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Status of 104 Drugs on 30 HMO Formularies

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Price: $69
Pages: 46
PDF Version: 287
KB
ISBN:
1-931467-89-7
© 2005

Pub Code: BFORM

 
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Formularies are the basis of many key strategies for controlling the cost and utilization of drugs, both in the private sector and under the new Medicare Part D drug benefit. Status of 104 Drugs on 30 HMO Formularies provides information on some of the most popular pharmaceutical products on 30 different HMO formularies as of February/March 2005, giving you valuable insights you can put to use in establishing or modifying your own formulary.

A convenient, easy-to-read format makes this an essential reference for P&T committees and others involved in designing formularies, negotiating pricing and rebates, and design benefits. It includes some of the most popular injectable drugs that are beginning to be covered under the pharmacy benefit and managed via formulary restrictions.

Use this report to:

  • See real-life examples of how drug products are presented on formularies at 30 large HMOs.
  • Get examples that illustrate a variety of options for managing drug costs via formulary restrictions.
  • Identify formulary restrictions that you may be underutilizing in your own pharmacy benefit plan.
  • Compare HMO formularies to help determine if your own formulary is too strict, too liberal, or just right for your membership.
  • Identify untapped opportunities for real savings for your prescription drug plan, and enhanced safety and well-being for your members.
  • Spot techniques for promoting the goals of your health plan via formulary policies.

The drugs covered in Status of 104 Drugs on 30 HMO Formularies were selected based on their potential for demand, direct-to-consumer advertising, high cost, or controversial coverage issues. The report compares 30 different on-line HMO formularies, predominantly three-tiered structure, and their treatment of these drugs on the formulary. It includes tier placement, preferred alternatives, quantity limits or other coverage restrictions, or prior authorization criteria. Products are listed by diagnostic category to easily compare how an entire class of drugs is managed by the 30 different formularies.

Drugs include popular oral and injectable brand-name products and generic alternatives in the following categories:

  • Anemia
  • Allergy/Respiratory/Pulmonary
  • Alzheimer's
  • Antibiotics
  • Anticonvulsants
  • Antidepressants
  • Antifungals
  • Antipsychotics
  • Antivirals-HIV/AIDS
  • Antivirals-Miscellaneous
  • Benign Prostatic Hyperplasia
  • Cardiovascular
  • Cholesterol
  • Diabetes
  • Erectile Dysfunction
  • Gastrointestinal
  • Migraine
  • Osteoporosis
  • Pain
  • Rheumatoid Arthritis/Anti-inflammatory
  • Urinary Incontinence

 

Table of Contents

Introduction
Methodology
Disclaimer

Featured HMO Formularies

Featured Medications

Medication Formulary Comparisons

Allergy/Respiratory
Alzheimer's Disease
Anemia
Antibiotics
Anticonvulsants
Antidepressants
Antifungals
Antipsychotics
Antivirals-HIV/AIDS
Antivirals-Miscellaneous
Benign Prostatic Hyperplasia
Cardiovascular Products
Cholesterol-Lowering Drugs
Diabetes
Erectile Dysfunction
Gastrointestinal
Migraine
Osteoporosis
Pain
Pulmonary
Rheumatoid Arthritis
Urinary Incontinence

 

Written By

This book was written by the editorial staff of AIS.

 

Written For

  • Health Plans
  • Medical Groups
  • Employers

 

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Related Publications

Drug Benefit News
Pharmacy Benefit Trends & Data
Specialty Pharmacy: Stakeholders, Strategies and Markets
PBM Formulary Strategies and Their Impact on Payers
Specialty Pharmacy News


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Pharmacy Benefit Trends & Data

Specialty Pharmacy: Stakeholders, Strategies and Markets

PBM Formulary Strategies and Their Impact on Payers

Specialty Pharmacy News

 


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