The “Big 3” Pharmacy Benefit Managers (OptumRx, Express Scripts, CVS Caremark) released updates to their 2019 formulary exclusions and this year’s changes come with expansion into some uncharted territories. There is a focus on high-cost drugs with no rebate implications, as well as reversing changes that were made as recently as six months ago in commonly rebated categories. The findings of an impact analysis across our book of business suggest the changes will impact 2.5% of members and 3.3% of total drug spend.
Want to find out how these changes may impact you? Contact PSG today to get the formulary strategy and support you need for an ever-evolving market.
Highlights of the most notable formulary changes are discussed below.
PSG has developed a review of each of the big three PBMs and is providing insights into the changes plan sponsors can expect in 2019, but your PBM may not be represented here. If you would like more information on another PBM, please feel free to contact us at [email protected] to gain further insight into your specific situation.