More than any other classes of drugs, HMG-CoA reductase inhibitors and proton-pump inhibitors are affected by three-tier formularies. Nearly 4 in 5 HMOs that use a three-tier system will put one or more HMG-CoA reductase inhibitors for treatment of hypercholesterolemia on the third copayment tier, while more than 9 in 10 pharmacy benefit managers will do the same with at least one PPI. Pharmacy executives surveyed by the consultant Scott-Levin say high utilization and the availability of therapeutic equivalents invite use of the third tier for the three most-often-named classes. Products used to treat chronic conditions also commonly earn consideration for the highest tier.
Products routinely considered for third tier
SOURCE: BENEFIT DESIGN: HOW IT'S CHANGING MANAGED CARE, SCOTT-LEVIN, NEWTOWN, PA, JUNE 2001