Do formulary exclusion list benefit the patient?

Express Scripts and CVS Caremark, the two largest pharmacy benefit managers, increased the numbers of drugs on their 2020 exclusion lists.  A formulary exclusion list includes the drugs that an insurer, health plan, or pharmacy benefits manager (PBM) does not cover.  Since 2017 to present day, CVS Caremark increased the numbers of excluded drugs by 88%, and Express Scripts by a staggering 208%. Why is this important? Exclusions are one of the key factors behind falling brand-name net drug prices; however, do lower net prices help patients in terms of producing better value for dollars spent? Will they reduce patients out-of-pocket spending? Read article here…

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