Prilosec OTC™

Innovative coverage of over-the-counter Prilosec to provide savings

The cost of prescription proton pump inhibitors (PPIs) is enough to give anybody heartburn, but now there’s some relief in sight: RegenceRx will be offering prescription medication coverage of Prilosec OTC™ for the generic copay.

Members who suffer from erosive esophagitis, heartburn and ulcers will realize cost savings on the heartburn medication that The Regence Group spends the most on. This new coverage will save a significant amount on member copays and pharmacy claim costs.

Why would an over-the-counter medication be covered under the prescription-drug benefit?

Because it saves money for everyone while providing effective treatment. The member’s generic copay is less than both the Prilosec OTC™ retail price and the brand-name copays they’d pay for other similar prescription medications.

Members will benefit two ways:

• Members currently taking Prilosec®, Aciphex® or Nexium® are paying a brand-name copay. By choosing Prilosec OTC™, members will pay the less expensive generic copay.



• Members already paying a generic copay (for omeprazole) can also save. Prilosec OTC™ comes in package sizes of 14, 28 and 42, so members can receive up to a 42-day supply for the same copay they’d pay for a typical 34-day generic. That equates to an additional eight days of medication at no extra charge.

How it works

Prilosec OTC™ will be covered when a member receives a new written prescription from their physician for Prilosec OTC™ or when their physician gives the pharmacist a verbal authorization to dispense Prilosec OTC™. The member will need to fill the prescription at a pharmacy using their member card. (Benefits will be available only when the claim is processed electronically; benefits will not be available when the member submits a receipt.)

Cost comparison

Prilosec OTC™ will cost about $22 per month compared to other prescription PPIs, which cost between $86 and $123 per month. By choosing Prilosec OTC™, members will pay the lowest copay possible.

For more specific information regarding Prilosec OTC, please view our ConsumerRx review.