Through the MedStart Formulary Connect(TM) program, health systems and pharmaceutical companies can collaborate to create new contracting models and develop point of care based medication formularies
and medication access programs.
Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies
After studying the treatment of five diseases in 13,000 patients, the researchers concluded that HMOs with the most restrictive formularies
showed twice the number of office visits, hospital admissions and emergency-room visits, and greater overall drug use.
CMS plans to require that drug plan formularies
be developed by a P & T committee that includes practicing physicians and pharmacists.
New classes of agents are typically reimbursed, but more surveyed pharmacy directors say they would not add Prolia to their commercial and Medicare formularies
if it is priced equal to or above the net price of Forteo, indicating managed care organizations may shy away from novel therapies for this indication if they are priced at a premium.
Pharmacopeia (USP) last month released its final model guidelines for use in developing Medicare prescription drug formularies
Some health plans, however, have some concerns about Exubera's full potential, which may dictate where the drug is placed on their formularies
Wang YR, Pauly MV: Spillover effects of restrictive drug formularies
on physician prescribing behavior: Evidence from Medicaid.
While at least 17 other states have formularies
, the drug lists in those states are prepared through private negotiations.
This is achieved through the development of product formularies
that drive toward lower-cost alternative products.
The CMS Formulary Finder is scheduled to be linked directly to individual plan formularies
as of mid January.
The results of several studies to date, however, suggest that the reduction of drug costs achieved through various types of restrictions in drug formularies
may occur at the expense of increased costs associated with other health care use (such as increased hospital admissions) and may compromise patient care.
Useful links to the source formularies
and product websites are also included as an additional resource.
Despite Many Pharmacy Directors' Preference for Using Individual Drugs Over Fixed-Dose Combinations
MediMedia also offers free inclusion of formularies
within their InfoScan Formulary Database([TM]), used by most of the top e-prescribing and electronic medical record vendors to guide prescribing decisions.