The 2015 formulary exclusion lists have been announced by CVS Caremark and Express Scripts. The lists feature additional product removals in 2015, with Express Scripts increasing its list of product removals to 66, up from 48. CVS Caremark will exclude 95 products in 2015, up from 72 in 2014.
View the lists by clicking here*:
Targeted brands typically include those with branded or generic clinically equivalent alternatives. The trends towards specialty drug exclusions is likely to accelerate in the coming years, as seen with Express Scripts exclusion of Amgen's erythropoiesis-stimulating agents in 2015, Aranesp and Epogen. Additional specialty drugs within classes where a number of competitors exist may be targeted in future years.
HIRC research findings indicate that this trend in formulary management could permeate into health plan managed formularies. Results from HIRC's interviews with 20 commercial health plan pharmacy and medical directors revealed that 32% of health plans may implement an excluded drug list in the future, with 32% stating that they will not implement an excluded drug list. The remaining respondents were unsure and in a "watch and wait" mode, while others indicated alternative formulary management approaches.
In this new era of formulary management, it is critical that manufacturers continue to demonstrate product value propositions with evidence of improved patient outcomes to maintain market access.
*1/15 Update: With the launch of AbbVie's Viekira Pak, there has been increased activity in the hepatitis C segment, with Express Scripts exclusion of Sovaldi and Olysio and CVS Caremark's exclusion of Viekira Pak. The formulary exclusion lists above have been updated as of January 2015.
