A formulary, or list of preferred medications, is developed for CVS Caremark by a committee of pharmacists and physicians to include drugs that are the safest, most effective, and most economical.
As a consumer, you have the option of using the formulary list of the preferred brand name and generic medications at lower coinsurance amounts. Drugs from the formulary provide a safe, effective, and affordable alternative to non-formulary drugs, which will cost you more.
CVS Caremark Formulary/Drug List
Does the formulary change throughout the year?
This committee meets regularly to discuss new drugs and trends in drug therapy and is updated annually to reflect the most effective and economical brand drugs available. The formulary list may also change periodically throughout the year based on new findings from FDA safety concerns and as generic drugs become available during the year.
How can the formulary save me money on my prescriptions?
Formularies can help you save money in a number of ways. As we know, price does not always guarantee quality, and wise consumers want to get the best value for their money. This drug list helps guide members to generic and preferred drugs that have the same benefits and effectiveness for less money than many non-formulary medications.
Additionally, not only are CMU's copays/coinsurance for Generic and Formulary drugs lower than for Non-Formulary products, but the actual prices for these formulary equivalent drugs are less than the non-formulary drugs as well, offering more comprehensive savings for members who are looking for value.
Are all of the drugs listed on the formulary covered by CMU’s plan?
No, the formulary is a national list of preferred drugs. Just because a drug is listed on the formulary does not necessarily mean it is also covered under CMU’s plan design. Please refer to the plan comparison grid for drug exclusions and restrictions.
What is Step Therapy?
Step therapy is for people who take prescription drugs regularly for an on going condition such as arthritis, high blood pressure, or asthma. Step therapy points a patient to a first-step, lower cost, clinically effective drug in each therapy group, since there may be multiple drugs, within specific therapy classes, available to treat the same condition. Step therapy encourages patients and doctors to use lower cost effective drugs before "stepping up" to a higher cost drug.
How does Step Therapy work?
- Doctor & patient visit
- Doctor writes prescriptions (Rx)
- If Rx is not first step drug (generic), Pharmacist informs patient that our plan uses Step Therapy
- Pharmacist does a system check for history of first-step drugs(s)
- Pharmacist will contact the doctor, since only the doctor can change the prescription to a first-step drug
Brand-name drugs are covered at a later step if first-step drugs have first been tried or the doctor decides that a different drug must be used due to medical reasons.
Click here for a list of step-therapy medications: Step Therapy