Sheldon S. Sones, RPh, FASCP, is president of Sheldon S. Sones and Associates, a pharmacy and accreditation consulting firm based in Newington, Conn. Q: Is there a certain format that has to be used ...

Covered drugs are arranged by cost in tiers or levels. Generics are in the lowest tiers and are generally the lowest cost. Coverage and drug lists vary from plan to plan. Plans can change covered ...

Why aren’t all drugs covered by insurance? A formulary is the list of prescription medications covered by a health insurance plan. The list typically has brand-name and generic options. In addition to ...

Forty one percent of those over 65 take five or more medications a day.1 It’s a staggering number, but it underscores the necessity of prescription drug insurance coverage. That’s why almost 77 ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. We are only two weeks into the 2023 Medicare Open Enrollment ...

Pharmacy benefit managers (PBMs) and large employer organizations are taking measures to save healthcare costs in 2017, and for PBMs, formulary exclusions is a fool-proof tactic. “A key to containing ...

When it comes to your medication, it’s important to be clear on what your insurance company will pay for and what they won’t. Prescription drugs can be costly, especially if you don’t have insurance.

Express Scripts Holding, a pharmacy benefit manager that negotiates drug prices for many health plans, will launch a formulary with lower list price drugs in an effort to reduce reliance on rebates ...