When reviewing your prescription drug formulary, you may notice different types of medications listed. Understanding these categories will help you better navigate your pharmacy benefits and have better conversations with your doctors.

 

Your covered drugs often have a mix of the following to ensure medications are both clinically appropriate and cost effective for your needs:

 

Brand-name medications are sold under a proprietary, trademarked name by the manufacturer. These drugs are approved by the U.S. Food and Drug Administration (FDA) and undergo extensive testing for safety and effectiveness. The manufacturer typically holds exclusive marketing rights for a set period, during which time generic versions can't be marketed. Brand-name medications are often more expensive.

 

Generic medications are chemically identical to their branded counterparts but generally have lower prices. Generics are reviewed and approved by the FDA and feature the same safety, efficacy, quality, benefits, strength, and dosing as their brand-counterpart. Generics are typically lower in cost than brand-name medications.

 

Biosimilar medications are biological products that are highly similar to an already FDA-approved biologic, known as the reference product. While made with living organisms and not identical to the original drug, a biosimilar has no clinically meaningful differences in terms of safety, purity, and effectiveness. Biosimilars must meet rigorous FDA standards to be approved. Biosimilars offer a lower cost alternative to brand-name medications.

 

Understanding these medication types can make it easier to review your coverage, understand treatment options, and navigate your pharmacy benefits with confidence!

Connect

You can learn more about your pharmacy benefit and explore helpful resources anytime at pbdrx.com/members. As always, if you have specific questions about your coverage, Pharmacy Benefit Dimensions Member Services Department is available Monday through Friday from 8 a.m. to 11 p.m. ET. at (716) 635-7880 or 1-888-878-9172 (TTY/TDD users can call 711).