Medication Formulary: Preferred Medication List
A Formulary for a prescription benefit plan is merely an extensive list of preferred medications. The list includes generic and brand prescription drugs. All medications on a Formulary must be approved by the U.S. Food and Drug Administration (FDA) as safe and effective. In addition, medications on a Formulary are often cost-effective choices for specific therapies. HealthSmart Rx employs a team of medical and healthcare professionals to create and review our Formularies, which are based on the scientific evaluation of their safety, effectiveness, value and impact on health outcomes. Formularies typically comprise of several drug classes, which are based upon considerable research, data and evidence-based analyses.
To view the 3-Tier HealthSmart Rx Drug Formulary in condensed form, CLICK HERE or click on the image at right.
To view the HealthSmart Rx Drug Formulary organized by drug type,
CLICK HERE.
What is a 3-Tier Formulary?
A 3-Tier Formulary includes three levels of medications:
1.
|
GENERIC prescription medications are drugs that have been approved for placement on the formulary. In many prescription benefit plans, a Generic medication could be free to you or have a low copay. (For more on Generic vs. Brand medications, CLICK HERE.)
|
2.
|
BRAND NAME prescription medications are drugs that have been approved for placement on the formulary. A Brand Name medication often requires a higher copay for patients than its Generic version. (For more on Generic vs. Brand medications, CLICK HERE.)
|
3.
|
NON-FORMULARY prescription medications are drugs that have not been approved for placement on the formulary. In some cases a Non-Formulary medication may require a very high copay and will cost far more than Generic and Brand Name formulary medications. A Non-Formulary medication may require additional information from your doctor before your prescription plan covers a portion of the cost. Or, if you have a Closed Formulary prescription plan, you may be responsible for the entire cost of the medication.
|
What is an Open Formulary versus a Closed Formulary?
- Open Formularies are where members are encouraged to utilize medications approved for the Formulary, but non-Formulary medications may still be covered.
- Closed Formularies are where only Formulary medications are covered and the patient has to pay the full cost of non-Formulary medications.
Understand Your Prescription Benefit Plan
Be sure you understand your prescription plan, the kind of Formulary used by the plan have (open or closed), how many tiers the Formulary has, and what you are expected to pay for each tier. HealthSmart Rx does not offer one prescription plan to our clients. We customize each prescription benefit plan to fit the needs and concerns of each individual employer group. Contact your Human Resources benefit manager or HealthSmart Rx for details on your prescription plan.
No matter what kind of prescription plan you have, Formularies are not intended to be a substitute for the clinical knowledge and judgment of a doctor in his or her choice of drug therapy for you. In ALL cases, the doctor or prescriber is expected to select the appropriate drug therapy for the individual patient and provide the highest quality healthcare for you.