Thinking back to one year ago, when writing this commentary on the upcoming 2020 formulary changes, no one could have foreseen the challenges and difficulties 2020 has presented. The 2021 formulary changes proposed by the “Big Three” PBMs (Express Scripts, CVS, and OptumRx) may be even more meaningful to plan sponsors as they relate to cost containment.
Express Scripts leads the pack with the most drug exclusions at 70. While OptumRx is putting forward the least number of exclusions at 50.
When looking across our book of business, CVS’s changes are showing the lowest member impact at 1.4 percent, while cost impact across the Big Three ranges from 2 to 3.1 percent.
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.
All three have made changes in diabetes, specialty drugs, generics, and biosimilars. The most notable highlights are discussed below.
Headed into 2021, plan sponsors will be ever vigilant in their efforts to contain costs. The PBMs have put forward their proposed 2021 formulary changes to assist with these efforts. PSG is available to support clients as they navigate formulary changes with the Big Three PBMs, as well as other PBMs not featured here. Please contact us to gain further insight into how PSG can help in your specific situation.