The battle between drug companies and insurers is heating up and consumers are the ones who may get burned. National Public Radio (NPR) released a report this week titled, “Will Your Prescription Meds Be Covered Next Year? Better check!”
According to the NPR story:
CVS Caremark and Express Scripts, the biggest prescription insurers, released their 2017 lists of approved drugs this month, and each also has long lists of excluded medications. Some of the drugs newly excluded are prescribed to treat diabetes and hepatitis. The CVS list also excludes some cancer drugs, along with Proventil and Ventolin, commonly prescribed brands of asthma inhalers, while Express Scripts has dropped Orencia, a drug for rheumatoid arthritis.
ParentHerald.com added, “Other companies may also begin removing certain drugs from their list of coverage over the next couple of months. Although considering that CVS Caremark manages the prescriptions of over 75 million people, this is already a large loss. However, CVS claims that this is all part of their plan for formulary exclusion, which they claim could save customers up to $9 billion over the next five years.
Becker’s Hospital Review wrote that “a secretive board of physicians and a pharmacist decides which drugs will be excluded from Express Scripts coverage for the upcoming year, according to the .
St. Louis-based Express Scripts, the nation’s largest pharmacy benefit manager, does not disclose the names of its board members, or any possible conflicts of interest they may have, according to the report. The company’s opaque system is designed to protect experts from the “tremendous” influence of lobbyists, Express Scripts executives told the St. Louis Dispatch, but critics argue the process should be more transparent, especially since such transparency is enforced in other areas of the healthcare industry.”
Share your thoughts on what excluding some prescription medications could mean to the people in your community. We will continue to try to generate dialogue around hot-button health issues, because we believe those conversations will one day help us reach our goal of making Arizona the Healthiest State in the Nation!