List of prescribed drugs recommended by a managed care plan and dispensed by participating pharmacies to members of the plan. It is periodically reviewed and modified. See the three types—open, closed, and restricted formularies for information. See formulary .
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A schedule of prescription drugs approved for use which will be covered by the Health Insurance Plan of the insurer and dispensed through participating pharmacies.
Insurance Encyclopedia
Drug formulary (Health Insurance)
A list of approved prescription medications that the plan will cover and that will be distributed from affiliated pharmacies.
Drug maintenance list
See: adjusted drug benefit list .
drug price review (DPR)
Weekly update of drug prices at average wholesale price (AWP) that is from the American Druggist Blue Book . See maximum allowable cost list .
Drug price review (Health Insurance)
A process wherein the American Druggist Blue Book is used to establish the wholesale cost of medication. This information is then used to settle on a maximum drug price.
Drug provider
Entity licensed to dispense prescription drugs such as pharmacy (pharmacist), physician, or other licensed health care professional.
Drug tiers
Option introduced in the Medicare prescription drug plan that allows each plan to group different drug types together (i.e., generic, brand, preferred brand). Tiers could be used to describe drug groups that are based on classes of drugs. If the tier option is used, the plan should provide clarification on the drug types covered under the tier in the prescription drug plan notes section.
drug use evaluation (DUE)
Same as drug utilization review except it is qualitative. See drug utilization review (DUR) .
Drug Utilization Review
A method for evaluating or reviewing the use of drugs in order to determine the appropriateness of the drug therapy.
drug utilization review (DUR)
Evaluation of prescription drug use and prescribing patterns by physicians to establish the appropriateness of drug treatment. DUR may be done for individual patients, an entire insured group, for current, past, or future usage. Medication costs may be reduced by substituting generic for brand name drugs and use of a drug formulary.