Formulary Management

Formulary management is the systematic process of developing, maintaining, and updating a list of preferred medications (formulary) that are covered by an insurance plan, pharmacy benefit manager (PBM), or healthcare organization. Formularies are designed to promote cost-effective medication use while ensuring access to necessary treatments. Formulary management involves evaluating medications for inclusion, establishing tier structures, managing prior authorizations, and providing clinical decision support to guide prescribing decisions.