PBM Formulary Exclusions On The Rise, PhRMA Says

A trend of large pharmacy benefit managers (PBMs) restricting access to drugs by excluding them from formularies has grown, according to a new report by AmerisourceBergen Corporation./Xcenda that the Pharmaceutical Research and Manufacturers of America (PhRMA) underwrote, with increasing numbers of single-source drugs, biosimilar and authorized generic insulins, and cancer medicines excluded from coverage.

The report, issued on 25 May and titled "Skyrocketing Growth in PBM Formulary Exclusions Continues to Raise Concerns about Patient Access," reveals that the three largest PBMS – CVS Caremark, Cigna Corp.’s Express Scripts and UnitedHealth Group’s OptumRx – exclude a total of 1,156 medications from their standard formularies in 2022, up 29% from 2021