Quick Fact


Our pharmacists designed and implemented a formulary for the Massachusetts Medicaid program, MassHealth. As a result, the MassHealth Drug List has helped the state become a national leader in generic use. About 80 percent of the prescriptions written for MassHealth members are generic. 

Formulary Management

Prescription medication coverage is one of the most expensive components of a health plan for a state agency or health care organization. Using a formulary management system, or preferred drug list, that requires prior authorization for certain medications can help an organization better manage this expenditure.

Our Clinical Pharmacy Services team reviews and selects drugs for a client’s formulary based on three key factors:

  • Safety
  • Efficacy
  • Cost

By authorizing coverage of only those drugs on the formulary, our clients are able to manage the rate at which expensive new drugs are prescribed. Often there are equally effective — and less costly — medications already on the market. The formulary system encourages providers to prescribe less expensive drugs first, moving to higher-priced options only if the first therapies do not provide the desired result.

Building a formulary
Our team of more than 60 clinical pharmacists uses objective medical information and cost-benefit analysis to determine which drugs should be placed on our clients’ formularies. As we design our clients’ drug lists and formularies, we take into account these factors:

  • New-to-market drug reviews
  • Clinical guidelines
  • Therapeutic class reviews
  • Pharmacoeconomic analysis
  • Drug file changes

As the health care consulting division of a mission-driven, public medical school, we make evidence-based formulary recommendations. Our goal is to ensure that preferred drugs meet high standards for clinical efficacy, while also meeting the needs of our clients’ budgets.