|
||||||||||||||||
|
||||||||||||||||
The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. Other? (please specify the drug class) ___ How many covered lives are in plans with:
Closed FormulariesHow many covered lives are in plans that have a pharmacy benefit with a closed or partially closed formulary; that is, a formulary that limits and requires justification for use of drugs not listed on the formulary independent of those drugs excluded through benefit design? ___ How many covered lives are in plans with: (See top of page 2 for definition) 1–2 closed classes? ___ 3–5 closed classes? ___ >5 closed classes? ___ (That is, classes in which some drugs are not listed on the formulary, are not covered or reimbursed, and can be obtained only through a nonformulary exceptions process.) How many covered lives are in plans with closed classes that contain only one drug? ___ What are the closed classes in your plans? ___ ___ ___ Which processes are in place in closed formulary environments to allow for access to nonformulary drugs? (check all that apply) None, all nonformulary drugs are not covered. ___ Nonformulary drugs may be covered through an informal exceptions process. ___ Nonformulary drugs may be covered through a formal prior authorization process. ___ Other, describe. ___ Open–Preferred FormulariesHow many covered lives are in plans that have nonclosed formularies but have preferred classes, that is, classes in which there are drugs whose use is encouraged by incentives (lower copay, academic detailing, DUR, soft edits), or usage criteria, or in which prescribing of nonpreferred drugs is discouraged. ___
|
|
|||||||||||||||
