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      A View from a Managed Care Provider

      Cardiology

      S. Karger AG

      Administration, Drug formulary, Management, Savings

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          Abstract

          Formularies have been developed in response to specific forces which have affected pharmaceutical utilization and costs. Specifically, this is in response to an increase in the aging population requiring more drugs, inflation in the acquisition cost of drugs, increasing utilization, and the introduction of new technology. Well-researched formularies will provide the drug therapy needs for 85-90% of the population. Patients unresponsive to listed formulary drugs may use nonformulary drugs if appropriate methods of authorization are instigated. Various types of formulary management exist: open, where they can be used as a guideline, and drug benefits are not limited to the formulary; restricted or closed, where only drugs on the formulary or those previously authorized will be paid for; incentive based, where patients pay a higher price for nonformulary drugs, and patient driven, where the patient holds a list of drugs they can be supplied with. Effective formulary performance requires the joint co-operation of the pharmacists, payers, physicians, the pharmaceutical industry, and patients. These clinically based formularies then form an important measure to control costs while providing quality care. This paper will discuss the advantages of a formulary, its development, administration, and management.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-6144-0
          978-3-318-01954-4
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 85
          : Suppl 1
          : 30-35
          Affiliations
          Vice President and General Manager, WellPoint Pharmacy Management Inc., Calabasas Hills, Calif., USA
          Article
          176755 Cardiology 1994;85:30–35
          10.1159/000176755
          7743532
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 6
          Categories
          Session II: Drug Formularies – Good or Evil?

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