In a move expected to save $3.2 billion, Express Scripts Holding will drop 48 drugs from its lineup of covered therapies in 2019, reports Bloomberg.
The changes will raise the number of excluded drugs on its formulary to 242 next year, from 196 excluded drugs this year. Two drugs excluded now will be covered next year.
The pharmacy benefit manager said the changes will affect fewer than 0.2 percent of members and save the company billions.
Some of the drugs the PBM said it will drop include Gilead Sciences HIV treatment Atripla, AbbVie's popular hepatitis C treatment Mavyret and Sanofi's hemophilia treatment Eloctate.
The company said its decision wasn't solely based on negotiated rebates, but generic drugs or other brands with lower list prices make them a better deal.
Express Scripts negotiates rebates from brand-name pharmaceutical companies in exchange for including drugs on their coverage lists, also known as formularies. Critics argue the system encourages pharmacy giants to raise their list prices as PBMs seek larger rebates to bolster their profits instead of passing those rebate savings to consumers.