Formularies

Formularies define the set of covered drugs used when evaluating prior authorization requests. Each formulary can be linked to guidelines and scoped to specific business units.

Accessing formularies

From the Settings gear menu in the top navigation, select Formulary Manager.

The formulary list

The page shows a searchable table of all formularies. The columns are:

• Name — the formulary name.
• Description — a short description of the formulary (shown truncated if long).
• Managed BUs — the number of business units this formulary applies to.
• Guidelines — the number of guidelines linked to this formulary.

Use the search field at the top to filter by name.

Viewing a formulary

Click any row to open the Formulary Details panel on the right side of the screen. The panel shows:

• The formulary name and description.
• Managed Business Units — the business units that use this formulary, shown as chips.
• Guidelines — the guidelines linked to this formulary, each shown as a link you can open directly.
• Public formulary page — whether this formulary is published, its public URL slug, and a Copy URL button.

Pharmacy notices for excluded medications

When a formulary is in edit mode, Fax pharmacy and Pharmacy Contact Mode set whether pharmacies receive determination faxes, and whether those faxes go automatically or are held for staff. Exclusion notices follow these settings. A Fax pharmacy or Pharmacy Contact choice on an individual exclusion takes priority over them, and Default (inherit from tenant) uses your organization’s setting.

Publishing a formulary to a public page

Each formulary can have its own public page that prescribers and members can open without signing in. Nothing is public until you turn it on.

Setting up the public page, in order

1. Confirm your organization has a public slug. A GEMA administrator sets this in Tenant Details; until it is set, no formulary page can be shared.
2. Set this formulary’s Public URL slug, turn on Publish formulary page, and select Save.
3. Publish each guideline you want visitors to see, by turning on Publish on public formulary pages for it in Guideline Manager. See Configuring Guidelines.
4. Select Copy URL and share the address. See Provider Portal for what visitors see.

Steps 1 and 2 only make the page reachable. Step 3 is what puts policies on it, so work through the guidelines before you share the address.

Setting the slug and publishing

Open the formulary details and select Edit. Two controls in the edit form control the public page:

• Public URL slug — the short name that appears at the end of the public web address. Use lowercase letters, numbers, and hyphens only. The slug must be unique among your formularies; if you save a slug another formulary is already using, a message tells you that the public URL slug is already used by another formulary and nothing is saved. Correct the slug and save again.
• Publish formulary page — the switch that makes the page reachable at its public address. Only guidelines you have separately published appear on it.

Select Save to apply both. Leaving the slug empty or turning the switch off takes the page back offline; visitors then see a short message saying the formulary is not available.

Reading the current state

Back in the read-only details panel, the Public formulary page section shows Published or Not published, followed by the slug when one is set.

Copying the public URL

Select Copy URL to put the full public web address on your clipboard. A confirmation message appears when the address is copied.

Copy URL is unavailable until everything the address needs is in place. Hover over the button to see what is still missing:

• Set a public slug for the tenant before copying this URL. — your organization has no public short name yet. A GEMA administrator sets this in Tenant Details.
• Set a public slug for this formulary before copying this URL. — the formulary has no Public URL slug.
• Publish this formulary before copying its public URL. — the slug is set but Publish formulary page is still off.

Once all three are satisfied, the button becomes available and its tooltip reads Copy the public formulary URL.

If your published page has no policies

A page that reads No policies are currently published for this formulary. is working as expected — the formulary is published and reachable, but none of its guidelines are published yet. Publishing a formulary does not publish its guidelines.

To fill the page, open each guideline linked to this formulary and turn on Publish on public formulary pages in Guideline Manager.

Two things to check while you do that:

• A guideline appears only if it is linked to this formulary. The Guidelines section of the formulary details lists the ones that are; add any that are missing in Edit.
• Enable this guideline does not control public visibility. A guideline can be enabled and still be absent from the page, and a published guideline stays on the page even when it is turned off.

Creating a formulary

This action is available to tenant administrators. Select New Formulary in the upper-right corner of the page. The New Formulary panel opens on the right. Fill in:

• Name (required)
• Description (optional)
• Business units — which business units this formulary manages.
• Guidelines — which guidelines the formulary is linked to.

Select Save when done. The new formulary appears in the list immediately.

Editing a formulary

Open the formulary details by clicking its row, then select Edit in the panel. In edit mode you can update the name, description, Public URL slug, the Publish formulary page switch, business unit assignments, and guideline links. You can also manage the drugs within the formulary in this view. Select Save to apply your changes. If a save cannot be completed, a message explains why — for example, that the public URL slug is already used by another formulary.

Deleting a formulary

Open the formulary details and select Delete. Confirm the deletion when prompted. Deleting a formulary removes it from all linked guidelines and business units.