Final EHB rule allows some drug formulary flexibility

Health plans sold on publicly run marketplaces must cover at least one drug in each therapeutic category or the same number of drugs in each category and class as is covered by the state's benchmark plan, whichever is greater, under final HHS rules. "When plans have more flexibility to design clinically based formularies, they can negotiate bigger price concessions from drugmakers and offer more affordable, generous prescription drug benefits to patients," PCMA President and CEO Mark Merritt said.

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Pharma Letter (U.K.) (subscription required), The · Politico (Washington, D.C.)