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2016 Express Scripts & Caremark Drug Formulary Changes
Old 08-06-2015, 02:17 PM   #1
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2016 Express Scripts & Caremark Drug Formulary Changes

Express Scripts and CVS/Caremark have published their list of products that will be removed (excluded) from their 2016 drug formularies.

Link: Drug Channels: Here Come the 2016 PBM Formulary Exclusion Lists!
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Old 08-06-2015, 02:27 PM   #2
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I just ordered the prescription that I use from CVS/Caremark a few minutes ago. I had no idea that they exclude certain drugs. I am glad to see that mine is not on that list.
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Old 08-06-2015, 02:42 PM   #3
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I just ordered the prescription that I use from CVS/Caremark a few minutes ago. I had no idea that they exclude certain drugs. I am glad to see that mine is not on that list.
most if not all HI has a drug formulary. This divides the drug world into several tiers with the worst being not covered. This was even true for me at megacorp and microcorp
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Old 08-06-2015, 03:11 PM   #4
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It is interesting that there are several reasons to go first with generic drugs beyond just cost. One is the number of adds for lawyers that relate to bad happenings with non generic drugs, the idea becomes that by the time a drug gets generic most if not all bad things will have been seen and corrects (or even the drug removed from the market) because of the bad reactions. So beyond cost there is the reduction in the chance of bad reactions that generics make far less likely. (all the more reason to push back on your physician in favor of generic drugs as I do)
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Old 08-06-2015, 03:39 PM   #5
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It is interesting that there are several reasons to go first with generic drugs beyond just cost. One is the number of adds for lawyers that relate to bad happenings with non generic drugs, the idea becomes that by the time a drug gets generic most if not all bad things will have been seen and corrects (or even the drug removed from the market) because of the bad reactions. So beyond cost there is the reduction in the chance of bad reactions that generics make far less likely. (all the more reason to push back on your physician in favor of generic drugs as I do)
So if I get you right, other than cost another reason for using generics is that the original drug is that the original drug has been field tested ( used for years by patients) and corrections, removal, or other modifications have been made to the original drug and have gone into the formulation of the generic. So if you need drug X and there is no generic... you get drug X. If you need drug Z and there is a generic of drug Z called GZ. If cost was not a factor, you would buy GZ because it would not have the problems associated with the present formulation of Z?

My assumption is that the original drug co. makes mods to improve the drug or application of the drug during the exclusivity period and this gets wrapped up into the generics. But I could be wrong on this.
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Old 08-06-2015, 04:14 PM   #6
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Yes, off patent drugs have been road-tested, but there is also a lot less money for the class-action lawyers in pursuing generic manufacturers!
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Old 08-06-2015, 08:00 PM   #7
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The big news is that they excluded Viagra from the formulary--not that will affect me.

Since going on Medicare, I'm no longer using Express Scripts. A handful of doctors' samples might last someone a lifetime anyway.
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Old 08-06-2015, 08:14 PM   #8
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So if I get you right, other than cost another reason for using generics is that the original drug is that the original drug has been field tested ( used for years by patients) and corrections, removal, or other modifications have been made to the original drug and have gone into the formulation of the generic. So if you need drug X and there is no generic... you get drug X. If you need drug Z and there is a generic of drug Z called GZ. If cost was not a factor, you would buy GZ because it would not have the problems associated with the present formulation of Z?

My assumption is that the original drug co. makes mods to improve the drug or application of the drug during the exclusivity period and this gets wrapped up into the generics. But I could be wrong on this.
I guess I would say that if GZ and Z were the same drug then its a question of price. However in general the generic is cheaper that the branded drug even after the generics hit the market.
My main point is that you should push for a generic drug versus a drug still under patent since the longer time on the market would expose any problems that the drugs cause.

Quite often the " improvements" get new patents and reset the patent clock. One example in the statin area is to combine two drugs get a new patent and keep on trucking with money you are making.
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