Preferred drug lists

Pharmaceutical companies provide per prescription rebates on their selective products that are included on the PBMs formulary or preferred drug list. In return, the pharmaceuhcal companies receive information on the volume of their prescriptions dispensed through the PBM pharmacy network. 

Plan limitations, restrictions, and exclusions typically are major cost-containment elements of pharmacy benefits plan designs. Examples include a cap or limit on outpatient drug benefits (usually 2000 a year per member), the formulary or preferred drug list, and a limit on the quantity of drugs dispensed per prescription (fhe plan pays for only a limited supply of medication af one time). The mosf common scenario is fhaf fhe plan pays for a 30-fo 34-day supply of a prescribed drug at a pharmacy. 

Medicaid prescription drug program. The drug manufacturer s drug would then become part of the state Medicaid preferred drug list. 

The industry knows that it has to learn to live with restrictions of some kinds and one of the means of restriction is the formulary, a list of formulations of medicines with varying amounts of added information. A formulary may list all nationally licensed medicines prescribable by health professionals, or list only preferred drugs. 

Isoniazid is the preferred drug for treating latent TB infection. Generally, isoniazid alone is given for 9 months. The treatment of latent TB infection (LTBl) reduces a person s lifetime risk of active TB from about 10% to about 1 %. Because TB is spread easily through the air, each case prevented also prevents a second wave of cases that each prevented case would have produced. Historically, the treatment of LTBl has been called prophylaxis, chemoprophylaxis, or preventive treatment. By any name, it is one of the primary mechanisms for reducing TB in the United States. The LTBl treatment options are listed in Table 110-2. 

Thyroid hormones used in medicine include both the natural and synthetic hormones. The synthetic hormones are generally preferred because they are more uniform in potency than are the natural hormones obtained from animals. Thyroid hormones are listed in the Summary Drug Table Thyroid and Antithyroid Dragp. 

Clindamycin vaginal cream is the preferred therapy for bacterial vaginosis during lactation because metronidazole is listed as a drug of concern by the American Academy of Pediatrics (AAP)14 (Tables 44—4 and 44—5). Counsel patients that clindamycin cream weakens latex condoms and diaphragms, potentially rendering them ineffective. 

The side effects of antidepressants, sometimes very unpleasant, olten lead patients to interrupt their treatment or to reduce the drug dose, which involves a great risk in view of the high relapse rate and danger of suicide in depression. The newer antidepressants, such as trazodone, fluoxetine and other SSRIs and moclobemide, are characterized by better tolerability and lower toxicity and are therefore preferred in the treatment of outpatients and elderly patients (Rudorfer and Potter, 1989). A detailed list of general and specific common side effects associated with the newer generation of antidepressants is seen in Table 1.7. 

For example, if the preferred list of drugs used by the plan (called the formulary) does not include a desired drug, participants pay the full cost. More generally, critics say that the reliance on profit-seeking insurance companies and Medicare Advantage HMOs rather than on direct government payments raises costs to elderly consumers. 

It is apparent from the preceding discussion that certain drugs are often preferred when treating certain types of seizures. Table 9 4 lists some of the more... 

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