how to handle non-formulary drug requests

The many new drug approvals are bringing up questions about how to handle non-formulary drug requests.

You see this all the time. A doctor orders an expensive new drug...but it's not on the formulary or covered by insurance.

Often a call to the doc is needed to switch, for example, Kapidex to omeprazole...Lipitor to simvastatin...Alvesco to Flovent, etc.