Patient groups urge CVS to reconsider ICER-restricted formulary

At least 94 patient groups and individuals signed a letter urging CVS Health Corp. (NYSE:CVS) President and CEO Larry Merlo to reconsider a new formulary that would be restricted to drugs deemed cost effective by the Institute for Clinical and Economic Review (ICER). The formulary would allow clients to exclude from their plan any drug with a launch price that exceeds a cost-effectiveness ratio of $100,000 per quality-adjusted life year (QALY) gained as determined by ICER.

The new formulary, announced by CVS’s PBM CVS Caremark last month, will not exclude drugs FDA has designated as breakthrough therapies (see “CVS to Launch ICER-Restricted Formulary”)...