For Health Plans, PBMs, and TPAs, formulary management stands as a critical pillar in ensuring optimal patient care while managing costs effectively. As complexities surrounding formularies continue to mount, traditional approaches lack efficiency and are proving insufficient in meeting dynamic needs. At Agadia, we are continually working to deliver innovative solutions to address such needs in the Utilization Management space. One of our newest solutions, FormularyHub, is poised to transform formulary management and streamline processes for enhanced efficiency and efficacy.

Formulary Benefit Design

Addressing the Challenge:

With the constant influx of new drugs and evolving regulatory requirements, the manual administration and communication of formulary changes have become cumbersome tasks for healthcare organizations. The need for a solution that can adapt to these challenges and provide a streamlined approach to formulary management has never been more urgent.

Introducing FormularyHub:

FormularyHub represents a paradigm shift in formulary management, offering an end-to-end solution that can be tailored to meet the unique requirements of each customer. This comprehensive solution empowers Health Plans and PBMs to take control of the creation, implementation, and maintenance of both pharmacy and medical benefit formularies with unprecedented ease and efficiency.

Key Features and Benefits:

Flexibility & Control:

  • Control the creation, implementation, and maintenance of custom and standard formularies
  • Drive utilization of preferred alternatives
  • Create, administer, and manage both pharmacy and medical benefit formularies through a centralized solution in an automated fashion
  • Request customization to develop and produce member and client-specific communications


  • Ensure compliance with state and CMS regulations for file submission and website publishing
  • Leverage FormularyHub’s built-in workflow engine for quality control measures, as well as the Formulary Reference File to create new formularies, update existing formularies, compare changes, and submit content to CMS for approval
  • Access robust reporting to track all formulary file changes and configuration updates

Efficiency through Automation:

  • Automate the production of formulary guides
  • Request customization to seamlessly integrate with existing claims systems, e-prescribing networks, enterprise physicians, and member-facing platforms to ensure a smooth transition and minimal disruptions to ongoing operations

Unlocking Efficiency and Efficacy:

By automating processes, providing real-time access to critical information, and offering unparalleled configurability, FormularyHub empowers health plans, PBMs, and TPAs to navigate the complexities of formulary management with confidence and precision.

Why Health Plans and PBMs Choose FormularyHub:

Agadia’s web-based solution, FormularyHub, presents a transformative approach to formulary management that holds immense promise for Health Plans and PBMs.

Ensure CMS Compliance: The solution’s robust regulatory features empower Health Plans and PBMs to stay abreast of regulatory changes, mitigate compliance risks, and facilitate seamless adherence to guidelines. This not only safeguards the organizations from penalties but also nurtures trust among stakeholders by demonstrating a commitment to regulatory compliance.

Robust Reporting: The platform meticulously tracks all formulary file changes and configuration updates, delivering comprehensive insights into the evolution of formularies over time. This enables Health Plans and PBMs to perform audits, track performance metrics, and make informed decisions about formulary adjustments. Moreover, FormularyHub leverages these insights to generate member-centric communications, enhancing transparency and fostering better patient-provider relationships.

Experience the future of formulary management with FormularyHub – where innovation meets efficacy, and complexity meets simplicity.

Click here to schedule a demo.

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