Express Scripts excludes Amgen drugs from 2015 formulary

Fri Aug 1, 2014 5:12pm EDT

Aug 1 (Reuters) - Express Scripts Holding Co, the largest U.S. pharmacy benefit manager, on Friday said it will not include anemia drugs Epogen and Aranesp, both sold by Amgen Inc, on its 2015 list of preferred medications.

The company will, however, continue to include Procrit, a similar drug sold by Johnson & Johnson, on its formulary.

Epogen, and second-generation drug Aranesp, have been hugely profitable for Amgen, although their use has waned in recent years due to safety concerns, including increased risk of heart problems. Still, the two drugs generated U.S. sales of $2.7 billion last year.

Express Scripts said it knows that there are rare instances when a specific patient has a unique circumstance where they may require one of the excluded drugs, and it has a process for physicians to pursue in those cases.

"Of the more than 4,000 drugs available to patients, only 66 will be excluded from our 2015 formulary," the company said. It calculated that less than 0.2 percent of its members will be affected by the changes.

Further details on the changes were not immediately available. Officials at Amgen did not immediately respond to a request for comment.

Express Scripts, which has nearly 25 million Americans on its National Preferred Formulary, can drive enormous revenue toward drugmakers whose products it selects. They will typically be those that offer lower prices a for similar clinical benefit and for which patients will be charged lower co-pays

The company has been a vocal critic of rising prescription drug prices. For 2014, it excluded certain specialty drugs from five therapeutic categories, including multiple sclerosis and inflammatory diseases. It has also criticized the $84,000 cost of Sovaldi, the hepatitis C treatment introduced in December by Gilead Sciences Inc.

Pharmacy benefit managers administer prescription drug benefits for employers and health plans and run large mail-order pharmacies. (Reporting By Deena Beasley; Editing by Jonathan Oatis)

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