13 August 2018 - In an ongoing war over drug prices, leading pharmacy benefit manager CVS Caremark is rolling out a new weapon that aims to limit drug maker pricing power. 

The PBM plans to let clients exclude drugs based on assessments from a controversial pricing watchdog—and pharma is likely to hate the idea.

Under the program, unveiled in a drug pricing white paper, CVS Caremark will start allowing clients to exclude any drug with a quality-adjusted life years figure of more than $100,000, as determined by the ICER. Health organisations use the metric to determine the cost of medicines in the context of quality and expected remaining years of life. Critics, however, have said payers can use the metric and other cost-effectiveness analyses to deny patient access to drugs.

Read Fierce Pharma article