A formulary is a drug list used by doctors and other healthcare providers. It is a list of “covered” prescription medicines developed by doctors and pharmacists working for a healthcare organization or pharmacy benefits manager (PBM). Hospitals have used formularies for years to control costs while still providing quality medicines. Doctors working in healthcare organizations use a formulary as a guide when prescribing medicine for patients.
Covered medications are medications that are covered or paid for by your health insurance. The formulary contains a listing of the covered medications.
Formularies help to keep drugs affordable and remind doctors and patients that there are many effective medicine choices. All the dollars spent on advertising to launch new drugs has created a huge demand for new, high cost, brand-name drugs. As the number of drugs increases, it is important to give doctors an easy way to prescribe the best medicines for common conditions. This list of drugs helps.
Prescription drugs are reviewed for safety, effectiveness value. Cost is just one factor in putting a drug on or taking a drug off the formulary list when other similar medications are available.
First, the drug starts as a brand-name drug. The maker of a brand-name drug receives a patent on that drug. The patent is for the Active Pharmaceutical Ingredient (API) which is the main ingredient that makes the drug effective. The patent on the API is usually good for 20 years. During that time, no one else can make that drug.After they receive the patent, the maker of the brand-name drug submits a New Drug Application (NDA) to the Food and Drug Administration (FDA), asking the FDA for permission be able to sell the drug. In this application, the maker of the drug has to show clinical trials they’ve done that prove safety, overall effectiveness, effective dose, and any adverse reactions a person taking this drug could have.If the FDA finds the drug is safe and effective for its intended use, the drug maker is given final approval for the brand name drug, and it can go on the market.The drug maker keeps watching the drug while it is on the market to check for any new or known adverse reactions to the drug. They have to report this information to the FDA, who then shares it with healthcare professionals, including doctors.After the 20-year patent expires, then a generic version, with the same Active Pharmaceutical Ingredient (API) can be manufactured by the company that makes the brand name or by other companies.
There are two different types of generic drugs available. When you talk with your doctor he or she might mention one or both types of generics.A Generic equivalent“Generic equivalents” are drugs that are approved by the FDA, and have the same active ingredients, strength and purity as the brand-name drug. Most people are used to using generic equivalents (often just called “generics”) as a great way to save money on prescription drugs. You will find that your pharmacist will usually substitute a generic equivalent for a brand-name drug when it is available. If a generic equivalent is not available, a generic alternative drug may be a good option. A Generic alternative“Generic alternatives” are also FDA-approved drugs, and may treat the same conditions as their brand-name cousins. What is different is that the generic alternative drug contains different active ingredients, but comes from the same chemical family and can provide similar results. Your pharmacist will not automatically substitute a generic alternative. To use a generic alternative drug, you need a new prescription from your doctor.
The way a brand-name drug looks is actually trademarked, so the generic drug cannot look exactly like the brand-name drug. There may be other differences, as well. You may notice that the shape, color, taste and some of the extra ingredients are different in the generic drug. However, the active ingredients are exactly the same in both the brand-name drug and the generic equivalent drug.You can feel comfortable that the brand-name drug and the generic will be the same strength, purity and contain the same active ingredient. And both will work in exactly the same way.Best of all, usually the generic drug will provide all the benefits at a much lower cost.
Do you have unused or expired medicine? Before you throw it away, there are some things you should know.Disposal information varies from state to state; contact your local or state health department, regional or state environmental protection agency or the Office of National Drug Control Policy for specific information about drug disposal. (Visit www.epa.gov or www.whitehousedrugpolicy.gov.)Ways to dispose of are: Bring the medication to a local pharmacy.
Dispose unwanted medication at a community household hazardous waste (HHW) collection program, if one is available or national hazardous waste company.
Use Federal prescription drug disposal rules issued by the Office of National Drug Control Policy: Do not flush prescription drugs down the toilet or drain unless the label or patient information tells you to. For information on drugs that should be flushed, visit the FDA’s website.
To dispose of prescription drugs that cannot be flushed, your community may have drug take-back programs or other programs, such as household hazardous waste collection events, that collect drugs at a central location for proper disposal. Call your city or county government’s household trash and recycling service for more information.
If a drug take-back or collection program is not available: Take your prescription drugs out of their original containers.
Mix drugs with an undesirable material, such as cat litter or used coffee grounds.
Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag.
Conceal or remove any personal information, including Rx number, on the empty containers by covering it with a black permanent marker or duct tape, or by scratching it off to protect your privacy.
Place both the sealed container with the mixture and the empty drug containers in the trash.
Disposing of prescription drugs into the trash or by flushing down a toilet is strongly discouraged. Although these methods prevent the misuse of the medication to be destroyed, this practice can cause other problems: If the medication travels to a septic tank, it may harm the beneficial bacteria that are responsible for breaking down waste in the septic system.
If the medication travels to a wastewater treatment plant, many medicines are not captured or are only partially captured during the treatment process. The medications can then be released into a nearby lake, river or groundwater with the treated wastewater posing a threat to aquatic life.
Impermeable containers can become permeable in landfills and enable drugs to trickle into groundwater.