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State Health Plan: Nexium 24HR Added to Over-the-Counter PPIs

 

The State Health Plan will add coverage of Nexium 24HR to its current coverage of OTC proton-pump inhibitors (PPIs) on June 1, 2014, as it becomes available as an over-the-counter (OTC) drug in May.  Members must obtain a prescription written for Nexium 24HR in order to receive the OTC product.  A generic version of Nexium (esomeprazole) is due later in 2014.  It will be a Tier 2 generic with a $40 copayment for a 30-day supply for the State Health Plans' Traditional 70/30 and Enhanced 80/20 plans.  Members in the consumer-directed health plan (CDHP)  will be responsible for their deductible and 15% coinsurance. This coverage does not apply to Medicare Advantage plans. 

 

If you would like your State Health Plan patients to try an OTC product for their heartburn symptoms, please follow these stepsMembers may contact Express Scripts directly at 1-800-336-5933, if they have questions.

 

For additional information, please visit the State Health Plan website at www.shpnc.org.