Express Scripts says the 48 new exclusions on its 2019 National Preferred Formulary could lead to $3.2 billion in savings, but some stakeholders are questioning the excluding of more specialty drugs.
According to an MMIT report, the exclusions include:
- Extavia, a multiple sclerosis drug;
- Mavyret, a hepatitis C treatment; and
- Atripla, an HIV drug.
“The inclusion of categories like HIV, hereditary angiodema and hemophilia was certainly a surprise,” Precision for Value Senior Vice President Jeremy Schafer says. “Rare disease categories such as these were commonly seen as too sensitive and individualized to be managed by something as blunt as an exclusion. Even though Express Scripts is grandfathering current users, this move represents an aggressive step in the management of rare disease drugs.”
To read more on MMIT, click here.