THE PHARMACYFORMULARY SYSTEM
Formularies represent a selective list of drugs available for ____________.
Beneficiaries
what type of formulary includes all drugs, placing them on variuos benefit tiers.
Closed Formulary
A majority of health insurance plans utilize pharmacy benefit managers (PBM,s) to administer coverage of drugs for their subscribers...this includes what
Medicare Part D
What type of formulary excludes drugs from various therapeutic classes.
Open Formulary
Drugs included in a_________plan's formulary is a result of covered determination or appeal.
Part D
A formulary is developed through the consensus of the ____________________.
Pharmacy and Therapeutics Commitee
another way insurance companies and Medicare Pare D Plans control Cost, means a member must try a specific medication of class of meds before a more exspensive med be prescribed.
Prior Authorizaton
3.the PT committee should perare what report on the advantages, disadvantages, therepeutic impact (part of a request to add a drug to the formulary
White Paper
4.The actions of the committee and thier reasons for including or not including a drug should be published when
as soon as possible after the meeting
2. requests can be forwarded to the ________and________of the PT committee
chairman; secutary
formulary must be what
continously renewed and revised
Drugs categorized as _______________ are not included, and are identified by having a DESI (drug efficacy study Implementation) indicator code of either 5 or 6.
less than effective (LTE)
what does formulary system define
policies and procedures; coverage criteria concerning drug use; the scope of support of the formulary.
1.additions to the formulary should be requested in a formal fashoin through the use of a
request form.
Formularys should contain additonal information about what
the drugs their use and so far
National Formulary
the most revered formulary in the united states