Selection of Formulary Sample Clauses

Selection of Formulary. Prior to the Effective Date of this Agreement, Sponsor and PBM shall discuss and review PBM’s standardized Formulary. Xxxxxxx agrees to adopt the Formulary as of the Effective Date unless otherwise agreed upon by the parties. a. The parties agree that PBM may review and make changes with a forty-five (45) day notice to the Formulary from time to time during the term of this Agreement for safety and efficacy as necessitated by accepted medical and pharmacy practice, and based on drug price changes and Financial Benefits available for each drug. With respect to all such recommendations, PBM will ensure that all such recommended changes are made in the interests of Sponsor and Members. Unless medical and pharmacy practice requires the favoring of a higher net cost drug in a therapeutic category, PBM shall favor lower net cost drugs in each therapeutic category when making recommendations for Formulary changes. b. The parties further agree that Sponsor shall also have the right to make changes in the Formulary, as Sponsor deems appropriate. Should Sponsor consider any such Formulary changes, PBM shall be obligated to provide information to Sponsor concerning (a) the safety and efficacy of any such Formulary change; and (b) any changes in Financial Benefits that may result from Sponsor’s Formulary changes. Other than the possible change in Financial Benefits Sponsor will not incur any further charges or fees including but not limited to custom formulary management fees. Sponsor will notify PBM in advance of any Benefit Plan changes that may materially affect PBM’s ability to perform formulary management and/or other services described in this Agreement. c. The parties acknowledge that the prescribing physician has ultimate authority to determine which drug is prescribed to a Member.

Selection of Formulary. NDPERS may use PBM’s standardized formulary or customize its own formulary. The formulary that NDPERS implements for said Plans is referred to in this Agreement as the “Formulary.” NDPERS understands and agrees that if NDPERS chooses to use PBM’s standardized formulary, NDPERS may not change said formulary. However, if NDPERS customizes its formulary, NDPERS shall have sole discretion how to do so, subject to PBM’s right to request and obtain changes to Financial Guarantees as described in Section 2.6 of this Agreement. If NDPERS wishes to consider customization of its Formulary for its Plan Beneficiaries, or implements a customized Formulary, PBM agrees to provide the following information to NDPERS: (a) the safety and efficacy of any identified Covered Items; (b) the net drug cost of any identified Covered Items, factoring in potential Financial Benefits that might be passed through; and (c) a disruption analysis for NDPERS to assess the likely impact of using PBM’s standardized formulary or customizing PBM’s standardized formulary, or implementing changes to its customized Formulary.