For example, Prozac, which is an SSRI-class antidepressant, is slightly more expensive than many other antidepressants, whether they are SSRI or tricyclic. The same review process is used on new laboratory devices and new technologies, such as a new digitized system to evaluate Pap smears in women or new heart technologies, such as smaller heart-resuscitation machines. The pharmacy and therapeutics committees are usually composed of pharmacists and physicians who do literature reviews of controlled studies about which drugs work best or which one works best for other complications. They may select the five or so that they think are the best and the most cost effective for the course of therapy. Take Prozac, for example.
Some physicians dispense it very readily.
But this gets into difficult areas. And if there are restrictions on the physicians, then liability issues may arise for the plan rather than the physician. They are composed of providers, pharmacists and physicians who review the literature and published scientific data, such as from The Journal of the American Medical Association and The New England Journal of Medicine. The committee makes decisions based on whether the drug is good or better than other similar medications, and how it fares in clinical trials. It also considers safety issues, such as side effects.