Formulary changes happen from time to time if drugs are:
Recalled from the market; Replaced by a new generic drug; or, Clinical restrictions are added, including, but not limited to, prior authorization, quantity limits or step therapy.
How often do formularies change?
There are also some instances where the same product can be made by two or more manufacturers, but greatly vary in cost. In these instances, only the lower cost product may be covered. How often is the Formulary updated? Formulary changes typically occur twice per year.
Why do medications change tiers?
The formulary is divided into levels, called “tiers.” The tiers are based on the cost of the medicine. The amount you pay each time you fill a prescription depends on the tier the medicine is in.
