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73 11/2005
Preferred Drug List
The objective of the Preferred Drug List (often referred to as “Preferred Drug
Formulary”) is to ensure quality and cost-effective prescription drug coverage at an
affordable price for our members. The Pharmacy and Therapeutics (P&T) Committee
of BCBSGa/BCBSHP, composed of practicing BCBSGa/BCBSHP physicians and
pharmacists from around the state, has selected safe and effective products for
coverage under the Preferred Drug List. The Preferred Drug List is supported by
sound medical guidelines and treatment protocols researched from current medical
pharmacological literature, reference books and peer-reviewed journals.
The Preferred Drug List includes coverage for single source brand name drugs and
generic equivalent products for those multi-source agents. The Preferred Drug List
also targets our top 23 therapeutic categories. Within the top 23 classes, single
source drugs are limited to a specific list. Those drugs not included on the total
Preferred Drug List are considered non-preferred or non-formulary. Non-preferred
agents are not considered a covered prescription benefit unless they meet criteria
established by the P&T Committee. The BCBSGa/BCBSHP Prescription Drug Program
provides an exception process to provide coverage for a non-preferred drug
prescribed by you when, in your professional judgement, no effective alternative is
available on the Preferred Drug List. This process documents the need for an
exception when a formulary/preferred product has been proven to be ineffective or
causes adverse or harmful reactions to the patient.
As a network provider, you are asked to prescribe products from the Preferred Drug
List for all members. By prescribing preferred drugs when appropriate, you help
contain the rising costs of health care, ensure the use of quality pharmaceuticals, and
help maintain your patients’ continued drug coverage. We also ask that you assure
your patients of the safety and efficacy of generic equivalents. Please use the
Preferred Drug List when prescribing to your BCBSGa/BCBSHP members. The
Preferred Drug List is available on our Web site www.bcbsga.com and is updated as
needed.
To learn more about our Preferred Drug List, visit our Web site at www.bcbsga.com
,
or contact your local Senior Network Specialist.