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 2 of 2

Topic	Participants	Replies	Views	Activity
Revisiting: German, French and Dutch differences, compared Regional › European Union personal import formulary EMA cost per milligram Posting this under the heading it deserves: Revisiting: German, French and Dutch differences, compared Everything below is what sits behind that. A coverage question with the paperwork detail included, since…	+90	99	32k	9mo
Revisiting: Reading a denial letter as a specification for your appeal Access › Insurance & coverage prior authorisation insurance formulary appeals Posting this under the heading it deserves: Revisiting: Reading a denial letter as a specification for your appeal Everything below is what sits behind that. A coverage question with the paperwork detail…	+125	138	9.4k	10mo
Appeal templates and why they are deliberately unemotional — one year on Access › Insurance & coverage insurance appeals prior authorisation formulary Closed Appeal templates and why they are deliberately unemotional — one year on Writing it up because I had to work it out twice and would rather nobody else did. Documenting an access outcome, dated, because…		2	4.1k	11mo
EU-wide position versus national implementation Regional › European Union EMA personal import cost per milligram formulary Solved Under review EU-wide position versus national implementation Writing it up because I had to work it out twice and would rather nobody else did. Documenting an access outcome, dated, because everything in this category…	+22	29	356	11mo
Coming back to: Official shortage notices and what they authorise Access › Shortages FDA compounding shortage formulary Official shortage notices and what they authorise 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…	+85	92	5.5k	11mo
Revisiting: List price versus negotiated price versus what you pay Access › Pricing cost per milligram compounding data table formulary Revisiting: List price versus negotiated price versus what you pay — setting out what I have, and where I think it stops being reliable. A coverage question with the paperwork detail included, since that is…	+24	28	50k	12mo
[2026 update] Documentation that materially improves an appeal's chances Access › Insurance & coverage prior authorisation formulary appeals On the subject in the title: Documentation that materially improves an appeal's chances Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category…		2	2.4k	13mo
Pen wastage and its effect on real cost — the long version Access › Pricing formulary data table cost per milligram compounding Posting this under the heading it deserves: Pen wastage and its effect on real cost — the long version Everything below is what sits behind that. Documenting an access outcome, dated, because everything in…		2	34k	13mo
Coming back to: Why the cheapest option is often not the cheapest Access › Pricing formulary cost per milligram data table compounding Why the cheapest option is often not the cheapest — that is the question, and I have not found it answered plainly anywhere I have looked. Documenting an access outcome, dated, because everything in this…	+21	25	55k	13mo
Cost per milligram, computed honestly across formats — a second dataset Access › Pricing cost per milligram formulary compounding Closed Cost per milligram, computed honestly across formats — a second dataset Writing it up because I had to work it out twice and would rather nobody else did. A coverage question with the paperwork detail…		2	27k	13mo
[2026 update] An appeal that failed, and what I would do differently Access › Insurance & coverage prior authorisation insurance formulary Posting this under the heading it deserves: An appeal that failed, and what I would do differently Everything below is what sits behind that. Documenting an access outcome, dated, because everything in this…	+152	159	2.5k	13mo
Price changes over 2025 and 2026, tabulated and dated Access › Pricing formulary cost per milligram data table compounding Posting this under the heading it deserves: Price changes over 2025 and 2026, tabulated and dated Everything below is what sits behind that. Documenting an access outcome, dated, because everything in this…	+4	8	658	14mo
Cost per milligram, computed honestly across formats — the long version Access › Pricing cost per milligram compounding formulary data table Cost per milligram, computed honestly across formats — the long version Writing it up because I had to work it out twice and would rather nobody else did. A coverage question with the paperwork detail…	+111	124	24k	14mo
Coverage for the indication versus for the drug Access › Insurance & coverage insurance formulary appeals prior authorisation Coverage for the indication versus for the drug — 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…	+70	79	18k	14mo
About the Pricing category Access › Pricing cost per milligram formulary compounding Pinned Wiki List prices, negotiated prices, and cost per milligram compared honestly across formats. This post is a community wiki: any member at trust level 3 or above can edit it, and every edit is recorded with its…	+1	5	18k	15mo
Coverage for the indication versus for the drug — a second dataset Access › Insurance & coverage prior authorisation appeals formulary insurance Solved Closed On the subject in the title: Coverage for the indication versus for the drug — a second dataset Working notes rather than a conclusion. A coverage question with the paperwork detail included, since that is…	+46	50	41k	16mo
Second pass at: Manufacturer assistance programmes and their eligibility rules Access › Pricing cost per milligram data table compounding formulary Second pass at: Manufacturer assistance programmes and their eligibility rules — setting out what I have, and where I think it stops being reliable. Documenting an access outcome, dated, because everything in…	+13	17	1.8k	16mo
Prior authorisation: what the criteria usually require Access › Insurance & coverage prior authorisation formulary appeals insurance Solved On the subject in the title: Prior authorisation: what the criteria usually require Working notes rather than a conclusion. A coverage question with the paperwork detail included, since that is what…	+9	13	3.2k	17mo
Coming back to: Official shortage notices and what they authorise Access › Shortages shortage FDA formulary Solved Closed Official shortage notices and what they authorise — 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…	+39	43	510	17mo
Cost per milligram, computed honestly across formats Access › Pricing formulary cost per milligram data table Posting this under the heading it deserves: Cost per milligram, computed honestly across formats Everything below is what sits behind that. Documenting an access outcome, dated, because everything in this…		2	47k	18mo
[2026 update] EU-wide position versus national implementation Regional › European Union personal import cost per milligram formulary EMA Solved On the subject in the title: EU-wide position versus national implementation Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category expires. As of…		2	54k	19mo
Coming back to: Cost per delivered dose, which is the number that matters Access › Pricing formulary data table compounding cost per milligram Under review On the subject in the title: Cost per delivered dose, which is the number that matters Working notes rather than a conclusion. Documenting an access outcome, dated, because everything in this category…	+6	10	2.5k	19mo
EMA product information as a primary source — does this still hold? Regional › European Union EMA cost per milligram formulary personal import Solved Closed The question in the title: EMA product information as a primary source — does this still hold? I will give what I have already checked below so nobody repeats it. Documenting an access outcome, dated, because…	+127	150	41k	20mo
Second pass at: Reimbursement variation across member states Regional › European Union personal import formulary cost per milligram EMA On the subject in the title: Second pass at: Reimbursement variation across member states Working notes rather than a conclusion. A coverage question with the paperwork detail included, since that is what…	+23	28	45k	21mo
Pen wastage and its effect on real cost Access › Pricing cost per milligram compounding formulary data table Pen wastage and its effect on real cost 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 determines…	+29	33	19k	21mo
Hoarding and why it makes a shortage worse Access › Shortages formulary shortage compounding FDA Posting this under the heading it deserves: Hoarding and why it makes a shortage worse Everything below is what sits behind that. Documenting an access outcome, dated, because everything in this category…		2	12k	22mo