Express Scripts' National Preferred Formulary
Only members of the following trust(s) may view the full details of this program:
Under your prescription drug plan, your medication may be a brand name or a generic alternative. Your prescription drug plan also includes a formulary. At its most basic level, formularies are lists of drugs, generic and brand name, which offer the greatest overall value to plan participants. The Plan’s Formulary is provided by your Pharmacy Benefits Manager (PBM), Express Scripts Inc. (ESI).
Medications indicated on the formulary list are typically grouped into three tiers: generic, preferred brand and non-preferred brand. Formulary management enables you and your physician to choose clinically appropriate and cost-effective drugs for specific conditions. Medications not on the formulary list are not covered by the Plan.
Click here to watch a video on how formularies work.
Below is the Plan's 2017 Preferred & Excluded Formulary, including the most common generic and preferred drugs. This list is not all-inclusive and does not guarantee coverage as it is subject to change.
2017 National Preferred Without Contraceptives.pdf
Next year, out of more than 4,000 drugs available on the market, ESI will offer a formulary that excludes 87
. For each one of those excluded drugs, there are clinically equivalent, lower-cost options available. In most cases, if you fill a prescription for one of these excluded drugs, you will pay the full retail price. The plan's formulary will continue to ensure that clinically sound, cost-effective drugs are available to members and will drive greater savings, in part by minimizing brand inflation and by reducing the use of non-preferred brands.
To check the price and coverage of medications under your plan simply select “My Prescription Drugs” then “Price a medication” from the menu and search for your medication to see pricing. Click “View coverage notes” on the pricing results page to see any coverage details.
If a medication is non-preferred, coverage notes will display "This medication is covered under your plan; however, it is a non-preferred product."
and if the medication is excluded, coverage notes will display "This medication is no longer covered on your drug list; view preferred alternatives".
You can click the link to "view formulary alternatives."
Take action to avoid paying full price.
If you’re currently using one of the non-preferred or excluded medications, please ask your doctor to consider writing you a new prescription for a preferred alternatives.
Below is the Plan's 2016 Preferred & Excluded Formulary, including the most common generic and preferred drugs. This list is not all-inclusive and does not guarantee coverage as it is subject to change.
National Preferred Alpha without contraceptives PRMT22163-16.150915.pdf
If you are a member of one of these trusts, please login or register for more information.