Express Scripts and Cigna Add Zepbound to Formularies
Zepbound was approved in November 2023 to treat patients with obesity. It was added to the national preferred formulary for Express Scripts and Cigna Healthcare in December.
Health Plans Release 2024 Prescription Changes in Medicare Plans
Aetna, Cigna, Humana, United Healthcare — some of the largest providers of Medicare Advantage plans — have released updates to prescription drug programs.
CVS Caremark Switches Up Biosimilar Coverage in 2024
New biosimilars have been added and others removed from CVS Caremark’s standard formulary. One notable change is with the Humira biosimilars. The PBM has removed Amjevita and now prefers Hyrimoz and an unbranded biosimilar.
Optum Rx Announces Formulary Exclusions for 2024
Optum Rx has added more than 50 products — including both branded and generics — to the exclusion list for the 2024 Premium Formulary.
CMS Expands Leqembi Coverage After FDA’s Full Approval
Medicare will cover Alzheimer’s drugs with full approval, including Leqembi — if the physician and patient participate in a real-world registry trial to gather additional data.
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PBM-Offered Genomics Testing Could Reshape Prescribing of Medications
July 25th 2025Two PBMs, True Rx Health Strategies and Capital Rx, are using pharmacogenomics — how a person’s DNA affects their response to medications — to reduce the trial-and-error of prescribing medications, saving employers and patients time and money.
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FDA Extends Review of Blenrep Combinations in Multiple Myeloma
July 24th 2025Last week, an FDA advisory committee against the risk-benefit profile of Blenrep in combination with other therapies. Regulators and reviewers were concerned about the ocular side effects and dosing and tolerability. The new action date is Oct. 23, 2025.
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Sarepta to Pause Shipments of the Gene Therapy Elevidys
July 22nd 2025Sarepta officials said the temporary halt in shipments was done to maintain a productive working relationship with regulators while they address a safety labeling update about the risk of acute liver disease related to Elevidys.
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