Clinical Services / Formulary Optimization

Formulary Optimization

One of the clinical tools our clients have access to is the Formulary Optimization Edits (FOEs). This clinical tool helps clients improve their generic and preferred brand utilization across key therapeutic classes to help optimize clinical and financial outcomes in a targeted manner.

OPTIMIZED STEP THERAPY
AND PRIOR AUTHORIZATION PROGRAMS

When appropriate, Gateway can draw on our suite of step therapy and PA program to help improve clinical outcomes and drive lowest net cost within several key drug classes.

BRAND OVER GENERIC PROGRAMS

When the first new generic for a brand product is launched there is sometimes an opportunity to drive lowest net cost by blocking the new generic product and preferring the branded product. This happens when the manufacturer lowers the net cost of the brand relative to the new generic. Gateway is vigilantly evaluating these opportunities as they arise in the marketplace and presenting them to clients for consideration.

EXCLUSIONARY FORMULARIES

Although Gateway can help support clients’ custom formularies, we also have a wide array of standard formularies for clients to choose from as well. This includes exclusionary formularies that more closely manage key drug classes via drug exclusions. Although exclusionary formularies are more tightly managed, they are also one of the best tools to help drive lowest net cost.

Find out more about Gateway Health Partners’ clinical solutions.