No matter who wins in the upcoming United States presidential election, US citizens can be sure that the way their health care is managed will undergo a drastic change. This includes insurance and other forms of coverage. However, little do consumers know that how their insurance is handled can have a drastic effect on the distribution of their prescription drugs.
This is because the fight between drug companies, who want higher prices for their drugs in order to generate profit, and insurance companies, who want to make those said drugs affordable, persists to this day. And the tension between these two sides is ever increasing. And according to a report from NPR, this puts the consumer smack dab in the middle.
Two of the largest prescription insurers in the United States, namely CVS Caremark and Express Scripts, have officially revealed their respective lists of approved drugs for the year 2017. What's troubling for consumers is that these lists contain notable omissions. What's worse is that some of these drugs are vital to a certain person's medication regimen, which presents a problem if they are unaffordable.
CVS Caremark has omitted a lot more prescription drugs from their coverage list compared to Express Scripts. The 130 removals from CVS' list is a whole lot more considering that Express Scripts only removed 85. "For 2017, [CVS Caremark] has excluded nine drugs that it deems "hyper-inflationary" or products with egregious cost inflation that have readily available, clinically appropriate and more cost-effective alternatives," says spokeswoman Carolyn Castel.
Other companies may also begin removing certain drugs from their list of coverage over the next couple of months. Although considering that CVS Caremark manages the prescriptions of over 75 million people, this is already a large loss. However, CVS claims that this is all part of their plan for formulary exclusion, which they claim could save customers up to $9 billion over the next five years.
