ST. LOUIS, July 31, 2017 Deciding which medicines to include
on the nation's largest drug list starts where it should: by
determining which medicines deliver the best outcomes for
patients.
Experience the interactive Multichannel News Release here:
https://www.multivu.com/players/English/81495241-express-scripts-national-preferred-formulary-2018/
Once an independent panel of medical experts makes its
recommendations, Express Scripts (Nasdaq: ESRX) negotiates with
drug makers to ensure the medicines included on our National
Preferred Formulary (NPF) are the best combination of clinically
appropriate and cost effective. This rigorous process relies
on a complex interaction of high-tech data analytics,
pharmacological evidence, and predictive modeling to yield
clinically sound, cost-effective formularies.
Express Scripts provides pharmacy benefits to 83 million
members. Of these, more than 27 million obtain their pharmacy
benefit coverage through one of Express Scripts' standard
formularies and more people use the National Preferred Formulary
than any other formulary in the U.S.
For the 2018 benefit year, Express Scripts is making specific
changes to drug coverage, with 64 new drug exclusions. Taken
together with prior year exclusions, the total number of excluded
drugs is just 159 out of more than 3,791 available drugs.
The vast majority of patients we serve – 99.22% to be exact –
will not see any changes to their drug coverage. Of course,
some patients will be asked to use a different medication that
achieves the same health outcome at a lower cost. If any patient
has a clinical need that requires a medication that is not on the
formulary, we have provided a clear pathway to have that drug
covered. Our goal is always to make sure a patient gets the
medicine that helps them achieve the best outcome.
Because of our formulary strategies, employers who use the NPF
are expected to save an additional $2.5
billion in 2018. Collectively, from 2014-2018, Express
Scripts expects to save participating NPF clients and patients
$7.4 billion because of formulary
exclusions.
For an example of how the NPF has evolved, you can look at the
experience of Tymlos, a new osteoporosis treatment that was
launched this year. Tymlos has similar clinical outcomes as the
current market-leading drug, Forteo. However, following discussions
and negotiations with Express Scripts, the maker of Tymlos brought
it to market at a lower price than Forteo. Excluding Forteo and
moving to Tymlos will significantly lower client costs while
providing a clinically appropriate alternative.
Formulary management is one way to bring down drug costs.
Throughout the 2000s and on into today, increasing generic
utilization has helped lower net drug costs for plan sponsors. That
generic wave continues, but is now joined by a "formulary wave,"
where active pharmacy management can deliver greater value to
employers, health plans and other plan sponsors who pay the bulk of
the pharmacy bill in the United
States.
For the first time ever, in 2018, brand drug manufacturers must
provide significant savings to be included on the NPF if there are
clinically equivalent, lower cost options available. For the 2018
NPF, we focused on high-spend multi-source brand drugs and excluded
46.
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SOURCE Express Scripts