Two Largest Prescription Drug Plans Release Preferred Drug Lists

CWA health plans increasingly include prescription drug plans with a “preferred” or “formulary” list of brand name drugs offered at a lower copay. Drug plans use the lower copays to steer customers towards the preferred drug and gain leverage when bargaining with pharmaceutical companies for lower prices.

CVS/Caremark and Express Scripts, the two largest administrators of prescription drugs plans, have each released their updated 2017 formulary medications list.

The new 2017 lists exclude drugs that, according to the drug plans, are “products with egregious cost inflation that have readily available, clinically appropriate and more cost-effective alternatives."

Some of the drugs newly excluded are prescribed to treat diabetes and hepatitis. The CVS list also excludes some cancer drugs, along with Proventil and Ventolin, commonly prescribed brands of asthma inhalers, while Express Scripts has dropped Orencia, a drug for rheumatoid arthritis.

Patients on these drugs will be notified by their plan of the drug’s new excluded status and encourage to work with their doctor to switch to an alternative. A company spokesman commented:

"Express Scripts will only ask members to switch their medication if there is a clinically equivalent alternative and only if that switch delivers a significant cost savings for their employer."

Links:

CVS 2017 Standard Formulary List of Removals and Updates (CVS Health, August 2, 2016)

Express Scripts 2017 National Preferred Formulary (Express Scripts, August 1, 2016)

Will Your Prescription Meds Be Covered Next Year? Better Check! (NPR, August 15, 2016)