formulary

You can find your drugs on the plan’s formulary—the list of covered drugs—and compare that against the costs outlined for each coverage tier in your annual notice of change.

Finally, PBMs use their consolidated power to keep drugs off of health plan formularies — unless manufacturers pay exorbitant fees.

They negotiate drug prices with manufacturers on behalf of insurers, process prescription claims, and manage formularies — insurers' lists of covered drugs.

For example, Wegovy was added to the standard formulary for Medicare’s Part D prescription benefit after it received approval from the Food and Drug Administration in March for the treatment of heart attack risk.

DiGiacomo said her formulary, or list of covered drugs, has changed three times.