Module 5: Overview After P&T – Important Considerations for Making Monograph Recommendations

Module Description

This module provides an overview of key considerations following a P&T committee review, with a focus on how formulary recommendations are translated into real-world coverage and management decisions. Learners will review the purpose and structure of formularies, including tier placement, and examine common utilization management strategies such as step therapy, prior authorization, site of care, and quantity limits.

Learning Objectives

At the completion of this activity, participants should be able to:

  • Explain the purpose of a formulary and formulary tiers. 
  • Describe the role of utilization management strategies.  
  • Summarize how formulary tier decisions and utilization management strategies are implemented and managed. 

 

Course summary

Course opens: 
09/17/2026
Course expires: 
12/31/2027
Cost:
$0.00
Part of: 
AMCP Foundation P&T Competition

Faculty/Authors:

Navya Garimella
Pharmacy Resident
Premera Blue Cross

Jenn Huynh
Pharmacy Resident
Premera Blue Cross

Kristen Patti, PharmD, MS  
Manager, Clinical Drug Evaluation & Policy 
Blue Cross Blue Shield of Michigan 

Reviewers:

Elizabeth Hill, PharmD, MBA 
Independent Managed Care Consultant 

Amy Lugo PharmD, BCPS, BC-ADM, FAPhA, FAMCP 
Founder and CEO 
Lonestar Health Solutions 

Kristen Patti, PharmD, MS  
Manager, Clinical Drug Evaluation & Policy 
Blue Cross Blue Shield of Michigan 

Price

Cost:
$0.00
Please login or register to take this course.

Required Hardware/software

Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating websites. View the minimum technical and system requirements for continuing education online activities.