nonformulary

nonformulary

(non″for′myŭ-ler″ē) [ non- + formulary]
Not approved for use. The term is applied to a drug whose prescription is not usually reimbursed by a health insurer because it is absent from its formulary.
References in periodicals archive ?
Aripiprazole was added to the VA National Formulary in April 2004 but was available in the VA through a nonformulary request since its FDA approval in November 2002 (Personal communication 2014).
In addition, the association recommends PBMs, plans, and employers temporarily cover nonformulary drugs as if they are on formulary during the first 30 days after a formulary list is changed.
The DOC is spending millions of dollars on nonformulary medications.
We're seeing traditional three-tier drug plans (generic, formulary brand and nonformulary brand) with a preferred and nonpreferred category in each of the three bands.
The medical program director is responsible for the supervision and clinical support of the medical providers and midlevel providers working within RIDOC, approving consultants, outside referrals, nonformulary medications and labs, medical furloughs, medical complaints and outside elective medical care.
An unintended consequence could be, ironically, that it may decrease access for women because if contraceptives are reclassified as nonformulary drugs by going over the counter, can insurance companies say they're not going to cover them as they don't cover aspirin, for instance?
Outside documentation that supports a current nonformulary medication regimen can be crucial to a smooth transition of care.
In fact, in the president's budget submission for FY 2013, (57) DoD advanced this exact concept, proposing to raise copays for brand and nonformulary refills but keep copays for generic refills through home delivery and all refills made at the MTF free.
For example, between 2000 and 2011, the average copayment for brand name (preferred) drugs on a plan's formulary increased from $15 to $29, while the average copayment for nonformulary (nonpreferred) brand name drugs increased from $29 to $49.
I read Richard Hoover's column ("A Medication Education," Reasons & Remarks, redivivus, June 2010) about formulary and nonformulary medication very thoroughly.
DOD's decision to designate a drug as either formulary or nonformulary is based on the drug's clinical and cost-effectiveness relative to the other drugs in its therapeutic class.