Has your insurer ever switched your drug without talking to you or your doctor? This is called a formulary exclusion. But what risk does this pose to patients suffering from chronic illness?

"There is some action that can be taken to prohibit this type of practice. Or at least—for the minimum—to mandate that pharmacy benefit management companies and insurers that are doing, and implementing such policies, are held accountable," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode: 

1:09- Listener review

1:41- What is a drug formulary exclusion?

2:16- Who implements these formulary exclusion policies and how do they benefit from it?

2:50- Which drugs are most likely to be excluded from formularies

3:26- The impacts formulary exclusions have on people with chronic illness 

4:45- What it means when patients are forced to change medications 

6:04- How the care of a patient is being taken away from doctors because of formulary exclusion

7:02- What are the incentives for pharmacy benefit managers to follow these exclusionary guidelines?

8:25- What's being done about this practice? 

8:46- Robert shares the bottom line on personalized and precision medicine 

Contact our hosts: 

Dr. Robert Popovian, Chief Science Policy Officer at GHLF, rpopovian@ghlf.org 

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF, cmertens@ghlf.org 

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