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The NPF - Adding Value
The NPF - Adding Value
VALUE
NATIONAL PREFERRED FORMULARY
GENERATES SAVINGS
FOR PLANS AND PATIENTS
UNLOCKING
$10.6 BILLION
IN VALUE
FOR PLANS
Every year, the U.S. wastes nearly one trillion dollars on
unnecessary healthcare spending that provides no added
health benefit, such as prescribing a brand drug when a
lower-cost generic is available.
3.5 $10.6B
in projected savings tied to
3
About this report formulary exclusions (2014-2019)1
$3.2B
Billions of dollars
2.5
Express Scripts conducted
$2.5B
a retrospective analysis to 2
determine the impact of
$1.8B
1.5
our formulary development
1
$1.3B
and adherence.
0
2014 2015 2016 2017 2018 2019
1
Does not include savings generated from our clinical programs.
An independent, nationwide
Pharmacy & Therapeutics (P&T)
REDUCING COSTS
Committee of physicians and
pharmacists carefully reviews and
approves clinical evidence for
WITHOUT
medications. They recommend
which drugs our NPF must include,
may include, or must exclude.
COMPROMISING CARE
This P&T review ensures that
the NPF gives members access
to essential therapies that are
clinically effective and safe.
$450
Diabetes (36% savings)
$400 Pulmonary (30% savings)
$350
$424.22
$300
$396.38
$250
$330.18
$308.48
$200
$150
$100
$136.95
$114.44
$50
0
2016 2017 2018
Any member denied a formulary exception may appeal the decision with
their prescriber. Each year, approximately 13.6% of members seek an
appeal for a denied formulary exception; of those more than half are
granted approval.