The purpose of the Unity 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 is made up of a list of formulary medications, a list of non-formulary medications and a list of restricted medications.
How do you view the Formulary?
There are two ways you can view Unity’s Prescription Drug Formulary:
in our up-to-date Formulary. This is the easiest and fastest way to answer formulary questions such as whether or not your drug is on the formulary, if it requires Prior Authorization or has other restrictions and what tier copay it is.
Excluded Medications
Excluded medications are not listed on the formulary. These are medications that your prescription benefit 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 is the Formulary Developed?
Unity’s Pharmacy & Therapeutics (P&T) Committee is responsible for creating and maintaining the prescription drug formulary. This committee is made up of physicians and pharmacists who provide care for Unity members in our community. The P&T Committee meets monthly to review medications and determines the formulary status and restriction status of each medication. They consider a variety of factors such as safety, side effects, drug interactions, how well the drug works, dosing schedule and 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) for drug approval and recommendations from local or national treatment guidelines. Additionally, the committee asks for information from local practitioners who are experts in the use of the drug class under review.
