DaVinci Payer Data Exchange (PDex) US Drug Formulary
1.1.0 - STU 1.1

Publication Build: This will be filled in by the publication tooling

## ValueSet: Drug tier of medication in health plan

Summary

Defining URL: | http://hl7.org/fhir/us/davinci-drug-formulary/ValueSet/DrugTierVS
Version: | 1.1.0
Name: | DrugTierVS
Title: | Drug tier of medication in health plan
Status: | Active as of 2021-10-15T15:46:55+00:00
Definition: | The drug tier of a particular medication in a health plan. The base set are examples. Each plan may have its own controlled vocabulary.
Publisher: | HL7 Pharmacy Working Group
Source Resource: | XML / JSON / Turtle

References

- Drug Tier Definition
- Drug Tier ID

### Logical Definition (CLD)

- Include all codes defined in `http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS`

### Expansion

This value set contains 9 concepts

Expansion based on Codes for medication drug tiers in health plans v1.1.0 (CodeSystem)

All codes in this table are from the system `http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS`

Code | Display | Definition
generic | Generic | Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.
preferred-generic | Preferred Generic | Commonly prescribed generic drugs.
non-preferred-generic | Non-preferred Generic | Generic drugs that cost more than drugs in ‘generic’ tier.
specialty | Specialty | 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.
brand | Brand | Brand name drugs that cost more than ‘preferred brand’ drugs.
preferred-brand | Preferred Brand | Brand name drugs
non-preferred-brand | Non-preferred Brand | Brand name drugs that cost more than ‘brand’ drugs.
zero-cost-share-preventative | Zero cost-share preventative | Preventive medications and products available at no cost.
medical-service | Medical Service | 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
Source | 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