Haidri and Reddy (2024) Provides a good primer on drug formularies. Here's a quick overview.
What is a formulary?
A Specified is a continuously updated list of drugs, products, and technologies supported by current evidence-based medicine and the judgment of physicians, pharmacists, and other relevant experts in the diagnosis, treatment, and health care of disease.Prescription drugs often share an overarching goal of providing appropriate treatment while promoting efficient resource utilization, thereby enabling managed care pharmacy organizations to operate sustainably
What types of formula structures are there?
- closed formulary is a prescription that does not cover excluded products.
- open formulary Covers all available products; however, the trade-off is higher costs for payers and potential members.
- Hierarchical formularypatient Out-of-pocket expenses Depends on the classification level of the specific product. Therefore, patients are incentivized to use lower-level drugs through lower prices. copay.
- value based formulary Primarily use cost-benefit analysis to assess product value, assigning products with high assessed value (low incremental cost-benefit ratio) to lower out-of-pocket payments, and products with low assessed value (high incremental cost-benefit ratio) to higher of self-payment.
What factors do payers consider when developing formularies?
What are the key trends to consider in prescription drug development?
Some key issues include the increase in approvals and launches of biosimilars, prescription digital therapeutics and the growing focus on health equity.
