As generic Truvada (emtricitabine/tenofovir) is now available, Optum Rx will exclude both brand Truvada and Descovy the only two FDA approved for HIV-1 pre-exposure prophylaxis (PrEP).This change represents a large portion of the member impact for these PBMs. Express Scripts and Optum Rx will remove all branded formulations of Albuterol HFA products, covering only the generic in 2021.Optum Rx also announced changes to their utilization management programs for specialty drugs, including quantity limits for drugs used for the treatment of hereditary angioedema (HAE) and Stelara.Plan sponsors will experience the high upfront costs for required loading doses of Taltz for patients who transition to the new preferred therapy. Cosentyx will be removed, and Taltz will be added as the preferred drug therapy in 2021. Express Scripts is reversing the formulary status of two drugs used for the treatment of moderate to severe plaque psoriasis and other inflammatory conditions.OptumRx will remove Rebif offering Avonex or Betaseron as alternatives. Multiple Sclerosis is a targeted category for specialty drug changes with CVS removing brand Tecfidera and covering the generic.OptumRx ® is removing OneTouch test strips and adding Contour™ Next, which will be their preferred product.Members currently utilizing Accu-Chek test strips will have the option to continue at their current copay tier but OneTouch test strips will be the preferred product for new users. CVS is removing Accu-Chek ® and will add back OneTouch ® test strips, which were removed just two years ago.CVS and OptumRx are making changes to their preferred test strips.Express Scripts is narrowing coverage of its type 2 diabetes drug classes when Januvia and its combination products will be the only DPP4 inhibitor drugs covered.Diabetes is a top category of spend for most plan sponsors, and it will see changes from all three in 2021.The most notable highlights are discussed below. All three have made changes in diabetes, specialty drugs, generics, and biosimilars.

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