Major PBMs Release 2019 Formulary Exclusions

Leading pharmacy benefit managers (PBMs) recently released updates to their 2019 national formularies. For 2019, Express Scripts Holding Co. will exclude 48 drugs from its national preferred formulary, including hepatitis C drug Mavyret and HIV drug Atripla. Meanwhile, CVS Health and OptumRx cut 23 and 36 medications from their 2019 formularies, respectively. According to a recent Solid Benefit Guidance white paper, the changes are likely to negatively impact 0.2% to 1.24% of members, as estimated by two of the three largest national PBMs.

SOURCES: Solid Benefit Guidance; Express Scripts Holding Co.; CVS Health; OptumRx, Inc.