A formulary is a list of drugs that are covered by your plan. This list of drugs is often a combination of generic and brand medications.
The generic medications are identified with an asterisk (*) in your formulary. Not all strengths or dosage forms of the generic name may be generically available. An "A-rated" generic drug is a medication the FDA has determined is equivalent to the brand name product in safety and effectiveness. Only A-rated generic drugs may be substituted for brand name products in the formulary.
Brand products are available on your formulary. When a generic version is not available for the medications prescribed by your physician, a brand product may be obtained at a co-pay assigned by your plan. The cost of brand products is higher than generics, therefore your co-pay will also be higher. Each formulary contains "preferred brand products" (Preferred Drug List) which means your plan is able to obtain these medications at a better price. Therefore, you may save money in the form of co-pays for Preferred Brand Products.
If your physician prescribes a medication NOT on the formulary, the medication will not be filled until the physician completes a non-formulary/prior authorization request form. This form is located on United Drugs home page. To assist your physician in selecting appropriate therapies for you and your family, we suggest you take your formulary with you to all physician visits.
Step Therapy evaluation means that you must have tried certain drugs as First Line Therapy prior to obtaining the prescribed Second Line Therapy as determined by your disease state and medication use. If you have tried the First Line Therapies and your physician feels the First Line Therapy did not work well for you, you are able to receive Second Line Therapies. If your physician feels that the First Line Therapies are not appropriate in your situation, your physician must fill out a Non-Formulary/Prior Authorization Form before you are allowed to receive the prescribed Second Line Therapy. Authorization forms are available at www.uniteddrugs.com.
Specialty Drugs are special "self-injectible" or biotechnological medications that are usually very costly, or require special monitoring. United Drugs uses selected distributors of specialty injectible and biotech drugs. These pharmacies focus on the unique needs of patients requiring complex medications and a higher level of pharmaceutical care. The care provided by these pharmacies includes case management; medication fulfillment and nursing-patient follow up when required. Our Specialty Pharmacy Programs provide a wide selection of distribution and clinical services.