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PREFACE

The CHP/Healthy Families (HF) Formulary has been developed to act as a guide to aid plan providers when prescribing medications for plan members. The purpose of this guide is to provide a listing of drugs that have been determined to be therapeutically cost effective by the Pharmacy and Therapeutics (P&T) Committee. The committee meets on a regular basis to review new medications and any changes in the utilization of medications already on the market.

A CHP/HF provider can request a formulary medication addition or deletion by completing and submitting a Formulary Request Form to the P&T Committee for review. These forms will be sent to the providers when they call CHP/HF at (626) 299-5539 to make the request.

Plan providers are required to prescribe/dispense formulary and multisource drugs whenever possible. Should a plan physician decide that a non-formulary drug is medically needed, it will be necessary to get a prior authorization before the medication is dispensed. The prior authorization form will be sent to the provider for completion after calling CHP/HF at (626) 299-5539.

CHP/HF appreciates the efforts and cooperation for our medical and pharmacy providers in the care and treatment of our members.

VERSION 05/2002

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