Increasing pharmacy costs are among the fastest growing segments of the health care budget. Health plans are focusing on appropriately managing pharmaceutical costs, both from a long-term global perspective and a short-term approach emphasizing newly marketed products. Over the next six months, cox-2 inhibitors are expected to be approved by the FDA. This new class of drugs, investigated as a safer alternative to non-steroidal anti-inflammatory drugs (NSAIDs), is among the most highly anticipated medications to hit the marketplace. How health plans react to the launch of cox-2 inhibitors may serve as an example for future pharmacy management efforts. A proactive policy regarding the use of cox-2 inhibitors may be challenging, but should include: Reviewing clinical information; evaluating the cost of the new drug; and identifying appropriate patient selection criteria. The available management strategies include precertification, a tiered co-payment system, restricting prescriptions to a provider specialty, retrospective physician profiling, and physician education.