Welcome to the Drug Formulary Page! PHP uses this Drug Formulary as the cornerstone of drug therapy, quality assurance, and cost containment efforts in pharmacy services. Hospitals and managed care organizations have used Drug Formularies for many years to provide comprehensive, cost-effective pharmacy services. Each benefit plan is uniquely designed according to each employer's desired benefits. Please refer to your benefit plan for coverage. Drugs not listed within the formulary on this Web site are considered non-formulary. If you have any questions, please contact the PHP Customer Service Department at (260) 432-6690, (800) 982-6257 or (260) 459-2600 for the hearing impaired. You can also e-mail questions to: custsvc@phpni.com.

• Search the Drug Formulary
• 2010 PHP Drug Formulary (PDF format)
• Specialty Drug List (PDF format)
• Step Therapy Program (PDF format)
• PHP Pharmacy Benefits
• How to use the Online Drug Formulary

PHP Pharmacy Benefits

Physicians Health Plan members have several possible pharmacy prescription programs (a two-tiered program, a three-tiered program, or an HRA - High Deductible Health Plan program). Please refer to your Summary of Benefits, Certificate of Coverage, or Member ID Card to determine which program applies to you and your family. Detailed information of the programs may be obtained on the Pharmacy page of our site.

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How to use the Online Drug Formulary

To use the online Drug Formulary you must select the Formulary Search option from the menu. From there you may search any drug either by name or drug class. Once your search is complete, the screen will show the drug name, the dosage and strength, the status of the drug and any notes & restrictions.

Prior authorization is the request from a doctor for approval before a drug is dispensed as a covered benefit. If a drug needs prior authorization, this will also appear in the notes & restrictions section of your search results.

A key (example below) is provided under the drug name to explain the status of the drug.

Please note: a generic drug is only available if the symbol appears next to the name. If you have any questions about whether or not a generic is available, please call PHP Customer Service at (260) 432-6690 or (800) 982-6257.

Definition of Symbols

	Status	Definition
	Tier 1	Lowest copay. Generics are often placed in this tier.
	Tier 2	Middle copay. Formulary brands are often placed in this tier.
	Tier 3	Third tier copay. Non-formulary brands are often placed in this tier.
	Specialty Drugs	Specialty drugs are generally injectable, high cost medications that have special handling requirements or require special training before use. Some oral chemotherapy drugs are specialty drugs.
	Restriction	Definition
	Generic Drug	Medications that have generic equivalents are covered at a generic reimbursement level, and should be prescribed and dispensed in the generic form.
	Step Therapy	Some drugs require the use of an appropriate alternative therapy within a specified number of days before they can be covered by the plan.
	Quantity Limit	Some medications may be subject to quantity level limits based on the manufacturer's packaging size or adopted clinical guidelines.
	Prior Authorization	To promote the most appropriate utilization, selected high-risk or high-cost medications require a prior authorization by the health plan to be eligible for coverage.
	Member Note	Special notes or instructions.

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