PBM Drug Exclusions for 2016

PBIRx®

Intelligent Solutions in Pharmacy Benefits

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Though we still have about half of the year left, now is the time when many are starting to think about their health coverage for 2016. And if you hold prescription insurance through companies like CVS/Caremark and Express Scripts, you will most certainly want to know which drugs they are excluding for the next plan year.

To help you stay up-to-date with the latest changes, we did some research and found that the following drugs will no longer be covered next year:

CVS:

• Abilify
• Amitiza
• Avonex
• Bydureon
• Carac
• Cardizem
• Clobetasol spray
• Diovan
• Invokana
• Relistor

For a complete list of drugs that CVS is excluding, check out this article from CNN Money.

Express Scripts

• Abstral
• Alvesco
• Beconase AQ
• Dipentum
• Harvoni
• Onglyza
• Qysmia
• Saizen
• Sovaldi
• Teveten HCT

For a complete list of drugs that Express Scripts will not be covering and their alternative recommendations, please click here.

As an experienced pharmacy benefit consulting firm, we at PBIRx understand just how important it is for providing entities to be aware of how certain PBMs change their drug coverage from year to year. If you have questions about how your pharmacy benefit plan will be affected by these updates or would simply like to have your plan audited to ensure you are paying fair prices for the services you do have covered, be sure to give us a call at (888) 797-2479 to start working with us today.