Drug formulary exclusion lists reduce patient access to treatment

A report from the Doctor-Patient Rights Partnership (DPRP) shows that drug formulary exclusion lists are getting longer. Drug formulary exclusion lists ranked as the top reason why a patient's medication claim was denied in 2017, with 37% of patients reporting such, the report found.

A report from the Doctor-Patient Rights Partnership (DPRP) shows that drug formulary exclusion lists are getting longer. Drug formulary exclusion lists ranked as the top reason why a patient's medication claim was denied in 2017, with 37% of patients reporting such, the report found. Drug formulary exclusion lists have increased by nearly 160% since 2014, according to the DPRP study. The combined number of treatments in 2014 on CVS Pharmacy's and Express Scripts' drug formulary exclusion lists ran at 132 treatments. In 2018, that list grew to 344. CVS and Express Scripts, which have the largest pharmacy market share in DPRP's report, estimate that approximately 275,000 patients will need to switch medications because of the exclusions. CVS has become the first PBM to allow cancer patients to remain on their treatments regardless of formulary exclusion list status, the report notes. Despite this move, DPRP says the choice demonstrates that some medications on drug formulary lists are not equivalent alternatives. Treatments for diabetes are the most consistently found on exclusion lists, the study reveals, and low-income and minority patients are also likely to be adversely affected.