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restricted drug means any drug or substance capable of causing intoxication or impairment which is legally obtainable for recreational use and whose sale, purchase, possession, or transfer is restricted by law, such as cannabis, if and when legalized.
Types of Formularies Open Formulary: The payer may provide coverage for all formulary and non-formulary drugs. The payers include the health plan, the employer, or a PBM acting on behalf of the health plan or employer. Closed Formulary: Non-formulary drugs are not reimbursed by the payer.
Formulary restrictions are implemented to reduce pharmacy costs and ensure appropriate use of pharmaceutical products. As adoption of formulary restrictions increases with rising pharmacy costs, there is a need to better understand the potential effect of formulary restrictions on patient and payer outcomes.
Drug coverage (Part D) begins you may get a transition fill, a one-time, 30-day supply of a drug youve been taking that your plan either doesnt cover or requires prior authorization/step therapy. Check with your plan to find out their specific coverage rules.
MUSCLE RELAXANT DRUGS The restricted drug is carisoprodol (brand name Soma). HYPNOTIC DRUGS The restricted drugs are eszopiclone (brand name Lunesta) and zolpidem tartrate extended release (brand name Ambien CR). VARENICLINE The restricted drug is varenicline (brand name Chantix).
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