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FAQ

Frequently Asked Questions (FAQ)

What can I do to ensure my personal safety and the safety of my family when it comes to medication errors?

Although rare, medication errors can be fatal. Patient awareness and active involvement can decrease fatalities. eRemedy advises the following:

TEN TIPS ON MEDICATION SAFETY

  1. Talk with your doctor about your prescription. As the practitioner gives you your prescription, ask what drug is being prescribed and in what strength. Be sure the instructions to use the medication are clearly explained.
  2. Make sure you can read the prescription you receive from your Doctor. If you can't read the prescription, ask for the name of the medicine to be printed out. If you can't read directions for taking the medication, ask for printed instructions. This issue is not a concern if your doctor is using eRemedy.
  3. When you receive a prescription, make sure you know what illness the prescribed drug is to treat and the exact way you should take the medication.
  4. When you receive the filled prescription from your pharmacist, check the prescription label. Is the medication what your practitioner prescribed? Are the directions consistent with what the doctor told you?
  5. As you receive the product, ask the pharmacist to discuss the nature of the product, how it works, possible side effects, and how to most effectively take the prescription.
  6. Ask your pharmacist for a patient information brochure about the medicine and how to use it.
  7. When obtaining a refill, make sure it is the same color, shape, size and dosage as your original prescription. An exception may be when you receive a generic product. In this case, discuss and ensure with your pharmacist that the product you are receiving contains the same medicine, at the same strength.
  8. Keep a record of the names of all your medicines and what they look like. Should you receive a medication that is a different shape, size, or color, update the list when refilled.
  9. Buy a drug information resource book, or locate a guide on the Internet. In either case, make sure that the resource contains color pictures of the medications.
  10. If you are sight impaired, ask for assistance from your pharmacist. If you have trouble with your eyesight, ask the pharmacist to use different sizes or types of containers to help you differentiate your medicines. Some pharmacists will prepare special packages for patients who take a number of different medications at specific times throughout the day.

What is a generic drug?

A prescription or non-prescription drug that is chemically equivalent to a brand-name product. Once the patent on a pharmaceutical drug expires, any drug company can manufacture and dispense the drug under its generic chemical name. Generic drugs are usually less expensive than branded products. The Federal Drug Administration (FDA) requires that a generic drug be therapeutically equivalent to a brand-name product.

Does every drug have a generic equivalent?

Newly developed drugs may only be available under a brand name. This is due to the fact that drug companies typically hold patents on drugs. Patents prohibit other companies from making the same drug for a period of time so that the pharmaceutical company that developed the drug can recoup its research costs.

FORMULARY FAQ

What is a formulary?

The list of prescription drugs that your health plan will cover is called a formulary. Each health plan has its own formulary. Typically, your health plan will not pay for prescription drugs not listed on its formulary. However, all HMOs will offer at least one drug, either generic or brand name, designed to meet your specific health needs.

What is DAW?

DAW stands for "Dispense As Written". Some HMOs do allow for exceptions to be made to their formulary based on your doctor's recommendation and notation of DAW on your prescription.

How do HMOs develop their formularies?

Your HMO decides which drugs to offer on its formulary based on research on the clinical effectiveness and safety of the drug and its cost. As new drugs are introduced, your health plan may re-evaluate its formulary list and modify the drugs available to patients. For example, if a more effective drug for treating asthma becomes available, your health plan may replace an existing drug with a new one.

What do formularies mean to me as a consumer?

Typically, your health plan only covers the costs of the pharmaceuticals on its formulary. If you want full cost coverage for your prescription drugs, you will be limited to those drugs listed on the plan's formulary. If your doctor wishes to prescribe a pharmaceutical that is not on your health plan's formulary, you will need the plan's approval to get reimbursed for the cost of that drug. You should also be aware that the health plan formulary may change on a quarterly basis. That means that a drug currently listed on the formulary may be removed and a new or alternate drug added. You should contact your HMO member services for its most current formulary list.

How can I get an exception to my health plan's formulary?

Each health plan has a process in place to evaluate and approve medical exceptions which is typically termed prior authorization process. It generally requires a form to be filled and submitted by your primary care physician. You may also ask your health plan about the processes used by your health plan.