Biosimilars Council: Express Scripts’s National Preferred Flex Formulary is an Opportunity for Biosimilars

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Express Scripts has announced “a new drug reimbursement list with lower U.S. prices for brand-name medications, as a way to encourage drugmakers to move away from paying rebates after a prescription is filled.”  You can read Express Scripts’s press release here.  According to the Biosimilars Council, this could provide a particular opportunity for biosimilars to be listed on the formulary.

The Biosimilars Council suggests that the Express Scripts formulary could reduce the impact of the so-called “rebate trap.”  Some commentators have described the “rebate trap” as occurring when payers are offered rebates on a branded drug, but the rebate disappears if the payer also offers a biosimilar product.  According to the Biosimilars Council, this tactic can be less of a deterrent to biosimilar uptake if the formulary is designed to reduce reliance on brand rebates, which should mean biosimilars will have an improved chance to be listed on the Express Scripts formulary.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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