When a drug that is not on the managed formulary is prescribed, special authorization is required.  A drug not on the managed formulary is only approved if it meets specific criteria laid out by the drug adjudicator and finally approved by a physician.

Drugs on the managed formulary and generic versions are automatically approved. Those not part of the formulary require special authorization.

 Authorization requires that certain criteria be met.  This may mean a less expensive alternative, a less invasive and more effective alternative, or a more expensive but more effective alternative.