In the latest bid to control prescription drug spending, the nation's largest pharmacy benefits managers are again excluding dozens of medicines from their lists of products that are covered by health insurance, which are known as formularies. PBMs, you may recall, are crucial, behind-the-scenes middleman who negotiate drug prices on behalf of companies, unions, and government agencies.
On Monday, Express Scripts notified its customers that next year, 85 medicines will be excluded from its national formulary, and, as a result, the PBM hopes to recognize about $1.8 billion in savings, up from $1.3 billion this year. The number of excluded medicines, by the way, is down slightly from the 88 prescription drugs that were excluded from its 2016 formulary.
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