PBMs' drug formularies are rapidly shrinking, research shows

The share of drugs covered by insurers is dropping at an increasingly fast pace, leaving many Americans with prescriptions their health plans don't cover, according to research released Oct. 26 by GoodRx.

GoodRx analyzed Medicare Part D data, examining coverage from an average of 3,707 plans from 2010 to 2021.

On average, the share of covered drugs dropped by 18 percentage points from 2010 to 2021. The average plan covered 73 percent of prescribed drugs in 2010 but just 55 percent in 2021. The report said commercial plans likely saw an even steeper decrease in coverage.

The report also found that the average number of drugs in Part D plans with restrictions increased from 27 percent in 2010 to 47 percent in 2021.

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