Sheldon S. Sones, RPh, FASCP, is president of Sheldon S. Sones and Associates, a pharmacy and accreditation consulting firm based in Newington, Conn. Q: Is there a certain format that has to be used ...

Why aren’t all drugs covered by insurance? A formulary is the list of prescription medications covered by a health insurance plan. The list typically has brand-name and generic options. In addition to ...

As health care moves toward a value-based payment model, the pharmacy benefit is going in the opposite direction, one that places unit cost over clinical appropriateness. Have you ever used your drug ...

Pharmacy benefit managers (PBMs) and large employer organizations are taking measures to save healthcare costs in 2017, and for PBMs, formulary exclusions is a fool-proof tactic. “A key to containing ...

Each Medicare Part D plan, also known as a prescription drug plan (PDP), has a list of covered medications known as a formulary. Each formulary has tiers. More cost-effective medications, such as ...

Express Scripts Holding, a pharmacy benefit manager that negotiates drug prices for many health plans, will launch a formulary with lower list price drugs in an effort to reduce reliance on rebates ...

Recent press reports and other evidence suggest that Medicare Part D plans may be encouraging the use of brand-name drugs instead of generics. However, the scope of such practices is unclear. We ...

Tricare plans next week to expand its coverage of drugs used to treat premenopausal women with low sexual desire, a Tricare official said via email Thursday. Over the last five years, the Food and ...

Please provide your email address to receive an email when new articles are posted on . Starting Jan. 1, 2021, patients with inflammatory conditions who are part of the Express Scripts formulary will ...

A Department of Veterans Affairs panel has pushed back against efforts to rush a controversial anti-depression drug into use for its patients, voting not to include the drug, Spravato, on its list of ...