Express Scripts: 2025 National Preferred Formulary (NPF) Exclusions (1/3/25) Optum Rx: 2025 Premium Standard Formulary (1/1/25) Brand-name products with generic equivalents or therapeutic alternatives Biosimilars and reference biologics with biosimilar alternatives Heavily promoted drugs in therapeutic classes with multiple generic alternatives Cigna’s Evernorth segment operates Express Scripts and the Quallent Pharmaceuticals private label business. For 2025, Express Scripts’ formulary contains Quallent-branded Humira biosimilars manufactured by Boehringer Ingelheim and Alvotech/Teva. Both Quallent products are priced midway between the high- and low-list-price biosimilars. By contrast, Express Scripts had eight products (including Humira) on its formulary at the start of 2024. CVS Health owns both Caremark and the Cordavis private label business. For 2025, Caremark’…

As I describe in Humira Biosimilar Price War Update: Should We Be Glad that CVS Health and Express Scripts Are Using Private Label Products to Pop the Gross-to-Net Bubble?, CVS has led the adoption of low-list-price products. UnitedHealth Group’s Optum segment operates Optum Rx as well as the new Nuvaila private label business. For 2025, its Premium and Select formularies will have only two preferred formulary options: the high-list-price Amjevita from Amgen and the low-list-price Amjevita from Nuvaila (but manufactured by Amgen). Its Premium Value formulary will have the low-list-price private label product along with the low-list-price unbranded biosimilar from Boehringer Ingelheim. By contrast, Optum Rx had eight products (including Humira) on its formulary at the start of 2024. 2025 Gross-to-Net Realities at Eight Top Drugmakers: The Net Pricing Drug Channel Emerges