The Value formulary provides a comprehensive list of medications that include generics, brands, and specialty drugs. Three-, four-, and five-tier cost-sharing designs are available.
Drugs are included based on medical effectiveness, positive results, and value. The Value formulary is designed to include all therapeutic categories and provide physicians with prescribing options. In addition, the formulary is reviewed periodically to add new drugs and to remove brand drugs when a generic equivalent becomes available. Drugs may be not covered when there exist alternative medications used to treat the same condition in a more cost-effective manner.
Effective use of the formulary
Help your Independence Blue Cross (Independence) patients make the most of their health care dollars. Before prescribing a medication to an Independence member, please consider whether the drug is included in the formulary used for the member’s prescription drug benefit. If a member is currently taking a drug not on the formulary, you may be able to help him or her save money by changing the prescription to a generic equivalent or to a similar drug on the formulary.
However, the choice is still yours. Regardless of whether a drug is in the formulary or not, you may prescribe any covered medication at your discretion.