Pharmacy WG / DaVinci

Justification and Objectives

This project defines a FHIR interface to a health insurer's drug formulary information for patients/consumers. A drug formulary is a list of brand-name and generic prescription drugs a health insurer agrees to pay for, at least partially, as part of health insurance coverage. Drug formularies are developed based on the efficacy, safety and cost of drugs. The primary use cases for this FHIR interface enable consumers/patients to understand the costs and alternatives for drugs that have been prescribed, and to compare their drug costs across different insurance plans.  A drug formulary IG is in Standard for Trial Use (STU) ballot (July).

The objectives of the hackathon are:

This track will use the R4 version of FHIR.

Clinical input requested (if any)


Related tracks

DaVinci PDEX.

Proposed Track Lead

Dave Hill ( Track leads must be registered users on

Expected participants

Potential producers (health plans) and consumers (3rd party application developers) of formulary data.

Please add your name/organization here

Track Orientation

A webinar will be hosted on TBD to share further participation information about this track.

System Roles

Medical App for Patient


See the use cases section of the IG.

Scenario :  Medication Copays under Insurance Plan

Action:   Query Formulary content for list of medications

Precondition:  Determine list of medication for the patient

Success Criteria:  Display medication list with copay information to patient.

Bonus point:   None

Scenario : Shopping for Health Plans

Action:  Query formulary content of multiple drug formularies for a list of medications

Precondition:  Determine list of medication for the patient

Success Criteria:   Compare costs for medication list for multiple insurance plans

Bonus point:  None



Security and Privacy Considerations

No security or privacy considerations.   Data is not patient-related.