Express Scripts announced the impending launch of a novel formulary designed to ease out-of-pocket cost burden for members by allowing health plans to cover lower list price drug products.
Express Scripts announced the impending launch of a novel formulary designed to ease out-of-pocket cost burden for members by allowing health plans to cover lower list price drug products, according to a company press release
The National Preferred Flex Formulary, announced by the pharmacy benefit manager (PBM) this week, seeks to pave the way for coverage of lower list price drugs, such as new authorized alternatives to pricey brand name products. The novel formulary is designed to mirror Express Scripts’ National Preferred Formulary (NPF), covering more than 3800 brand and generic products.
According to Express Scripts, introducing authorized alternative products through a new or additional National Drug Code with a lower list price will create a competitive dynamic similar to a generic coming to market. Employers and health plans can either choose to cover the lower-priced option or the original brand name product, which may have a rebate.
“Some manufacturers have already followed our lead to create a pathway to help close the ‘gross-to-net bubble,’ and give cash-paying patients immediate access to more affordable medicine in a way that will not destabilize the drug supply chain,” Steve Miller, MD, chief medical officer, Express Scripts, said in a statement. “Our new National Preferred Flex Formulary demonstrates our flexibility to keep clients ahead of industry trends, so that they can fully leverage new opportunities to lower their prescription drug costs.”
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