The Medicare drug list, also called a formulary, lists the prescription drugs and vaccines that Medicare covers. Medicare provides this coverage through Medicare Part D or Medicare Advantage (also ...

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 the Centers for Medicare & Medicaid Services adjust regulations for the upcoming fiscal cycle, beneficiaries face a shifting landscape in healthcare expenses that alters how monthly budgets are ...

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 ...

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 ...

Optum Rx, the pharmacy benefits manager operated by healthcare behemoth UnitedHealth, is moving eight popular insulin products to preferred status on its standard formulary for commercially insured ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. We are only two weeks into the 2023 Medicare Open Enrollment ...