2022 CVS Caremark formulary updates

Building on our decade of exceptional value and care

Our decade of market leadership implementing formulary innovations — from drug removals to new-to-market evaluations, from Tier 1 to indication-based strategies — continues. Each year we evolve our formulary strategies to keep clients ahead of a rapidly changing market. Such an innovative approach to formulary management has helped save our clients tens of billions of dollars.

Negotiating discounts from manufacturers, as well as developing and implementing proactive solutions — such as utilizing generic and biosimilar drugs to drive competition within a therapy class — are some of the many ways we continue to focus on helping our clients save money.

Committed to innovation and delivering results

• 2012
  • Formulary removals
• 2015
  • New-to-market evaluations
• 2016
  • Specialty class review
• 2017
  • Indication based strategy
• 2018
  • Value-based strategy
• 2019
  • Tier-1 strategy
• 2020
  • Quarterly review and/or update

Continuing to deliver value in 2022

• $4.4B savings expected for those aligned to our template formularies
• $132 per member — for clients aligned to our template formularies

99.61% will not experience any changes from the formulary removals effective January 1, 2022*

2022 Standard Control Formulary Changes**

The changes we are making effective January 1, 2022 will help ensure our formulary strategies remain the most impactful tool for clients seeking to better manage costs.

• 20 drugs removed; 4 drugs added back***
• 2 drugs added to Tier 1 strategy
• Tier 1 strategy expected to deliver average savings of 31% per claim¹
• 99.61% of members will not be impacted by the formulary removals

Ensuring plan member access, affordability and convenience

We remain motivated to keep member costs low so they can afford their medications, work toward minimal member disruption and maximize member experience. Our formulary updates for 2022 ensure that 99.61 percent of members will not be impacted with changes.

Those members — and their prescribers — impacted by the removals will receive proactive communications to help with a seamless transition. We educate them on medications that will no longer be covered as well as clinically appropriate formulary options.

CVS Health is committed to providing a clinically sound formulary that drives lowest net cost for clients while ensuring members have affordable access to the drugs they need to manage their health.

* CVS Health, 2021. Client savings determined using cumulative value over 5-year period (Upcoming year, current year and 3 prior years).​ All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors.​

** Changes for Standard Control Formulary, Advanced Control FormularyTM, Balanced Formulary and Value Formulary, where applicable.

***Numbers may change with quarterly review and update.

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