Insurance providers update their list of covered medications every year. This list is called a formulary, and it helps plan enrollees understand whether or not their insurance will help pay for their medication.
More and more medications are removed from formulary lists each year. This means that if your medication was covered by your insurance last year, there’s a chance it won’t be covered this year. Formularies are important lists to pay attention to, as they can have a big impact on your healthcare spending and out-of-pocket costs.
Insurance companies work with pharmacy benefits managers (PBMs) to update their formularies. So whether you have coverage through UnitedHealthcare, Anthem, or another insurer, your formulary is set by a PBM. To learn which PBM handles your pharmacy benefits, contact your insurance plan administrator.
The two largest PBMs — managing pharmacy benefits for over 200 million Americans — are Express Scripts and Caremark. At the start of 2019, they removed over 90 medications from their formularies. Now, at the beginning of 2020, they are removing over 300 medications. That could mean that your medication will no longer be covered by your insurance.
But don’t despair, ADV-Care pharmacy compiled a list of the same Canadian drugs (up to 120) offered at savings up to 90% of its average retail prices in your local pharmacy,
Curtsey Ellie Riley at GoodRx
| Express Scripts Insurance | CVS Caremark insurance | |||||
|
Medication Name | $US Retail | $ ADV Price | Medication Name | $US Retail | $ ADV Price | |
| Acuvail | $129.00 | $71.10 | Aciphex | $1,327.00 | $39.75 | |
| Adcirca | $5,180.00 | $853.77 | Actemra | $573.14 | ||
| Akynzeo | $708.00 | $188.10 | Alrex | $336.00 | $57.46 | |
| Albuterol | $94.00 | $29.26 | Asmanex | $283.00 | $67.50 | |
| Alogliptin | $530.00 | $117.42 | Baraclude Tablet | $1,160.00 | $211.09 | |
| Alogliptin/metformin | $466.00 | $121.83 | Betapace AF | $310.00 | $90.59 | |
| Arimidex | $1,549.00 | $227.16 | Calcipotriene cream | $517.00 | $86.62 | |
| Avalide | $892.81 | $160.27 | Calcitriol ointment | $591.00 | $187.01 | |
| Avapro | $815.00 | $164.27 | Carafate carbinoxamine tablets 6 mg | $98.00 | $58.10 | |
| Avodart | $720.80 | $205.21 | Colcrys | $755.00 | $52.17 | |
| Baraclude Tablet | $2,107.00 | $841.35 | Contrave | $369.00 | $342.83 | |
| Celebrex | $543.00 | $193.99 | Coumadin | $97.00 | $40.23 | |
| Celexa | $288.77 | $75.35 | Diclofenac sodium gel 1% | $84.00 | $34.74 | |
| Cialis | $842.50 | $157.99 | Diclofex DC | $279.00 | $65.58 | |
| Complera | $3,533.00 | $1,643.25 | Dihydroergotamine Mesylate | $4,568.00 | $183.54 | |
| Coreg | $216.00 | $50.70 | Dulera | $424.00 | $161.59 | |
| Cosopt | $247.34 | $113.28 | Eryped | $410.00 | $33.04 | |
| Cozaar | $576.00 | $214.75 | Finacea | $419.00 | $61.29 | |
| Cuprimine | $26,565.00 | $486.00 | FML eye dropper | $97.51 | $43.46 | |
| Delstrigo | $2,312.02 | $1,062.75 | Fulphila | $4,267.00 | $3,038.58 | |
| Detrol | $710.00 | $100.97 | Humalog 50/50 | $670.00 | $165.81 | |
| Doxycycline hyclate DR 80 mg | $914.00 | $89.79 | Humulin 70/30 | $181.00 | $52.94 | |
| Elidel | $722.00 | $197.48 | Humulin N | $350.00 | $81.75 | |
| Emend Capsules | $440.00 | $106.36 | Humulin R | $186.00 | $81.70 | |
| Exjade | $24,130.00 | $4,496.53 | Indocin Inflammacin | $91.00 | $51.14 | |
| Ezallor | $285.59 | $224.14 | Lamictal | $1,828.00 | $218.96 | |
| FeMara co-pack | $833.00 | $297.27 | Lanoxin tablets | $237.00 | $51.80 | |
| Fiasp | $159.56 | $169.43 | Lialda | $1,472.00 | $272.65 | |
| FML S.O.P. | $383.00 | $63.95 | Lotemax | $573.42 | $77.15 | |
| Glucophage | $28.41 | $46.82 | Macrodantin | $652.00 | $121.14 | |
| Hyzaar | $107.00 | $214.75 | Miacalcin | $635.71 | $189.84 | |
| Imiquimod 3.75% cream pump | $1,224.00 | $397.84 | Minivelle | $246.00 | $58.74 | |
| Insulin lispro | $315.00 | $166.51 | Minocin | $365.00 | $48.53 | |
| Jadenu | $15,785.88 | $4,743.91 | Mupirocin cream | $53.24 | $43.78 | |
| Kapspargo | $175.00 | $67.45 | Naproxen CR | $45.45 | $101.54 | |
| Katerzia | $657.00 | $233.66 | Orencia intravenous | $6,954.00 | $1,745.12 | |
| Keppra | $1,201.44 | $336.81 | Orencia subcutaneous | $6,954.00 | $1,745.12 | |
| Loestrin 1/20 | $170.00 | $108.68 | Pred Forte | $183.00 | $54.82 | |
| Maxalt | $441.27 | $310.25 | Procrit | $1,452.00 | $598.91 | |
| Maxalt-MLT | $580.92 | $310.25 | Rapaflo | $680.00 | $228.50 | |
| Namenda XR | 363.62 | $114.84 | Rimso-50 | $747.00 | $161.31 | |
| Osmolex ER | $1,335.00 | $86.15 | Sabril | $13,875.80 | $132.66 | |
| Pataday | $260.00 | $52.98 | Tirosint | $460.00 | $34.28 | |
| Praluent | $1,170.00 | $695.60 | Tobi | $7,416.00 | $3,812.40 | |
| Prezcobix | $2,449.41 | $905.28 | Toprol XL | $238.90 | $73.15 | |
| Prolia | $1,227.00 | $479.62 | Vectical | $655.80 | $121.35 | |
| Rabeprazole DR sprinkle | $423.00 | $35.77 | Xolegel | $917.00 | $50.70 | |
| Rapaflo | $974.00 | $91.49 | Yaz | $198.00 | $42.88 | |
| Siklos | $1,768.00 | $83.56 | Zarxio | $1,694.00 | $891.59 | |
| Spiriva Respimat | $525.00 | $101.17 | Zytiga | $14,151.00 | $4,400.75 | |
| Stribild | $4,194.00 | $1,811.65 |
|
|
| |
| Striverdi Respimat | $258.00 | $99.64 |
Dropped by insurance in 2019 | |||
| Symtuza | $4,676.00 | $1,910.62 |
Medication Name | $US Retail | $ ADV Price | |
| Tolsura | $2,209.00 | $356.65 | Acticlate | $282.74 | $63.84 | |
| Topamax | $2,033.30 | $223.06 | Alprolix | $213.22 | $38.22 | |
| Trileptal | $1,145.00 | $246.65 | Benzaclin | $3,661.58 | $1,682.07 | |
| Tudorza Pressair | $633.00 | $101.70 | Invokamet | $368.00 | $342.82 | |
| Uroxatral | $2,376.00 | $152.27 | Invokana | $474.91 | ||
| Vagifem | $514.00 | $112.90 | Jentadueto XR | $23,769.00 | $13,702.98 | |
| Vivlodex | $938.00 | $51.95 | Mavyret | $6,944.30 | $1,815.49 | |
| Yasmin | $154.00 | $37.97 | Praluent | $166.00 | $35.81 | |
| Zocor | $951.00 | $384.02 | Tirosint | $107.25 | $33.76 | |
| Zomig | $2,868.00 | $131.04 | Vanatol S | $812.00 | $150.83 | |
| Zytiga | $14,151.00 | $4,400.75 | Zolpimist | $15,530.58 | ||
Written By Curtsey Ellie Riley | Photo by Hush Naidoo Jade Photography on Unsplash