Pharmacy benefit manager formulary exclusion growth 2015-2022

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This statistic shows the growth rate of the total number of unique prescription medicines excluded from one or more formularies by the leading three U.S. pharmacy benefit managers (PBMs) from 2015 to 2022. In 2022, the number of such exclusions increased by 29 percent compared to the preceding year. The leading three PBMs — CVS Caremark, Express Scripts, and OptumRx — handle around 80 percent of all prescriptions in the United States.

Growth rate of prescription medicines excluded from one or more pharmacy benefit manager (PBM) formulary from 2015 to 2022

Characteristic	Growth rate of unique Rx drugs excluded
2022	29%
2021	6%
2020	56%
2019	39%
2018	57%
2017	19%
2016	53%
2015	26%

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Release date

May 2022

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Region

United States

Survey time period

2015 to 2022

Supplementary notes

This statistic includes the leading three PBMs: CVS Caremark, Express Scripts, and Optum Rx. In 2014, medicines were either excluded from CVS Caremark, Express Scripts, or both. OptumRx did not begin excluding medicines from its formulary until 2016.

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