DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.1.0 - STU2.1 US

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)

 

Expansion

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

This value set contains 11 concepts

SystemCodeDisplay (en)DefinitionJSONXML
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  genericGenericCommonly prescribed generic drugs that cost more than drugs in the 'preferred generic' tier.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  preferredPreferredCommonly prescribed drugs that are preferred by the plan.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  non-preferredNon-preferredCommonly prescribed drugs that cost more than drugs in the 'preferred' tier.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  preferred-genericPreferred GenericCommonly prescribed generic drugs.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  non-preferred-genericNon-preferred GenericGeneric drugs that cost more than drugs in ‘generic’ tier.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  specialtySpecialtyDrugs 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.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  brandBrandBrand name drugs that cost more than ‘preferred brand’ drugs.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  preferred-brandPreferred BrandBrand name drugs
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  non-preferred-brandNon-preferred BrandBrand name drugs that cost more than ‘brand’ drugs.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  zero-cost-share-preventativeZero cost-share preventativePreventive medications and products available at no cost.
http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE  medical-serviceMedical ServiceDrugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.

Description of the above table(s).