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Due to the shifting nature of the pharmaceutical world, formularies change often. As new drugs are approved and more information about new uses for current drugs becomes available, pharmacy and therapeutic committees meet regularly to review their drug formularies and make adjustments.
This means that drugs can be added or removed from the drug formulary at any time. They can also move specific medications from tier to tier depending on several factors.
What are some reasons your drug formulary may change?
The Food and Drug Administration approves a new medication.
The Food and Drug Administration approves an existing medication as part of treatment for a new disease category.
A medication has been withdrawn from the market for safety reasons.
A medication becomes available without a prescription. Over-the-counter drugs are not typically covered under prescription drug plans.
A brand-name medication loses its patent and generic versions become available.
Insurers adjust based on the usage patterns
Because your drug formulary can change at any time, it is important that you check it regularly. If you haven’t already, look for a copy of your drug formulary on your health plan benefits website. You can also contact them on the phone and request a printed copy.