Information on this Provider Resource Center site is for members who have moved onto Highmark's systems.
For information related to members who have not moved onto Highmark's systems, please visit bcbswny.com/provider.

What is the Formulary?

The Highmark Drug Formulary is a list of FDA-approved prescription drug medications reviewed by our Pharmacy and Therapeutics (P&T) Committee. This committee is comprised of network healthcare providers who select products on the basis of their safety, efficacy, quality and cost to the plan.

The formulary is designed to assist in maintaining the quality of patient care and containing cost for the patient's drug benefit plan. Our P&T Committee approves revisions to the drug formulary on a bi-monthly basis; updates will be provided to reflect such additions.

Products are removed from the formulary twice a year, typically January 1st and July 1st after a minimum of 30 days notification is given to providers.

Prescribers are requested to prescribe medications included in the formulary whenever possible. Our Medical and Pharmacy Affairs department will monitor provider-specific formulary prescribing and communicate with providers to encourage use of formulary products.

The drug formulary is divided into major therapeutic categories for ease of use. Products that are approved for more than one therapeutic indication may be included in more than one category. Drugs are listed by brand and generic names. Most dosage forms and strengths of a drug are included in the formulary.

Healthcare providers who have questions about the formulary and its use can contact Pharmacy Provider Service at (800) 950-0051 or (716) 884-3461. To obtain a copy of the formulary, providers should also use the Pharmacy Provider Service number.

Last updated on 10/6/2021 11:43:17 AM

 

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