Itasca Medical Care (IMCare) will maintain a formulary for products offered to its membership that is based on sound clinical evidence. The formulary will be reviewed and updated annually by the Pharmacy and Therapeutics Subcommittee.
IMCare will collaborate with its delegated Pharmacy Benefit Management (PBM) vendor on the development of the formulary and management procedures. IMCare contracts with Caremark to manage and pay pharmacy claims.
IMCare will maintain a policy that outlines how to use pharmaceutical management procedures including quantities, generics, therapeutic interchange, and step-therapy protocols, prior authorization, and exceptions to the formulary. The policy will be reviewed and updated annually and as needed, in cooperation with Caremark and includes the participation of specialists to evaluate each class of pharmaceuticals.
IMCare will annually and as needed communicate pharmaceutical management procedures to providers via direct mail, website, and/or formulary booklet.