Table 1. Centers for Medicare and Medicaid Services (CMS) Part D Spending for Drugs on CVS Caremark and Express Scripts Formulary Exclusion Lists and Potential Savings Through Generic Substitution, 2012-2015.
| Parameter | Year | ||||
|---|---|---|---|---|---|
| 2012 | 2013 | 2014a | 2015a | Total (Unique)b | |
| Excluded drugs, No. | 19 | 27 | 48 (9) | 55 (9) | 149 (62) |
| Excluded drugs with a bioequivalent generic substitute, No. | 1 | 4 | 14 (1) | 18 (0) | 37 (19) |
| Excluded drugs with only therapeutic generic substitutes, No. | 18 | 23 | 34 (8) | 37 (9) | 112 (43) |
| Therapeutic generic substitutes, No. | 28 | 44 | 93 (24) | 122 (43) | 287 (151) |
| CMS spending on excluded drugs, $ |
183 487 318 | 846 732 825 | 1 180 103 354 (27 415 545) | 1 396 504 737 (90 665 200) | 3 606 828 233 |
| Projected CMS spending if generics had been substituted, $ | 45 097 054 | 262 737 040 | 219 596 661 (7 612 062) | 174 403 662 (5 021 370) | 701 834 416 |
| Potential CMS savings if generics had been substituted, $ | 138 390 265 | 583 995 784 | 960 506 693 (19 803 483) | 1 222 101 075 (85 643 830) | 2 904 993 817 |
a
Numbers in parentheses represent the value only among the drugs excluded by both CVS Caremark and Express Scripts in a given year.
b
Many of the formulary-excluded drugs and generic substitutes are listed in multiple years. The “unique” value refers to the total unique excluded drugs and unique generic substitutes per excluded drug between 2012 and 2015.