Chapter 4: Drug Formularies Flashcards
What is a Formulary?
An insurance company’s approved drug list.
What is the purpose of a Formulary?
To guide providers to the least costly, effective medications for treating a patient’s health condition.
Most formularies use a tiered system designed to?
Encourage providers and patients to choose lower cost drugs.
Tier 1 drugs are usually generic and available to patients at?
Little to no cost.
Higher-tier drugs are brand name medications and the patient pays?
An escalating co-pay for drugs in each tier.
Formularies include drugs that are safe and effective for?
Treatment of diseases and committee of doctors and pharmacist updated them several times a year.
What does the provider need to indicate when determines that it’s medically necessary for a patient to receive a drug not on the formulary?
DIspense as Written (D.A.W.) on the prescription.
