Which formulary tier is typically designated for non-preferred brands with higher cost?

• A. Formulary Tiers 1
• B. Formulary Tiers 2
• C. Formulary Tiers 3
• D. Formulary Tiers 4

Answer: (C)

Formulary tiering assigns drugs to levels that correlate with cost-sharing and formulary status. Generics sit at the lowest tier with the smallest copay, then preferred brands at a moderate tier, and non-preferred brands with higher costs are placed in the next tier to reflect higher patient cost sharing. This structure encourages use of lower-cost, clinically appropriate options while still allowing access to more expensive, non-preferred brands when needed, albeit with a higher out-of-pocket burden. Tier four is usually reserved for specialty or very high-cost drugs that often involve additional requirements. So, non-preferred brands with higher cost are designated to the third tier.