DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.1.0 - STU2.1 United States of America flag

DaVinci Payer Data Exchange (PDex) US Drug Formulary, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pdex-formulary/ and changes regularly. See the Directory of published versions

ValueSet: Drug tier of medication in health plan

Official URL: http://hl7.org/fhir/us/davinci-drug-formulary/ValueSet/DrugTierVS Version: 2.1.0
Standards status: Trial-use Computable Name: DrugTierVS
Other Identifiers: OID:2.25.74595174031514506193398850787025340071.48.4

The drug tier of a particular medication in a health plan. The base set are examples. Each plan may have its own controlled vocabulary.

References

Logical Definition (CLD)

Generated Narrative: ValueSet DrugTierVS

 

Expansion

Generated Narrative: ValueSet

Expansion performed internally based on codesystem Codes for medication drug tiers in health plans v2.1.0 (CodeSystem)

This value set contains 11 concepts

CodeSystemDisplay (en-US)Definition
  generichttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Commonly prescribed generic drugs that cost more than drugs in the 'preferred generic' tier.

  preferredhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Commonly prescribed drugs that are preferred by the plan.

  non-preferredhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Commonly prescribed drugs that cost more than drugs in the 'preferred' tier.

  preferred-generichttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Commonly prescribed generic drugs.

  non-preferred-generichttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Generic drugs that cost more than drugs in ‘generic’ tier.

  specialtyhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary.

  brandhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Brand name drugs that cost more than ‘preferred brand’ drugs.

  preferred-brandhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Brand name drugs

  non-preferred-brandhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Brand name drugs that cost more than ‘brand’ drugs.

  zero-cost-share-preventativehttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Preventive medications and products available at no cost.

  medical-servicehttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code