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Pharmacy benefit manager to slash compounded medication coverage
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 medicines are ineffective or overpriced.
The company, which manages prescriptions for 90 million Americans, plans to drop coverage for 1,000 drug ingredients commonly found in compounded medications. The company says the move is a cost-saver for employers that will reduce spending on the prescriptions by 95 percent.
"What we are eliminating is, pure and simple, wasteful spending," said Senior Vice President Glen Stettin. "These drugs are being used when there are other things available that are already approved by the FDA and are less expensive."
Compounding pharmacists argue that such cuts deprive patients of crucial medications not available as manufactured drugs. An industry spokesman said similar efforts are in the works from several insurers and benefit providers, including some Blue Cross Blue Shield plans.
The Express Scripts cuts take effect Sept. 15, unless customers specifically ask to continue paying for the compounded drugs.
Associated Press
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