Student Health Pharmacy

Formulary Guidelines

A formulary is simply a list of drugs.  This list is not all inclusive and may be subject to change as new products and information become available.  Some of the brand name drugs are available under multiple brand names.  This list may not include all the brand names that are available for a specific drug.  The list is updated monthly and subject to change. 

Newly Approved Prescription Drugs

Brand name drugs that are newly available and approved by the FDA will be considered non-formulary until review by the Student Health Pharmacy Formulary Committee to determine if they will be added to the formulary.  The committee meets once every semester.

Quantity Limits

There are some drugs that may be less effective or even dangerous when taken at higher than normal doses.  These drugs have quantity limits consistent with the manufacturers’ recommendations.  The actual quantity limits are noted on the formulary.  Your pharmacist has authorization to dispense only up to the specified quantity limit.

Limitations

• Summary of clinical practice guidelines for appropriate use of treatment of acute respiratory tract infections in adults to be applied to anti-biotic usage subject to quarterly review.
• Accutane is excluded with exceptions of cystic acne diagnosis.
• Medications for treatment of attention deficit disorders are covered expenses only when pre-approved by the psychiatrist on staff at Student Health Services.
• Medications stocked in Student Health Pharmacy inventory.

Exclusions

• Fertility drugs;
• Non-legend prescription drugs other than insulin;
• Therapeutic devices or appliances such as hypodermic syringes, support garments, and similar items;
• Experimental drugs or, as noted above, medications that are not maintained on the formulary;
• Retin-A after age 26
• Immunization agents, biological sera, blood or blood plasma;
• Prescription drugs for smoking cessation or other health enhancement programs;
• Medications which are subject to pre-authorization;
• Prescription drugs for treatment of obesity;
• Medications for treatment of sexual dysfunction;
• Medication special orders for medications not regularly stocked in Student Health Pharmacy.

Non-Formulary Drugs

A non-formulary drug request form must be submitted to fill prescriptions for medications not listed in this formulary.  Non-formulary medications are subject to the deductible, co-insurance and exclusion provisions of the Student Health Insurance Program.  Full charges will be placed on your student account and a claim will be submitted to Klais & Company, Inc. on your behalf.  Reimbursements after satisfaction of your deductible will be credited to your student account.  You will receive an Explanation of Benefits for any claims submitted on your behalf.