Express Scripts knocks many newer brands off formulary
Express Scripts, the big PBM, issued its new formulary for 2014, and a list accompanying the formulary shows many recently approved brands won't be covered, reports FiercePharma. Among those being excluded from reimbursement: Pfizer RA drug Xeljanz, Johnson & Johnson psoriasis treatment Stelara, and GlaxoSmithKline respiratory drug Breo Ellipta. Alternatives are listed beside each.
It's the first time the PBM's preferred formulary designates certain drugs as “not covered,” an Express Scripts spokesman told FiercePharma, adding "Drug choices in some classes are larger than ever, with many products costing more with no additional health benefit."
The co-pay card, a marketing tactic often used by pharma to provide patient assistance for branded drugs, played into Express Scripts's decision, FiercePharma points out.