Tags · Access

formulary

The list that decides what is covered and at what tier.

56 topics 16 solved Group: Access

Related in this group: insurance · prior authorisation · appeals · cost per milligram · compounding · shortage · NHS · EMA · FDA · MHRA · personal import · telehealth

56 topics · page 1 of 2

Topic	Participants	Replies	Views	Activity
Follow-up: Prior authorisation: what the criteria usually require Access › Insurance & coverage insurance appeals formulary prior authorisation Solved Prior authorisation: what the criteria usually require — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is what…	+95	100	9.1k	10h
German, French and Dutch differences, compared Regional › European Union cost per milligram formulary EMA German, French and Dutch differences, compared — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is what determines the…		2	12k	10h
Why the cheapest option is often not the cheapest Access › Pricing compounding formulary cost per milligram data table Solved Wiki Why the cheapest option is often not the cheapest I have a specific reason for asking rather than idle curiosity, and the context is below. Documenting an access outcome, dated, because everything in this…	+19	23	1.2k	12h
Tracking a shortage from primary sources rather than rumour Access › Shortages shortage FDA formulary Tracking a shortage from primary sources rather than rumour — setting out what I have, and where I think it stops being reliable. Documenting an access outcome, dated, because everything in this category…	+121	126	35k	13h
Follow-up: External review after an internal denial Access › Insurance & coverage prior authorisation formulary insurance Solved Posting this under the heading it deserves: External review after an internal denial Everything below is what sits behind that. A coverage question with the paperwork detail included, since that is what…	+6	10	12k	15h
How shortages have affected compounding permissions — does this still hold? Access › Shortages compounding shortage formulary FDA Solved How shortages have affected compounding permissions — does this still hold? — that is the question, and I have not found it answered plainly anywhere I have looked. A coverage question with the paperwork…	+27	31	21k	17h
Prior authorisation: what the criteria usually require — a second dataset Access › Insurance & coverage prior authorisation insurance formulary appeals Posting this under the heading it deserves: Prior authorisation: what the criteria usually require — a second dataset Everything below is what sits behind that. A coverage question with the paperwork detail…	+67	74	19k	21h
[2026 update] Comparing prices across jurisdictions without misleading yourself Access › Pricing formulary compounding data table On the subject in the title: Comparing prices across jurisdictions without misleading yourself Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category…		2	809	23h
Peer-to-peer review: what actually happens on the call Access › Insurance & coverage prior authorisation appeals formulary On the subject in the title: Peer-to-peer review: what actually happens on the call Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category expires.…		2	1.2k	1d
An appeal that succeeded, with the letter structure Access › Insurance & coverage appeals formulary prior authorisation insurance On the subject in the title: An appeal that succeeded, with the letter structure Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category expires. As…	+12	16	15k	1d
Tracking a shortage from primary sources rather than rumour — the long version Access › Shortages compounding formulary FDA Solved On the subject in the title: Tracking a shortage from primary sources rather than rumour — the long version Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in…		2	60	1d
How shortages have affected compounding permissions Access › Shortages shortage compounding FDA formulary How shortages have affected compounding permissions I have a specific reason for asking rather than idle curiosity, and the context is below. A coverage question with the paperwork detail included, since that…	+61	71	3.6k	2d
Substitution between formats during a shortage — what changed since Access › Shortages shortage formulary FDA compounding Solved Substitution between formats during a shortage — what changed since — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is…	+17	21	2.7k	9d
Manufacturer assistance programmes and their eligibility rules Access › Pricing formulary data table compounding On the subject in the title: Manufacturer assistance programmes and their eligibility rules Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category…	+37	42	32k	11d
An appeal that succeeded, with the letter structure — the long version Access › Insurance & coverage appeals formulary insurance An appeal that succeeded, with the letter structure — the long version — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that…	+113	136	32k	1mo
Official shortage notices and what they authorise Access › Shortages compounding formulary shortage Posting this under the heading it deserves: Official shortage notices and what they authorise Everything below is what sits behind that. Documenting an access outcome, dated, because everything in this…	+106	119	18k	1mo
External review after an internal denial Access › Insurance & coverage appeals prior authorisation insurance formulary Solved External review after an internal denial Writing it up because I had to work it out twice and would rather nobody else did. A coverage question with the paperwork detail included, since that is what…		2	18k	1mo
Step therapy requirements and how to satisfy them Access › Insurance & coverage prior authorisation insurance formulary Posting this under the heading it deserves: Step therapy requirements and how to satisfy them Everything below is what sits behind that. A coverage question with the paperwork detail included, since that is…	+21	25	49k	2mo
EU-wide position versus national implementation — what changed since Regional › European Union EMA cost per milligram personal import formulary Pinned EU-wide position versus national implementation — what changed since Writing it up because I had to work it out twice and would rather nobody else did. A coverage question with the paperwork detail included,…	+22	26	58k	2mo
Managing an unplanned gap in supply Access › Shortages shortage formulary FDA compounding Managing an unplanned gap in supply — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is what determines the answer.…	+105	110	5.1k	3mo
Price changes over 2025 and 2026, tabulated and dated — does this still hold? Access › Pricing compounding formulary cost per milligram Solved Price changes over 2025 and 2026, tabulated and dated — does this still hold? I have a specific reason for asking rather than idle curiosity, and the context is below. Documenting an access outcome, dated,…	+147	156	18k	3mo
List price versus negotiated price versus what you pay Access › Pricing formulary data table compounding Under review On the subject in the title: List price versus negotiated price versus what you pay Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category expires.…	+99	115	11k	3mo
Cost per delivered dose, which is the number that matters Access › Pricing cost per milligram data table compounding formulary Solved Cost per delivered dose, which is the number that matters — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is what…	+54	59	30k	4mo
Peer-to-peer review: what actually happens on the call — one year on Access › Insurance & coverage appeals formulary insurance Peer-to-peer review: what actually happens on the call — one year on — setting out what I have, and where I think it stops being reliable. Documenting an access outcome, dated, because everything in this…	+2	6	41k	5mo
Appeal templates and why they are deliberately unemotional Access › Insurance & coverage formulary insurance prior authorisation appeals Posting this under the heading it deserves: Appeal templates and why they are deliberately unemotional Everything below is what sits behind that. Documenting an access outcome, dated, because everything in…	+25	29	764	7mo
Substitution between formats during a shortage Access › Shortages compounding FDA formulary shortage Solved Closed On the subject in the title: Substitution between formats during a shortage Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category expires. As of…	+114	123	47k	7mo
Documentation that materially improves an appeal's chances Access › Insurance & coverage insurance appeals formulary prior authorisation Documentation that materially improves an appeal's chances — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is what…	+93	98	3.6k	8mo
Cross-border purchase rules within the EU Regional › European Union personal import formulary cost per milligram EMA On the subject in the title: Cross-border purchase rules within the EU Working notes rather than a conclusion. A coverage question with the paperwork detail included, since that is what determines the answer.…	+45	49	15k	8mo
Managing an unplanned gap in supply — what changed since Access › Shortages compounding FDA formulary On the subject in the title: Managing an unplanned gap in supply — what changed since Working notes rather than a conclusion. A coverage question with the paperwork detail included, since that is what…	+114	124	54k	8mo
EMA product information as a primary source Regional › European Union personal import formulary EMA Posting this under the heading it deserves: EMA product information as a primary source Everything below is what sits behind that. Documenting an access outcome, dated, because everything in this category…	+70	74	7k	8mo

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