Introduction
The University of Michigan formulary is an open formulary, most self-administered outpatient prescription medications are covered whether listed in the formulary or not. Specifically excluded drugs and member cost share for drugs included on the formulary are determined by the clinical judgment of the Pharmacy Benefits Advisory Committee (PBAC), an appointed committee of University of Michigan physicians and pharmacists, based on published medical evidence in the diagnosis and treatment of disease. For more information about excluded drugs and drugs with special limitations and coverage requirements, view the Chart of Drugs with Coverage Requirements and Limitations.

Disclaimer
Please be advised that the formulary is updated periodically and changes may appear prior to their effective date to allow for client notification. The University of Michigan does not warrant or assure accuracy of such information nor is it intended to be comprehensive in nature. The medical provider should consult the drug manufacturer's product literature or standard references for more detailed information.

Finding a Drug on the Formulary
For your convenience, two formulary versions are provided. The formulary is provided sorted by drug name and by therapeutic groups (either drug class or disease state). Every effort is made to ensure complete and accurate information, however this is a manually maintained document. Your most accurate source of medication coverage and member cost is the on-line pricing tool at https://umi.rxportal.sxc.com. The RxPortal pricing tool will not provide cost estimates for the Generic Incentive Program Penalty, medications that required prior authorization, or the co-pay reductions for members who qualify for the Focus on Diabetes program.

Legend

Coverage and Tier placement: For more information, see drug co-pays.

Tier 1 - Low Copay: All generic drugs.

Tier 2 - Intermediate Co-pay: Preferred brand name products selected by the University of Michigan plan for the intermediate co-pay.

Tier 3 - High Co-pay: Brand name products not selected for Tier 2. In most cases there are alternative medications available in Tier 1 or Tier 2.

OTC - Over-the-Counter: medications available without a prescription and their prescription alternatives are not covered by the plan.

PA - Prior Authorization: For more information about drugs with PA and other special coverage requirements, view the Chart of Drugs with Coverage Requirements and Limitations.

Message: If there is unique coverage information regarding a particular medication it will be provided here.

Navigating
The formulary is a PDF, which requires the free Adobe Acrobat Reader to open. You can use the reader navigation tools to find the drug information you are looking for.

• Using the Search Feature

1. Click the Find button on the Acrobat Reader toolbar or choose Find from the Edit menu.
2. Enter the word to find in the Find What box.
3. Click Find. Acrobat Reader finds the first occurrence of the word.
4. To find the next occurrence of the word, click Find Again.

• Using the Zoom In Tool
  To increase the display size of a page, select the zoom-in tool , and click the page. Each subsequent click increases the magnification.

Printing
Before printing the formulary, keep in mind it is over 100 pages long. You may find it more convenient to print only the pages you need. Controls may vary between printers, but the functions should be similar to these general instructions.

• To print a single page :
1. Navigate to the page you want to print.
2. Click File, and then click Print.
3. In the printer dialog box, under Print Range, click the Current page radio button.
4. Click the OK button.
• To print multiple pages :
1. Navigate to the first page of the section you would like to print.
2. Make note of the page number in the readout at bottom of the screen. For example, page 10 is displayed as "10 of 100." Then navigate to the last page of the section you want to print and note its page number.
3. Click File, and then click Print.
4. In the printer dialog box, under Print Range, click the Pages from: radio button.
5. Enter the first and last page numbers of the section you want to print in the entry boxes.
6. Click the OK button.

Troubleshooting
If you have trouble opening or printing the formulary PDF, view the PDF Help page. View Acrobat Reader Help if you need help navigating within the PDF.

U-M Formulary Sorted by Drug Name (PDF)

U-M Formulary Sorted by Therapeutic Group (PDF)
(by drug class or disease state)