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2026 annual formulary updates

Express Scripts® Pharmacy Benefit Services continues its commitment to clinically appropriate, cost-effective prescription drug coverage. Annual changes to our formularies are available now.

man with pill bottle
Clients notified on August 19, 2025

2026 annual formulary updates

Our mutual clients are committed to having the most up-to-date, clinically appropriate and cost effective prescription drug coverage for their members. Because of our partnership with thousands of clients, we use our unmatched scale and proven track record to advocate on their behalf, leveraging negotiations to provide competitive pricing. When clinical considerations align with these opportunities, patients and payers benefit.

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What you need to know

Annual changes to the National Preferred Formulary

On January 1, 2026, we will exclude 50 additional products from the National Preferred Formulary, demonstrating our commitment to minimizing health care waste by excluding high-cost medications that may not provide greater clinical results.

View the list of new exclusions and preferred alternatives
Over
99%
of members will have no disruption at the pharmacy counter1
Annual changes to the National Preferred Flex Formulary

On January 1, 2026, we will exclude 47 additional products from the Flex Formulary. The National Preferred Flex Formulary gives clients a pathway to cover alternative products with lower list prices.

View the list of new exclusions and preferred alternatives
Over
99%
of members will have no disruption at the pharmacy counter1

Annual changes to the Basic and High Performance Formularies

Additional opportunities were identified for Basic and High Performance to help client and member savings. Detailed 2026 annual status updates for these formularies are now available.

View updates

Supporting clients and their members

The small percentage of members being asked to switch to preferred medications will receive personalized outreaches, including a list of alternative medications and information on switching to a preferred product.

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No action is required from you, but optionality is available

Clients were notified of these changes on August 19, 2025. To encourage faster adoption of biosimilars, alternative utilization management offerings rolled out earlier this year are available. Clients should contact their account team no later than September 16, 2025, to determine eligibility and an effective date.
View our consultant FAQs.

Questions? Contact our team.

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1 Express Scripts claims data, 3/15/25-7/22/25