Proton Pump Inhibitors - Nexium® for suspension (esomeprazole), Prevacid® SoluTab™ (lansoprazole), Zegerid® for suspension (omeprazole and sodium bicarbonate) - Step Therapy - UnitedHealthcare Commerc
UnitedHealthcare step therapy program that requires trial of specified lower-cost PPIs before coverage of Nexium suspension (esomeprazole), Prevacid SoluTab (lansoprazole ODT) and Zegerid suspension (omeprazole + sodium bicarbonate). Applies to commercial members; claims for Nexium suspension and lansoprazole ODT will process automatically for patients under age 6. Authorization issued for 12 months.
Annual review with update noting additional clinical rules may apply.
Updated to note brand Prevacid SoluTab and brand/generic Zegerid suspension are typically excluded from coverage.
Added Zegerid suspension to criteria and allowed coverage when patient has a feeding tube.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.