Insurance Providers Dropping Brand Name Drugs – 40+ To be Exact

Millions of people today are going to get a rude awakening come 2015. Insurance companies are dropping 40 plus brand-name drugs that are going to stop being covered starting January 2015. More than 200 million Americans will feel the crunch of this issue, and there will be a lot of people that are looking at this in the wrong manner. Last year over 50 drugs were removed, and this is a constant cycle of change that has many individuals a bit panicked as to what’s going to happen next.

Two Companies At The Helm

It’s important to understand that prescription medications are usually administered between the coordinative efforts of two major companies. They are Express Scripts and Caremark, which provide benefits for a great number of companies and Tricare. While your insurance provider may have a different name, you will find that these are two major companies that work within the pharmaceutical benefits that are covered by the provider you have. The formulary choice is a matter of health plan and provider, so this makes things a bit harder to understand for some.

What The Change Really Means

When it comes to prescription drugs, you’re going to find that there are a lot of names on the list. It’s important not to panic, but rather understand that there are some that are related to the fact that there are generic alternatives or less costly solutions on the market as of 2015. However, those medications not covered any longer will cost full retail value at the pharmacy, which is something worth noting.

Coverage may change, but doctors can help with alternatives and figure out the right course of action for you. Some people won’t be able to switch, but there are some options such as GoodRX that can help with covering the cost.

What Drugs Are On The List?

Express Scripts will be limiting a lot of drugs including those that are meant for pain, testosterone, diabetes, acne, migraines, and even arthritis. Some big names include Vimovo, Duexis, Zohydro ER, Tanzeum, Axert, Frova, Hyalgan, and Euflexxa to name a few.

As for Caremark, this is nothing new, as they’ve been making changes throughout the past few years. Each company has their own list, and there’s not a lot of crisscross between the two.

Medicare and Individual Plans

As for those that have Medicare plans or individual options, coverage doesn’t necessarily change. Medicare.gov has a few answers to this as well, to include a variety of different answers overall.

Providers that have individual insurance plans may have to deal with the formulary changes that are being pushed forward by Express Scripts or Caremark, and each plan should be checked out for further details.

 

Many of these dropped medications are offered for free through Patient Assistance Programs. To find out if you qualify please contact The Rx Connection Patient Assistance Advocacy Group.

The following are some of the scripts that excluded as of January 1, 2015:

Abstral (Express Scripts)

Accu-Chek test strips and kits (Caremark)

All non-OneTouch strips and kits (Caremark)

Adderall XR (Caremark)

Aerospan HFA (Caremark)

Amrix (Caremark)

Apexicon E (Caremark)

Apidra (Caremark)

Aranesp (Express Scripts)

Axert (Express Scripts)

Benzaclin gel pump (Express Scripts)

Byetta (Caremark)

Cetraxal (Express Scripts)

Duexis (both)

Epogen (Express Scripts)

Euflexxa (both)

Farxiga (Caremark)

Fentora (Express Scripts)

Frova (Express Scripts)

Gel-One (Express Scripts)

Hyalgan (Express Scripts)

Incivek (Express Scripts)Lunesta (Caremark)

Naprelan (Caremark)

Natesto (Caremark)

Norvasc (Caremark)

Orthovisc (Caremark)

Pancreaze (Express Scripts)

Pennsaid (Caremark)

Pertyze (Express Scripts)

Proventil HFA (Caremark)

Rebif (Caremark)

Stendra (Express Scripts)

Subsys (Express Scripts)

Supartz (Express Scripts)

Symbicort (Caremark)

Tanzeum (Express Scripts)

testosterone gel (both)

Ultresa (Express Scripts)

Veltin (Express Scripts)

Vimovo (both)

Vogelxo (both)

Zohydro ER (Express Scripts)

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2 Comments

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