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