WASHINGTON (July 3, 2014) The nation's largest pharmacy benefit manager, Express Scripts, is dramatically scaling back its coverage of compounded medications, saying most of the custom-mixed formulas are either ineffective or overpriced.
The company, which manages prescriptions for 90 million Americans, plans to drop coverage of 1,000 drug ingredients commonly found in compounded medications in a move it says will cut wasteful spending and lower its customers' compounded drug costs by 95 percent.
But the coverage change prompted a swift pushback from compounding pharmacists, who argue that the cuts will deprive patients of crucial medications that are not available as traditional manufactured drugs.
A spokesman for the pharmacists says similar efforts to curb coverage are in the works from several other pharmacy benefit providers and health insurers.
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