NEXIUM formulary database
The NEXIUM formulary database is a simple-to-use tool that allows you to
determine NEXIUM coverage for health plans specific to your area. Simply select
your state and up to two health plans. Your results will show available
coverage and any restrictions that may apply.
This information is provided for general informational purposes only and is
current as of June 2007. Individual plans may vary and all information is
subject to change. For the most current formulary information, contact your
patient's drug benefit provider.
The following definitions are generally applicable, though they may vary by
plan. Please contact your patient's plan for specific information regarding
his or her tier structure.
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Tier 1 (Generic)
This drug is available at the lowest co-pay. Most commonly, these are generic
drugs.
Tier 2 (Preferred)
This drug is available at a co-pay that is higher than the co-pay for Tier 1
drugs, but lower than the co-pay for other Tiers. Most commonly, these are
brand drugs that have a formulary status of "preferred."
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Tier 3 or higher (Non-preferred)
This drug is available at a higher level co-pay than Tier 1 or Tier 2 drugs.
Most commonly, these are "non-preferred" brand drugs and are sometimes off of
formulary.
Tiers 4, 5 and 6
Some plans have these tier levels. Drugs on these tiers are generally
"non-preferred" and/or off of formulary. They also generally have higher
co-pays than drugs that are on Tiers 1 or 2.
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QL (Quantity Limits)
Drugs that require prior authorization. Typically, additional information must
be provided to the health plan in order for these drugs to be covered.
PA (Prior Authorization)
This drug is available at a co-pay that is higher than the co-pay for Tier 1
drugs, but lower than the co-pay for other Tiers. Most commonly, these are
brand drugs that have a formulary status of "preferred."
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NC (Not covered)
Drugs that are not covered by the plan.
PPD (Patient pays the difference)
The plan requires that the patient pay the difference in cost between the brand
product and the generic product.
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