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Drug Formulary Management - DFM

However you need it, we’ll design it...

Esorse is able to customize plan designs so plan sponsors are utilizing drug formulary management tools that address the usage characteristics of each employer and/or employer location.

  • Customization and programming of plan designs
     
  • In-house services include cost-management tools such as:
     
    • DFM-plan-designGeneric substitution

    • Tiered plans
       
    • Exception coverage
       
    • Deductibles/maximums
       
    • Prior authorization
       
    • Step therapy
       
  • In-house pharmacy ‘analytics’ for plan design and drug utilization reviews to identify claim trends and health/disease issues at the plan sponsor level.
     
  • Customized trial prescription programs and drug maintenance programs.
     
  • Access to Canada’s most up-to-date database of eligibility criteria for drugs covered by government programs (e.g. high cost/specialty drugs and cancer products), thereby supporting integration of claims to mitigate unnecessary high cost claims.
     
  • Integration of formulary plans with overall plan designs to provide high cost protection (e.g. yearly plan maximums with add-on catastrophic coverage).
     


Want to learn more? Contact us today!

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