What is a Drug Formulary?
A formulary is a list of drugs eligible for reimbursement. There are 3 types of formularies offered at GreenShield: Open, Tiered and Managed.
What is an Open Formulary?
An open formulary would include all drugs that have received their Notice of Compliance (NOC) and assigned a Drug Identification Number (DIN). Some drugs may require prior authorization.
What is a Tiered Formulary?
The list of eligible drugs in this formulary are divided into tiers (preferred or non-preferred), and the copay varies depending on which tier the drug is in. Some drugs may require prior authorization.
What is a Managed Formulary?
Using an evidence-based approach, GreenShield’s Pharmacy and Therapeutics Committee evaluates all new drugs prior to them being listed on our formularies. Each drug is evaluated by committee members to determine its clinical effectiveness, safety, cost effectiveness, the unmet need the drug fulfills, and the impact on the sustainability of drug plans.Eligible drugs listed on this formulary are based on the committee approach. Some drugs may require prior authorization.