Which statement describes non-formulary drugs?

Which statement describes non-formulary drugs?

• A. Drugs on the plan's preferred list and typically less expensive.
• B. Drugs not on the plan's preferred list and usually more expensive or not regularly stocked.
• C. Drugs that are not prescription medications but supplements.
• D. Drugs that are exclusively available through mail-order.

Answer: (B)

Non-formulary drugs are medicines not on the plan’s preferred formulary. Because formularies designate which drugs are covered with better terms, drugs outside that list are not considered preferred and are often more expensive or not stocked routinely. This is why they typically require extra steps like prior authorization and may lead to higher out-of-pocket costs for patients. The other statements don’t fit: drugs on the preferred list and usually cheaper describe formulary options, not non-formulary. Supplements are not prescription medications and aren’t defined by formulary status. A drug being available only through mail-order speaks to distribution, not its formulary designation.

Non-formulary drugs are medicines not on the plan’s preferred formulary. Because formularies designate which drugs are covered with better terms, drugs outside that list are not considered preferred and are often more expensive or not stocked routinely. This is why they typically require extra steps like prior authorization and may lead to higher out-of-pocket costs for patients.

The other statements don’t fit: drugs on the preferred list and usually cheaper describe formulary options, not non-formulary. Supplements are not prescription medications and aren’t defined by formulary status. A drug being available only through mail-order speaks to distribution, not its formulary designation.