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In the US, where a system of quasi-private healthcare is in place, a formulary is a list of prescription drugs available to enrollees, and a tiered formulary provides financial incentives for patients to select lower-cost drugs. For example, under a 3-tier formulary, the first tier typically includes generic drugs with the lowest cost sharing ...
Tier 1 (lowest copayment): most generic prescription drugs. Tier 2 (medium copayment): preferred, brand-name prescription drugs. Tier 3 (higher copayment): non-preferred, brand-name prescription drugs
Plans will show you costs like premiums, deductibles, drug tier, and copays based on quantity (e.g., 30 days versus 90 days). Plan formulary information will include: the name of the medication ...
By 2011 in the United States a growing number of Medicare Part D health insurance plans—which normally include generic, preferred, and non-preferred tiers with an accompanying rate of cost-sharing or co-payment—had added an "additional tier for high-cost drugs which is referred to as a specialty tier".
The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse of the drug or other substances may lead to severe psychological or physical dependence. The complete list of Schedule II substances is as follows.
The spokesperson said the methodology used to determine drug tiers is the same regardless of the condition. This practice is not unique to Blue Cross Blue Shield NC.
The drug or other substance has a potential for abuse less than the drugs or other substances in schedules I and II. The drug or other substance has a currently [2] accepted medical use in treatment in the United States. Abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence.
Branded drugs may have marketing budgets that meet or exceed the cost of research and development. [116] Generic drug manufacturers determine price based on what the name-brand equivalent is sold for. If multiple generic drug companies manufacture the same drug, price is often driven down towards production costs.
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