Health / Health Insurance / Formulary: A listing of drugs, classified by therapeutic category or disease class, that are considered preferred therapy for a given managed population and that are to be used by an MCO's providers in prescribing medications.
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Health / Health Insurance / Open Formulary: The provision that drugs on the preferred list and those not on the preferred list will both be covered by a PBM or MCO. MORE
Health / Health Insurance / Closed Formulary: The provision that only those drugs on a preferred list will be covered by a PBM or MCO. MORE
Health / Health Insurance / Generic Substitution: The dispensing of a drug that is the generic equivalent of a drug listed on a pharmacy benefit management plan's formulary. In most cases, generic substitution can be performed without physician appro MORE
Health / Health Insurance / Therapeutic Substitution: The dispensing of a different chemical entity within the same drug class of a drug listed on a pharmacy benefit management plan's formulary. Therapeutic substitution always requires physician approval MORE
Health / Health Insurance / Pharmacy And Therapeutics Committee: Committee charged with developing a formulary, reviewing changes to that formulary, and reviewing abnormal prescription utilization patterns by providers. MORE