Define: Non-Preferred Drug
Non-Preferred Drug means a medication requiring pre-approval, not listed in a preferred directory, and subject to high cost-sharing or coverage limits.
Non-Preferred Drug means a medication requiring pre-approval, not listed in a preferred directory, and subject to high cost-sharing or coverage limits.
Relevant Circumstances
- When a health plan applies higher cost-sharing to medications outside its formulary
- If prior authorisation is required before a non-preferred drug is dispensed
- Where prescribing decisions must consider cost-tier implications