As a number of states consider establishing workers’ compensation formularies, the American College of Occupational and Environmental Medicine (ACOEM) has reviewed how formulary use might affect medical quality and cost in the care of injured workers. ACOEM recognizes that the use of drug formularies has produced significantly lower direct costs for drugs in workers’ compensation cases, but also recognizes that if the details of a formulary system are not well managed, formulary use may delay care for some patients and increase administrative costs. Furthermore, ACOEM recognizes that a well‐organized formulary system, founded on the principles of evidence‐based medicine, can be expected to drive improvements in medical quality.