Formulary tier
The vocabulary of getting a claim paid, of FDA enforcement, and of what on-label and off-label really mean.
Definition
Where a drug sits in a plan's cost-sharing ladder. Tier 1 generic, Tier 2 preferred brand, Tier 3 non-preferred brand, Tier 4 specialty. Wegovy and Zepbound usually land in Tier 3 or 4 on commercial plans, so copays of $100–$500 a month are normal even AFTER approval, and some plans exclude them outright. No generic exists — semaglutide's US patent runs to 2032.
GLP Watchdog writes these definitions from FDA labels and peer-reviewed PubMed literature. Not one of them is an AI-generated summary.
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