TMRW

Pharmacy

Specialty drug

A high-cost prescription typically used for complex conditions (cancer, MS, rheumatoid arthritis). Specialty drugs are usually placed in a separate formulary tier with higher cost-sharing and often require prior authorization plus delivery through a specialty pharmacy.

Last reviewed: · TMRW Benefits is a benefits brokerage, not a tax or legal advisor. Consult a CPA or attorney for situation-specific guidance.

Related terms

Formulary

List of drugs covered by a plan, in tiers.

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Prior authorization

Insurer pre-approval for certain treatments.

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PBM (Pharmacy Benefit Manager)

Manages prescription drug benefits.

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More in Pharmacy

Formulary

List of drugs covered by a plan, in tiers.

Prior authorization

Insurer pre-approval for certain treatments.

Step therapy

Try lower-cost drugs before insurer covers expensive alternatives.

Generic vs brand drugs

Generic = same chemistry, lower cost than brand.

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