Quarterly Formulary Updates

Formulary2Highmark regularly updates our prescription drug formularies and related pharmaceutical management procedures. To keep our network physicians apprised of these changes, we provide quarterly formulary updates on the Formulary Updates page under Pharmacy Program/Formularies.

Providers who do not have internet access or do not use NaviNet® may request paper copies of the formulary updates by contacting Highmark’s Pharmacy department at 800-600-2227.

Pharmaceutical Management Procedures

To learn more about how to use pharmaceutical management procedures refer to the Pharmacy Program/Formularies pages, accessible from the left-hand menu on the Provider Resource Center.

This section includes information on:

  • Providing information for exception requests
  • The process for generic substitutions
  • Explanations of limits/quotas, therapeutic interchange, and step-therapy protocols

Federal Employee Program (FEP) Drug Formularies and Pharmaceutical Management Procedures

The FEP specific drug formularies are available online . Providers who don’t have internet access may obtain formulary information via phone by using the below toll-free numbers and following the prompts for Pharmacy:

  • Delaware: 800-721-8005
  • Pennsylvania: 866-763-3608
  • West Virginia: 800-535-5266
  • New York: 800-234-6008

To learn more about the FEP exception request processes for non-formulary drugs, click here .