Formulary exclusion drug lists for 2018 | LowestMed
Insurance companies modify their drug formulary every year, around this time. Express Scripts, who is responsible for 83 million insurance plan members’ drug coverage, got the ball rolling by announcing their drug formulary exclusions for 2018.

Why do I need to know if my formulary has changed?

It’s important to know if your formulary is expected to change in the coming year, so you can start planning for what you will do if your drug’s coverage is dropped.

What can I do if my drug is dropped from my insurance’s drug formulary?

If your drug’s coverage is dropped from your insurance’s drug formulary, there are a couple things you can do:

1: Find out if there is a generic version of your medication available. Usually drug companies modify their formulary, because a less expensive version of the medication has been made available.

2: Talk to your physician about treatment options. Are there other medications your doctor can write a prescription for?

Try Searching the LowestMed Price for your Drug!

What is a drug formulary?

Drug formularies are lists of medications covered by insurance plans. Pharmacy Benefit Managers (PBMs) work closely with insurance companies to determine what medications their plans will cover.

Express Scripts has introduced 64 new drug exclusions to their preferred formulary. The company says their formulary is designed to bring the greatest value to their clients and members, while increasing the use of the lowest net-cost products. Express Scripts claims the updates to their formulary will deliver an additional $2.5 billion in client savings.

Always shop around for your medications

All hope isn’t lost if you find your medication on the updated formulary exclusions list. Since drug prices vary by pharmacy location and also by which insurance is used, you can often find deals on your medication costs. Using tools, like LowestMed, can help you find out which pharmacy has the lowest price for your medication. You can also use LowestMed’s search tool to find out if there is a generic equivalent for your medication.

Express Scripts’ Formulary Exclusions for 2018

Abilify
Aciphex
Aciphex sprinkle
Adderall
Androgel 1%
Anusol-hc
Atacand/hct
Azor
Benicar/hct
Bupap
Cymbalta
Cytomel
Effexor xr
Epinephrine auto-injector (by a-s medication, impax & lineage)
Femring
Forteo
Fosrenol
Imitrex
Inderal la
Intuniv
Lazanda
Lexapro
Librax
Lidoderm
Lovenox
Lunesta
Minastrin 24 fe
Nasonex
Neupogen
Nevanac
Opana er
Oxycodone er

Plaquenil
Plavix
Prevacid
Prevacid solutab
Prilosec suspension
Pristiq
Protonix
Protonix suspension
Provigil
Prozac
Pulmicort respules
Renagel
Sandostatin lar depot
Signifor lar
Seroquel/xr
Singulair
Strattera
Tikosyn
Timoptic ocudose
Tobi solution
Tribenzor
Trulance
Valium
Valtrex
Vytorin
Wellbutrin sr
Xanax/xr
Xenazine
Zegerid
Zetia
Zoloft
Zyflo cr

CVS Caremark Formulary Exclusions for 2018

Doryx/Doryx MPC
Monodox
Follistim
Elelyso
Tanzeum
Sumavel Dosepro
Benicar/Benicar HCT
Effexor XR
Nuvigil
Seroquel XR
Zetia
Horizant
Dulera
Jardiance
Synjardy/Synjardy XR
Hyalgan
Synvisc/Synvisc One

CVS says they remove drugs only when clinically-appropriate, lower-cost (often generic) alternatives are available. They say their targeted approach ensures minimum member disruption. CVS says they estimate 99.76 percent of members should not be affected by the formulary changes.

OptumRx Formulary Exclusions for 2018

Abbott (FreeStyle, Precision)
Abstral
Acanya
Adlyxin
Adrenaclick
AirDuo
Aktipak
Alogliptin
Alogliptin with metformin
Alogliptin with pioglitazone
Alvesco
Amrix
Apidra
Aranesp
Arkray(Glucocard)
Arymo ER
Asacol HD
Asmanex
Auvi-Q
Axiron
Basaglar
Bayer (Breeze, Contour)
Bravelle
Cambia
Delzicol
Duexis
Dulera
Epinephrine by Impax
EpiPen
Epogen
Extavia
Farxiga
Fentora
Follistim AQ
Fortesta
Genotropin
Humatrope
Inflectra
Kazano
Kitabis Pak
Kombiglyze XR
Lazanda
Levalbuterol Inh
Levemir
Levitra

Lialda
Mesalamine DR
Nesina
Nipro (TRUEtest, TRUEtrack)
Novolin
Novolog
Nucynta ER
Onglyza
Opana ER
Oseni
Pancreaze
Pertzye
Plegridy
Proventil HFA
QVAR
Rebif
Rescula
Roche (Accu-Chek)
Saizen
Staxyn
Stendra
Subsys
Taltz
Tanzeum
Testim
Testosterone 1% Gel
TOBI Podhaler
Tobramycin Neb
Tresiba
Trokendi XR
Tudorza
Ultresa
Veltin
Vimovo
Viokace
Volgelxo
Xigduo XR
Xopenex HFA
Xtampza ER
Zioptan
Zohydro ER
Zomacton
Zorvolex

OptumRx Excluded Brand-name Medications with Generics

Aciphex
Acticlate
Adderall XR
Alphagan P
Ambien
Ambien CR
Androgel 1%
Azor
Benicar
Benicar HCT
Benzaclin
Benzamycin
Beyaz
Carafate
Celebrex
Concerta
Crestor
Cymbalta
Cytomel
Depo – Testost Injection
Dilantin
Dilantin Chewable
Dilantin Suspension
Diovan
Diovan HCT
Duac
Duragesic
Effexor XR
Glumetza
Kadian
Lexapro
Lidoderm
Lipitor
Lovaza
Lunesta
Minastrin
Nasonex
Nexium

Nitrostat
Norco
Norvasc
Nuvigil
Ortho Tri Cyclen
Ortho Tri Cyclen Lo
Percocet
Prevacid
Pristiq
Prozac
Pulmicort Inh Suspension
Retin-A Micro Gel
Singulair
Taclonex
Tamiflu
Tobi Nebulizer
Tobradex
Toprol XL
Tribenzor
Vagifem
Valium
Vitafol
Vivelle-Dot
Voltaren
Vytorin
Wellbutrin
Wellbutrin SR
Wellbutrin XL
Xanax
Xanax XR
Yaz
Zegerid
Zetia
Ziana
Zoloft
Zomig
Zomig ZMT
Zovirax

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