Stream: Da Vinci PDex Drug Formulary
Topic: Mail Order Question
Saul Kravitz (Jan 28 2021 at 17:21):
Received this question:
We’re currently mapping a formulary to Coverage Plan (List) and FormularyDrug (MedicationKnowledge). The CoveragePlan profile has the mail order indicator (Yes/No) and it appears to be required under the usdf-DrugTierDefinition-extension. However, mail order is not a “plan-level” attribute. It is an attribute of the drug. e.g. I’m on Medicare Advantage plan and I can get Atorvastatin through mail order but I can’t get Adempas via mail order. Both drugs are in the same formulary. Has anyone come across this issue and, if so, how did you handle it?
Saul Kravitz (Jan 28 2021 at 17:30):
The current IG (based directly on the QHP formulary) only allows specification of mail order at the plan-level, as you noted. There is no facility to identify FormularyDrugs that do (not) have mail order options. You could submit a tracker against the IG for consideration on future revisions.
Saul Kravitz (Feb 04 2021 at 19:58):
https://jira.hl7.org/browse/FHIR-30925
Last updated: Apr 12 2022 at 19:14 UTC
