Caremark, Express Scripts and OptumRx — the three largest pharmacy benefit managers in the U.S. — increased the number of drugs excluded from their formularies in 2023, according to a Jan. 10 blog post from the Drug Channels Institute.
PBMs' exclusion lists have steadily grown since the practice was first introduced in 2012. At present, Caremark, Express Scripts and OptumRx's exclusion lists each include about 600 medications. In 2022, each exclusion list contained about 550 products.
"Growth in the number of excluded drugs slowed for the second year, due partly to the fact that so many drugs have already been dropped from PBMs’ formulary," according to the institute.
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