You want this, you’re on your own

Insurance companies are balking at the high prices of some drugs, so this should surprise no one:

CVS Health, the giant pharmacy benefits manager, moved Tuesday to counteract the financial impact of high-cost medications by excluding a number of drugs used to treat patients with cancer, diabetes and hepatitis C.

“We expect to remove 35 products from our standard formulary” — a list of covered products — “including 10 hyperinflationary drugs,” said CVS Health, which provides prescription benefit management services to several thousand health plans.

In some cases, higher-cost drugs are being replaced with lower-cost options, the company said.

I looked at the list [pdf], and there’s nothing particularly surprising there. They will no longer pay for brand-name Nexium, for instance, but will pay for generic esomeprazole. And one drug I’ve used before, Dymista (azelastine), previously scrubbed from the formulary, has been reinstated.





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