Formulary Management
and Design

Trailblazers in Formulary Management

 

Helping our partners understand the value of driving a clinically appropriate formulary.

Through clinically-sound formularies, pharmacy-centric benefit designs, and real-time management, we’re empowering cost savings and improved clinical outcomes.

  • Formulary Designs Specific to Your Business
  • Enhance Overall Cost Containment
  • Management of High-Cost and High-Utilization Therapeutic Categories

For Pharmacies

Collaborate with pharmacy benefit administrators to develop formulary management protocols, benefit designs, and plan edits to drive cost containment and partner with long-term care facilities to provide medications, formulary management services, and exceptional patient care.

For Facilities

Collaborate with long-term care pharmacies and their staff to implement clinically-sound formulary management protocols, streamline medication approvals, and facilitate provider approvals for therapeutic interchanges, resulting in improved patient outcomes and cost savings.

KEY FEATURES

 

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Benefit Designs

We design a clinically appropriate formulary that favorably places the manufacturer’s drug relative to competing products to help lower costs

  • Days Supply Limitations
  • Quantity Limits
  • High-Cost Thresholds
  • Refill Thresholds
  • Facility-level management

Real-Time Adjudication

Providing formulary management at the point of sale through our real-time adjudication platform.

Customizable Edits

  • National Drug Code (NDC) Exclusions
  • Maximum Allowable Cost (MAC) Management
  • Pricing Validation
  • Custom Formularies