimalarials
Antimanic Agents
Antimuscarinics/Antispasmodics
Antipruritics And Local Anesthetics
Antipsychotic Agents
Antithyroid Agents
Antitussives
Antivirals (Skin & Mucous Membrane)
Astringents
Barbiturates (Anticonvulsants)
Barbiturates (Anxiolytic, Sedative/Hyp)
Basic Lotions And Liniments
Basic Ointments And Protectants
Benzodiazepines (Anticonvulsants)
Benzodiazepines (Anxiolytic,Sedativ/Hyp)
Beta-Adrenergic Blocking Agents
Biguanides
Caloric Agents
Carbonic Anhydrase Inhibitors
Cardiotonic Agents
Cathartics And Laxatives
Cell Stimulants And Proliferants
Central Alpha-Agonists
Contraceptives
Contraceptives (E.G. Foams, Devices)
Diabetes Mellitus
Digestants
Dihydropyridines
Direct Vasodilators
Disinfectants (For Non-Dermatologic Use)
Diuretics
Estrogen Agonist-Antagonists
Estrogens
Expectorants
Fibric Acid Derivatives
Genitourinary Smooth Muscle Relaxants
Hemorrheologic Agents
Hydantoins
Iron Preparations
Keratolytic Agents
Keratoplastic Agents
Local Anesthetics (Eent)
Local Anesthetics (Parenteral)
Macrolides
Mineralocorticoid (Aldosterone) Antagnts
Misc. Anxiolytics, Sedatives & Hypnotics
Misc. Central Nervous System Agents
Miscellaneous Analgesics And Antipyretic
Miscellaneous Antibacterials
Miscellaneous Antifungals
Miscellaneous Anti-Infectives (Eent)
Miscellaneous Antilipemic Agents
Miscellaneous Antimycobacterials
Miscellaneous Antiprotozoals
Miscellaneous Eent Drugs
Miscellaneous Local Anti-Infectives
Miscellaneous Vasodilating Agents
Multivitamin Preparations
Mydriatics
Nitrates And Nitrites
Nonsteroidal Anti-Inflammatory Agents
Nucleosides And Nucleotides
Opiate Agonists
Opiate Partial Agonists
Oxytocics
Parasympathomimetic (Cholinergic Agents)
Peripheral Adrenergic Inhibitors
Pharmaceutical Aids
Pituitary
Potassium Sparing Diuretics
Protectants
Quinolones
Replacement Preparations
Respiratory Smooth Muscle Relaxants
Scabicides And Pediculicides
Skeletal Muscle Relaxants
Sulfonamides (Systemic)
Sympatholytic Adrenergic Blocking Agents
Sympathomimetic (Adrenergic) Agents
Thiazolidinediones
Uricosuric Agents
Urinary Anti-Infectives
Vasoconstrictors
Vitamin B Complex
Vitamin C
Vitamin D
Vitamin E
Vitamin K Activity

Source: http://www.employersresource.com/Forms/Benefits/1_Medical/3_Framework/Framework_Discount_Pharmacy_Prescription_Guide.pdf

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