WASHINGTON – The nation’s largest pharmacy benefit manager, Express Scripts, is dramatically scaling back its coverage of compounded medications, saying most of the custom-mixed formulas are ineffective or overpriced.
The company, which manages prescriptions for 90 million Americans, plans to drop coverage of 1,000 drug ingredients commonly found in compounded medications.
Express Scripts says the move will cut wasteful spending and lower its customers’ compounded drug costs by 95 per cent.
But the coverage change has prompted a swift pushback from compounding pharmacists, who argue that the cuts will deprive patients of crucial medications that are not available as traditional manufactured drugs. A spokesman for the pharmacists says similar efforts to curb coverage are in the works from several other pharmacy benefit providers and health insurers.