By Ransdell Pierson and Bill Berkrot, Reuters Staff
(Reuters) AUGUST 6, 2015 — CVS Health Corp, which operates the nation’s second-biggest pharmacy benefit manager, said that next year it will exclude an additional 31 prescription medicines from insurance coverage, including Viagra (sildenafil) and widely used treatments for diabetes and multiple sclerosis.
The 2016 excluded drugs, disclosed on Wednesday, also include Vivus Inc’s weight loss treatment Qsymia (phentermine and topiramate), which last week was excluded from the 2016 formulary of rival PBM Express Scripts Holding Co. Vivus officials could not immediately be reached for comment.
Pharmacy benefit managers, or PBMs, which administer drug benefits for employers and health plans and also run large mail-order pharmacies, have been challenging the rising cost of new medications. When drugs are knocked off their formularies, patients may have to pay full price for them. PBMs often keep or dump a product depending on whether they can obtain favorable pricing.
Viagra, the world’s first approved pill for erectile dysfunction, has annual sales of $1.8 billion, including $1.3 billion in the United States. Cheaper generic versions are expected to be launched by December 2017.
“Pfizer is committed to ensuring patient access to our medicines,” the drugmaker said in an emailed statement.
The CVS formulary, however, does include Eli Lilly and Co’s rival Cialis (tadalafil) anti-impotence treatment.
Next year’s formulary will also exclude two interferon-based multiple sclerosis treatments from Biogen, big-selling Avonex (interferon beta-1a) and its new longer-acting Plegridy (peginterferon beta-1a). Avonex, Biogen’s second-biggest product, has annual sales of almost $2.5 billion.
