Essential

Welcome

Welcome to the SmithRx Essential Formulary. The Essential Formulary is a list of drugs that your doctor may prescribe for you and includes information related to the coverage and cost of these drugs. This list may change over time, so please refer to plan documents or formulary update documents for detailed information about your drug benefit coverage.Our Pharmacy and Therapeutics Committee (P&T) and Value Assessment Committee(VAC) dedicates many hours to the clinical analysis and evaluation of peer reviewed literature and medical care guidelines to determine a drug’s safety and efficacy. After this rigorous clinical evaluation, the committee weighs the financial implications of a drug compared to other similar drugs and selects appropriate Tier placement based on the drugs’ safety, efficacy and cost- effectiveness. Please note all drugs on the SmithRx Essential Formulary are subjected to periodic review and amendment. Please keep in mind when a generic medication is chosen, patients pay the lowest copay available under their pharmacy benefit plan. When clinically appropriate, please consider talking to your doctor about choosing a generic product.

Formulary Tool Instructions

How to Search For Drugs

Use the alphabetical list to search by the first letter of your medication.

Search by typing part of the generic (chemical) and brand (trade) names.

Search by selecting the therapeutic class of the medication you are looking for.

Printable Files

The following files require Adobe Acrobat. Download Adobe Acrobat

• Formulary
• Prior Authorization
• Step Therapy
• Step Therapy Drug List
• SRx Preventative Meds
• Machine Readable Plans JSON
• Machine Readable Providers JSON
• Machine Readable Drugs JSON

How to Request an Exception

You can ask us to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make:

• You can ask us to cover your drug even if it is not on our formulary.
• You can ask us to waive coverage restrictions or limits on your drug.
• You can ask us to provide a higher level of coverage for your drug.

You should contact us to ask us for an initial coverage decision for a formulary, tiering or utilization restriction exception. When you are requesting a formulary, tiering or utilization restriction exception you should submit a statement from your physician supporting your request.