Administering the Pharmacy Benefit
This module begins with a discussion of the role of prescription drugs in the delivery of healthcare services and what is meant by the pharmacy benefit. It then discusses the role of PBMs in managing the pharmacy benefit and how financial risk is influencing the pharmacy benefit.
Criteria for Product Approval to the Formulary
This module focuses on the formulary approval process in both managed care organizations and hospitals, and how decisions are made regarding which drugs are approved for formulary inclusion.
This module describes three major formulary design concepts: open, closed, and multi-tier, and discusses an emerging approach to formulary structure: value-based formulary design.
Hospital and Managed Care Formularies
This module discusses the use of formularies in hospital and managed care organizations (MCOs).
Medicare and Medicaid Formularies
This module explores the role of formularies in controlling healthcare costs under two major public programs—Medicare and Medicaid.
Role of Clinicians and Pharmacists in Managing the Pharmacy Benefit
This module focuses on the role of clinicians and pharmacists in pharmacy benefit management.
Selling in the Formulary Environment
This module discusses how pharmaceutical companies have responded to and are succeeding in a formulary environment. Their strategies include negotiating with buying groups, creating new departments within the company, expanding research initiatives, and ensuring representatives are prepared to prosper in this complex setting.
Strategies for Managing the Pharmacy Benefit
This module describes the key methods used by health plans, insurers, and hospitals to manage the pharmacy benefit.
The Managed Care Pharmacy
This module discusses current strategies for managing pharmacy coverage, the changing role of the pharmacist, and the role of pharmacy benefit management (PBM) companies.
The Pharmacy and Therapeutics Committee
This module focuses on the role of the P&T Committee in the formulary system.
This module discusses the rationale behind formularies and considers the advantages and disadvantages that come with their use.
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