Cigna Corp.-owned PBM Express Scripts says it will exclude nearly 150 brand medications in its 2021 National Preferred Formulary. But one consultant says only a handful of the exclusions — notably, Novartis Pharmaceuticals Corp.’s biologic Cosentyx (secukinumab) and Amgen, Inc.’s bone marrow stimulant Neulasta (pegfilgrastim) — are likely to cause much member disruption.
“They [Express Scripts] essentially said 98.7% [of customers] don’t really experience any disruption with their formulary changes,” says Stephen Wolff, Pharm.D., R.Ph., pharmacy management consultant for Milliman Inc. He notes that many of the exclusions were multi-source brands, which aren’t likely to be particularly disruptive for members. “So we’re really thinking about those 45 or so single source brands that they excluded,” Wolff tells AIS Health.