PBM Tools Offering
LOW VALUE DRUG LIST
ELIMINATING UNNECESSARY COSTS
Pharmaceutical manufacturers do not focus all of their R&D efforts on new drugs for new diseases. Often their efforts are directed at making small changes to existing therapies that allow for a new patent or extension on a medication that may have been available for many years. A new formulation, route of administration, or indications is all the FDA sometimes needs to grant this exclusivity. The manufacturer then uses their well joined and funded direct-to-consumer marketing machine to drive utilization of these unnecessary products.
The low value drug list (LVDL) program identifies and excludes from coverage drugs that are marketed in a formulation or combination that allows the manufacturer to maintain a patent to inflate the cost. These medications offer no clinical value over alternative products and serve only to increase manufacturer profits. Members who are prescribed drugs on the LVDL are moved to a more cost-effective, equally safe and efficacious alternative.
Plan costs are reduced without impacting patient care.
