A Brief Introduction To Formularies

1. A Brief Introduction To Formularies At its most basic level, a formulary is a list of medicines that are approved to be prescribed under a particular health insurance policy. A formulary may contain additional clinical information such as side effects and contraindications or reasons to withhold a certain medical treatment due to the harm the medication may cause to the patient. Formularies are updated regularly to ensure that patients receive appropriate medication. When newer medications become available, formulary teams decide either to add them to the formulary or make the medication not covered, if similar medications are already available on the list. A national formulary contains all medications approved for prescription throughout a country, including the interchangeable ones. A basic formulary is typically developed by the companies known as the Pharmacy Benefit Managers (PBMs) that offer it to the payer-clients who customize it in a way to encourage the formulary compliance by the covered individuals, based on safety, FDA-approved prescribing information, clinical-trial results and cost-effectiveness of the medication. Some medications with generic versions, or those considered as less-effective may not be covered at all by a particular plan’s formulary. Tiers and medication costs My insurance plans utilize a tiered system when designing their plans formulary. This approach provides financial incentives to the patients for choosing preferred or low-cost medications. A 3-tier formulary for example, has generic medications in the first tier with lowest cost-sharing or coinsurance, say 10%, the second tier includes the preferred brand-name drugs with higher copayments or coinsurance, while tier-3 will includs non-preferred brand name medications with the highest copayments or coinsurance of up to 40% or even more. For the medicines that are not in a healthcare plan’s formulary, the customer may have pay the full price for the medication. Not all formularies are the same. Based on the formulary design they may contain 3 to 7 tiers that may be named differently to identify each tier, such as those containing “Preferred Drugs”, “Non-Preferred Brand”, “Preferred Generics” and “Specialty Drugs.” A medicine in a certain tier

2. in a formulary may be placed in a higher (expensive) or lower (cheaper) tier in another formulary. Moreover, certain restrictions such as step therapy, prior authorization and quantity limits vary from one formulary to another. When crafting a drug formulary, each plan provider sets a committee of pharmacists and physicians to determine the coverage, resulting in a unique formulary for every plan. Get access to affordable medications Because formularies vary significantly from plan-to-plan and insurer-to-insurer, it is important for you to understand the formulary attached to your current coverage for your journey to better health and save on medication costs with insurance. Effective use of formularies can improve your access to more affordable medication and minimize overall healthcare costs. Most healthcare plans have deductibles, where you are responsible for your own prescription medication costs up to a certain limit. For some high deductible health plans (HDHPs), one may have to pay up to $6000 in deductibles. Some plans may require you to pay coinsurance, which is a percentage of a medication’s full retail price. Most insurers will also limit the quantity of certain medications that you can purchase in a given period of time. You may be asked to try step therapy with a typically cheaper drug first or prior authorization by your caregiver before receiving a prescribed medicaiton. Discounted medication with EzRx drug card It’s here that the drug discount cards such as EzRx drug card are helpful even for the insured. The EzRx drug discount program is FREE and negotiates pricing directly with pharmacies in your area to give you discounted drug prices. www.ezrxdrugcard.com or Text the Keyword “EZRX” to 21000 to get a digital card. Download your EzRx prescription Share your EzRx drug discount card with your family, friends, relatives and colleagues to help them save on prescription medications and improve treatment adherence by making their medications more affordable. EzRx drug savings card is accepted at over 65,000 pharmacies in the USA including the large national drugstore chains such as CVS, Publix, Target, Walgreens, Kroger and Winn Dixie. Simply show your EzRx drug discount card to the pharmacist while filling your brand-name or generic medication prescription to get discounts of up to 85% on their retail price in the best of situations. Generics tend to be discounted at a higher rate than their brand-name counterparts. Save on your each prescription fill Check drug prices at www.ezrxdrugcard.com for the lowest price at a local pharmacy near you to increase your savings on prescription medications. The card can be used even if you have

3. health insurance, as you may get many medications at a lower price than what you will end up paying as copayments, deductibles or coinsurance with your insurance plan. EzRx drug card can be used to save on medication costs with insurance as it works independently of insurance. Use your EzRx drug card as Adipex saving card,Benzonatate saving card,Viagra discount card, flu discount card, Albuterol discount card, or a general prescription savings card to save on meds each time you to go your local pharmacy for a prescription fill or refill. A medications discount card for all Anybody can get their free EzRx prescription cost savings card irrespective of their age, income and coverage. We do not receive collect any personal information or require you to register for EzRx prescription savings card,so you can confidently download your EzRx drug card from www.ezrxdrugcard.com for Free, or get your free digital drug savings card by texting the keyword “EZRX” to the phone number 21000. It will be provided activated to you for immediate use.