The purpose of Unity's Prescription Drug Formulary is to promote use of the safest, most effective and most cost-effective medications. A formulary is an important tool to help Unity meet its goal of providing coverage for safe and effective medications in an affordable manner.
What is the formulary?
Unity’s formulary categorizes prescription drugs as: Formulary Medications, Non-Formulary Medications and Restricted Medications.
Excluded medications
Excluded medications are not listed on the formulary. These are medications that your prescription drug plan specifically excludes from coverage. Examples of commonly excluded medications include hair loss medications, sexual dysfunction medications, most over-the-counter (OTC) medications and cosmetic medications. Your specific benefit exclusions are listed in the Exclusions section of your Unity Prescription Drug Benefit Rider.
How can I view the Formulary?
There are two ways you can view Unity’s Prescription Drug Formulary:
. This is the quickest way to answer questions, such as whether or not a particular drug is on formulary, whether it requires Prior Authorization, whether it has restrictions, and what copayment applies.
How is the Formulary developed?
Unity’s Pharmacy & Therapeutics (P&T) Committee is responsible for creating and maintaining the Prescription Drug Formulary. The P&T Committee is made up of physicians and pharmacists who provide care for Unity members. The committee meets monthly to review medications and determine the formulary status and restrictions for each. Committee members consider a variety of factors, such as safety, side effects, drug interactions, efficacy, dosing schedule, dose form, appropriate uses and cost-effectiveness.
In making formulary decisions, the committee obtains the most up-to-date information on the medication from a variety of sources, including published clinical trials, data submitted to the Food and Drug Administration (FDA), and local and national treatment guidelines. Additionally, the committee asks for information from local practitioners who are experts in the use of the drug class under review.
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