ALLERGY-CONGESTION RLF 12H TAB

1What is this price?

The price shown is NADAC (National Average Drug Acquisition Cost) — what pharmacies across the US actually pay their suppliers for this drug, surveyed weekly by CMS/Medicaid. Think of it as the wholesale floor price. Your out-of-pocket cost at the pharmacy will be higher, since pharmacies add a dispensing fee (typically $3–$12) and a markup to cover their overhead.

2Why can't we show what your insurance pays?

Unlike hospital prices — which are now legally required to be published — drug prices negotiated between insurers and pharmacies are trade secrets. Pharmacy Benefit Managers (PBMs) like CVS Caremark, Express Scripts, and OptumRx negotiate confidential rates on behalf of insurers. What your plan pays, and what your copay will be, depends on:

• Which PBM manages your plan's drug benefit
• What tier this drug is on your plan's formulary (Tier 1–5)
• Whether you've met your deductible yet
• Whether your plan uses copays (flat fee) or coinsurance (percentage)
• Whether the drug requires prior authorization

To find your specific cost: check your plan's drug formulary online, call the number on your insurance card, or ask your pharmacist to run it through your insurance before you pick up.

3How to use this information