CVS Health Excludes Coverage of Viagra, Other Popular Drugs
CVS Health and rival Express Scripts, which together administer drug-benefit plans to the majority of employers and insurers in the United States, plan to exclude 28 prescription drugs, including Viagra from its list of covered medicines in 2016.
According to CVS, the drugs are being excluded because they all have viable, cheaper equivalents that will remain covered by the insurance plan. For example, patients Pfizer’s Viagra for erectile dysfunction will now be directed to take Eli Lilly’s Cialis. This, CVS says, will result in significant savings for employers.
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Before 2012, pharmacy benefit managers would encourage patients to use cheaper drug options by requiring out-of-pocket payments for “less favored” drugs. In 2012, CVS changed its strategy, excluding 30 drugs from their preferred drug list. Between 2012 and 1016, CVS will have excluded 124 drugs from its coverage, while Express-Scripts, which later followed suit, will have banned 90 drugs.
The exclusions, which take effect on January 1, 2016, remove the following drugs from CVS’s preferred drug list:
Abilify, Amitiza, Avonex, Bydureon, Carac, Cardizem, Clobetasol spray, Clobex spray, Cymbalta, Diovan, Exforge, Extavia, Fluorouracil cream 0.5%, Fortesta, Fosrenol, Incruse Ellipta, Intuniv, Invokameet, Invokana, Matzim LA, Monovisc, Noritate, Plegridy, Qsymia, Relistor, Valcyte, Viagra, and Zubsolv.
—Michael Potts
Reference:
Wall Street Journal. Drug-plan managers wield “potent weapon.” August 6, 2015. http://www.wsj.com/articles/drug-plan-managers-wield-potent-weapon-1438905295. Accessed August 10, 2015.