WSJ: Benefit managers are curtailing coverage of compounding ingredients

NEW YORK — Express Scripts has taken as many as 1,000 active ingredients widely used by compounding pharmacies off of their coverage list, according to a Wall Street Journal report published Tuesday. 

 

The change comes as costs of the compounding ingredients have spiked. 

 

“It’s an issue of waste,” Glen Stettin, Express Scripts SVP clinical, research and new solutions, told WSJ. “For nearly all of these products, there’s already a commercial preparation already available — a generic or brand-name product approved by FDA. And there is no evidence to support their use at all.”

 

Express Scripts is not alone, WSJ noted. Optum Rx, the benefits manager that is part of United Health Group, CVS Caremark and the Catamaran pharmacy benefits manager have also started placing restrictions on coverage, WSJ reported. Last year, Harvard Pilgrim Health Care, the largest insurer in New England, ended coverage, except for children and medically necessary drugs for adults.