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Formulary Management
Our clients can choose from several open or closed formulary types. They can also work with us
to define a custom formulary to meet the needs of their members and providers to help reduce
total drug spend. As part of formulary administration, we provide clinical drug evaluations,
economic evaluations of therapeutic alternatives, clinical recommendations, P&T support, rebate
management and communication programs to clients.
| Rebate Administration |
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NMHC’s formularies promote the most clinically appropriate and cost effective medications,
independent of manufacturer bias. Our philosophy is to create a formulary providing the best
possible healthcare outcomes at the lowest possible cost. It is not to maximize rebates.
In virtually all cases, a plan sponsor can save more money through increased generic
utilization than through rebates, leading to the conclusion that the formulary employed has a much greater
effect on client savings than does the rebate program.
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| Generic and Therapeutic Substitution |
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The effective use of generic drugs within a formulary can produce a significant impact on
pharmacy program costs. NMHC offers clients flexibility in designing a generic substitution
program that will achieve optimum savings while ensuring quality of care.
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Utilization Management
- Utilization is a key driver in prescription drug program costs. NMHC employs sophisticated
utilization management tools to ensure patient safety, quality of care, and appropriate drug
therapy at the lowest possible cost to the plan. These include:
- Quantity Limits/Dosing Guidelines
- Step Therapy
- Dose Optimization
- Drug Utilization Review (DUR)
For more information, please contact the NMHC Sales Department.
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