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Nearly all of these widely covered drugs are generics, and the drugs covered by Part D formularies are likely to change as generics become available and as new clinical data are released (JAMA 2007;297:2596-602).
In addition to the categories and classes created by USP, the group also created a separate listing of formulary key drug types to help the Centers for Medicare and Medicaid Services assess the comprehensiveness of proposed formularies.
Jaeger: For the product formularies, we work with a chain's corporate purchasing department and key nurses to develop a formulary of "core products" for that chain's facilities.
When cancer drugs appear on multiple formularies, pricing variations can be significant--and physicians and staff might even want to help patients navigate such variations, especially as more oral drugs for cancer become available.
The following states currently have SPAPs that can cover both aged and disabled: Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, Vermont and Wyoming; all have open formularies except Illinois, which does not include any HIV drugs.
Creating a formulary for drugs used to treat mental illness is not likely to save money for health plans as readily as formularies for other types of drugs, according to an analysis by Haiden A.
Health plans have responded to these sharp price increases by reducing drug coverage and restricting their formularies. The increase has also resulted in cost shifting to seniors through increased out-of-pocket costs, including higher co-pays, deductibles, and premiums.
Prime mandate of the Pharmacopoeia Commission is to steer the work of developing quality standards of Ayurvedic, Siddha, Unani and Homoeopathic drugs and publish and revise Ayurvedic & other Pharmacopoeias, Formularies and regulatory compendia of these drugs.
Moreover, formulary management processes often result in prescriptions being written outside of formularies, which increases drug costs and discourages patients from filling scripts or taking medications.
One audience member pointed out that although plans are supposed to review their formularies once every 180 days, their pickup of drugs approved in 2005 was "unbelievably poor." If the plans base their formulary decisions on the model formulary published by the United States Pharmacopeia, that formulary is updated only once a year, he noted.
Drug formularies are essential tools for pharmacy benefit management, enabling health benefit plans to provide appropriate and cost-effective prescription drug benefits to consumers.
Most successful formularies require significant discounts from the pharmaceutical manufacturers before a drug is listed.