Best Read Drug Coverage Stories in 2023
Express Scripts and Cigna Add Zepbound to Formularies
Zepbound was approved in November 2023 to treat patients with obesity. It was added to the national preferred formulary for Express Scripts and Cigna Healthcare in December.
Health Plans Release 2024 Prescription Changes in Medicare Plans
Aetna, Cigna, Humana, United Healthcare — some of the largest providers of Medicare Advantage plans — have released updates to prescription drug programs.
CVS Caremark Switches Up Biosimilar Coverage in 2024
New biosimilars have been added and others removed from CVS Caremark’s standard formulary. One notable change is with the Humira biosimilars. The PBM has removed Amjevita and now prefers Hyrimoz and an unbranded biosimilar.
Optum Rx Announces Formulary Exclusions for 2024
Optum Rx has added more than 50 products — including both branded and generics — to the exclusion list for the 2024 Premium Formulary.
CMS Expands Leqembi Coverage After FDA’s Full Approval
Medicare will cover Alzheimer’s drugs with full approval, including Leqembi — if the physician and patient participate in a real-world registry trial to gather additional data.
Navitus to Offer Unbranded Stelara Biosimilar, Remove Stelara from Formulary
March 13th 2025Lumicera Health Services, Navitus’ specialty pharmacy, has made a deal with Teva to offer an unbranded biosimilar that they estimate will save $112,000 and $336,000 per patient per year. Navitus will remove Stelara from formulary on July 1, 2025.
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FDA Approves Neffy 1 mg Nasal Spray for Pediatric Patients
March 6th 2025Neffy 1 mg is now approved by the FDA to treat pediatric patients who weigh 33 to 65 lbs. Neffy was first FDA-approved as a 2 mg dose in August 2024 for the emergency treatment of anaphylaxis in children and adults weighing at least 66 lbs.
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