Express Scripts Holding, a pharmacy benefit manager that negotiates drug prices for many health plans, will launch a formulary with lower list price drugs in an effort to reduce reliance on rebates and rein in the out-of-pocket costs its clients' members pay.
Express Scripts is creating a choice for its customers, who can choose a formulary with a high list price and high rebate, or the newer formulary with a lower list price and lower or no rebate. Some health plans may stick to the original formulary because they rely on guaranteed rebates in their budgets. But the new formulary may appeal to health plans seeking to reduce patient out-of-pocket costs and reliance on brand rebates.
The new coverage list, called the National Preferred Flex Formulary, will be available to clients Jan. 1. It will mirror Express Scripts' National Preferred Formulary, which covers more than 3,800 branded and generic drugs for nearly 25 million people.
The first authorized treatments that will be managed through the National Preferred Flex Formulary will be Gilead's generic versions of its blockbuster hepatitis C treatments, Epclusa and Harvoni. The alternative versions of the medicine will cost $24,000 for a course of treatment, down from the brand-name versions which cost nearly $100,000.
Read the full news release here.