In August CVS Caremark (now CVS Health) and Express Scripts released their formulary restrictions, effective January 2015. CVS Health and ESI, which together cover nearly half of all Americans, make formulary decisions that influence roughly 150 million covered lives. Thus, pharmaceutical manufacturers are in a must play position to have any chance at maintaining a presence in the brand medication market.
Here are the highlights of each PBM’s formulary changes and their potential impact on your plan and participants.
CVS Health
CVS Health’s closed formulary has been in place for several years. For 2015, CVS Health continues its aggressive removal process with no signs of easing up on formulary management efforts. CVS Health removed an additional 22 medications from its formulary, increasing the total to approximately 100. A few of the exclusions include: Byetta (diabetes); all diabetes testing strips and kits except for OneTouch brands; Rebif (specialty treatment for MS); Lunesta (sleep aid) and Levitra (erectile dysfunction). CVS Health is also planning to exclude one of the newer Hepatitis C treatments in 2015. Without significant discounts on both products, one treatment will likely be removed, depending on the price of the product and the latest agents (i.e. Solvaldi).
continue to read here
Here are the highlights of each PBM’s formulary changes and their potential impact on your plan and participants.
CVS Health
CVS Health’s closed formulary has been in place for several years. For 2015, CVS Health continues its aggressive removal process with no signs of easing up on formulary management efforts. CVS Health removed an additional 22 medications from its formulary, increasing the total to approximately 100. A few of the exclusions include: Byetta (diabetes); all diabetes testing strips and kits except for OneTouch brands; Rebif (specialty treatment for MS); Lunesta (sleep aid) and Levitra (erectile dysfunction). CVS Health is also planning to exclude one of the newer Hepatitis C treatments in 2015. Without significant discounts on both products, one treatment will likely be removed, depending on the price of the product and the latest agents (i.e. Solvaldi).
continue to read here
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