Medicare Formularies Need One Of Each USP “Key Drug Type,” CMS Says
This article was originally published in The Pink Sheet Daily
Executive Summary
The Centers for Medicare & Medicaid Services expects Medicare prescription drug plan formularies to include at least one drug from each of U.S. Pharmacopeia's "formulary key drug types" list
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Medicare Rx Formularies May Omit Lexapro Or Celexa, CMS Says
Both antidepressants are not needed on Part D drug formularies “since escitalopram is the component of citalopram that is responsible for the antidepressant effects,” CMS says. Iressa and Cerebyx may also be left off formularies despite the requirement that “all or substantially all” drugs in their categories be included.
Medicare Rx Formularies May Omit Lexapro Or Celexa, CMS Says
Both antidepressants are not needed on Part D drug formularies “since escitalopram is the component of citalopram that is responsible for the antidepressant effects,” CMS says. Iressa and Cerebyx may also be left off formularies despite the requirement that “all or substantially all” drugs in their categories be included.
Medicare Rx Formulary Reviews Will Be Largely Automated, CMS Says
The automated process will account for approximately 75% of the Part D formulary review process, CMS Division of Finance & Operations-Medicare Drug Benefit Group Director Edgar says. “Outliers” identified by the automated process will then be reviewed by a clinical pharmacist, the agency rep says.