Prime Therapeutics: Processing Update for Generic Nexium® for Covered Persons of Florida Blue

Author: Angie Shirley/Monday, March 30, 2015/Categories: APCI Choice

In February 2015, generic Nexium® (Esomeprazole) became available in limited supplies to pharmacies. Currently it has been estimated that production of Esomeprazole will supply less than 25% of the need over the next several months until production increases. Due to the limited supply of Esopmeprazole in the market place, both generic Esomeprazole and the brand Nexium® will be covered by Florida Blue at the same tier.*

Action Required: If Participating Pharmacies receive a prescription for generic Esomeprazole and generic Esomeprazole is not in stock, please dispense brand Nexium and submit the claim as such. Covered Person cost shares will be reduced to the generic cost share, given the limited availability of this product during this time of shortage. If a Dispense as Written (DAW) code is needed, please follow your pharmacy procedure when the drug is not in stock. Prime suggests using DAW code 4 “Generic Drug Not in Stock”.

*Coverage of Nexium® is dependent on the Covered Person’s benefit plan

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