Processes
Manage drug Formulary
How manage drug formulary are reshaped as AGI capability advances.
ProcessesManage drug Formulary
Business-as-Code
Read as an executable program — the work decomposed into Code, Generative, Agentic, and Human.
Manage drug Formulary sits inside a larger value-flow — 1 parent structure it composes into. The hierarchy is grounding, not the story: it tells you which aggregate exposure Manage drug Formulary inherits.
Where Manage drug Formulary sits
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How the work flows
Trigger: A scheduled review cycle initiates, or a new prescription drug enters the market following regulatory approval.
- Monitor regulatory approvals and drug market changes
- Conduct clinical evaluation via Pharmacy and Therapeutics committee
- Analyze financial impact and negotiate manufacturer rebates
- Assign medications to formulary tiers and define utilization rules
- Update pharmacy benefit systems with new coverage criteria
- Distribute updated formulary guidelines to members and providers
Outcome: The health plan's approved list of covered medications is updated, categorized by cost-sharing tiers, and distributed to claims systems and stakeholders.
Measured by
Pharmacy Cost Per Member Per MonthGeneric Dispensing RateFormulary Update Cycle TimeRebate Yield