Using this Site

This site provides information on the Highmark Medicare-Approved Prescription Drug Formulary. The data will be updated on an ongoing basis. Throughout this web site you will see certain symbols that draw your attention to key information that we would like you to consider.

To find a drug on this web site click on the Drug Search tab.

To search alphabetically:

Click on the letter that matches the first letter of the drug name you are looking for. You now see a list of all drug names which begin with the selected letter. Click on the drug you want to review.

To search by therapeutic class:

Select a therapeutic class which best corresponds to your prescribing needs. A Therapeutic Subclass table will appear. Select the appropriate subclass. A list of drugs will appear which match the therapeutic class and subclass previously chosen.

Plan Policies / Formulary Information

The Highmark Medicare-Approved 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 physicians and pharmacists 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. Formulary drugs are those reviewed and recommended for inclusion by Highmark�s P&T Committee. These drugs are selected based on their safety, efficacy, quality, and cost. The P & T Committee approves revisions to the formulary on a quarterly basis; updates will be provided to reflect such additions.

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

The Highmark Medicare-Approved Drug Formulary is divided into major therapeutic categories for easy 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.

Highmark covers both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

Benefit related questions should be referred to the telephone number located on the member's ID card.

Information About Formulary Changes

Products may be removed from the Highmark Medicare-Approved Drug Formulary--after a minimum of 60 days notification to members, authorized prescribers, CMS (Centers for Medicare & Medicaid Services), SPAPs (State Pharmaceutical Assistance Programs), network pharmacies, and pharmacists. The formulary may change during the year and the formulary website will be updated with any changes. Please contact Highmark Member Services using the phone number on the back of your identification card for further details on formulary changes.

To download a copy of the Highmark Medicare Part-D formulary, go to www.Highmark.com

For information on Highmark's Medicare Part D Exceptions and Appeals Process click on the following link: Medicare Appeals Information

Y0037_11_0110 CMS Approval (02/24/2011)