Retail Preferred Product List definition
Retail Preferred Product List means, for the purposes of the SHBP, the list of Covered Drugs that are referred to as “preferred”, “non-preferred” or “neutral” for purposes of benefit and coverage decisions in the SHBP pharmacy benefit plan offered to covered Members. The Retail Preferred Product List is developed by the Contractor’s Pharmacy and Therapeutics Committee (“P&T Committee”) taking into consideration safety, medical appropriateness, efficacy, quality of life, and relative cost indications within applicable therapeutic categories. The Retail Preferred Product List will be maintained by the Contractor, and may be modified from time to time by the Contractor, as a result of the factors described above and new therapeutic agents that become available. Notwithstanding the foregoing, the Contractor will consult with DCH in the development of and subsequent modification(s) to the Retail Preferred Product List. At least quarterly, the Contractor will deliver a copy of the Retail Preferred Product List, and any updates thereto, to DCH and to the Retail Pharmacy Network at the Contractor’s sole expense, and to Members in a format mutually agreed upon by the Parties and pursuant to the applicable provisions of Exhibit III. DCH shall retain the right, in its sole discretion, to determine the level and coverage of benefits under the SHBP, including the determination of Covered Drugs and non-Covered Drugs, and Prior Authorization of Covered Drugs.