1. Express Scripts Exclusions Target 25 Drug Classes
12/5/2018
Health Strategies Group
Author/Artist
Express Scripts Exclusions Target 25 Drug Classes
Express Scripts indicated that rebates, along with lower list prices, drove its exclusion decisions. 22
With the addition of the 48 new exclusions, the total number of Express Scripts exclusions increase to 242 for 2019.
Have low-cost generic alternatives, even when brand drugs include rebates, the generic drugs have
a better value 12 11 10 9
Instances of brand-to-brand competition, where drugs have the same active ingredient, but the excluded drug has a higher net cost
Specialty drugs with a lower-cost brand or biosimilar alternative and a lower list price
Drugs that are multisource brands with direct generic equivalents.
Short-term therapies, such a topical creams and ophthalmic treatments .
Source: Express Scripts, 2019 National Preferred Formulary: Better Access Better Value. Retrieved from Accessed August 8, 2018;
Health Strategies Group, Leading Health Plans and PBMs, August 2018.