FOR AGENT/BROKER USE ONLY. DO NOT DISTRIBUTE.
2027 formulary updates
Express Scripts® Pharmacy Benefit Services continues its commitment to clinically appropriate, cost-effective prescription drug coverage. Changes to our annual formularies are available now.
2027 annual formulary updates
Effective January 1, 2027, Express Scripts is introducing the annual formulary enhancements across National Preferred, Flex, Basic, and High Performance formularies. These updates focus on excluding high‑cost products that do not demonstrate additional clinical value, while preserving access to preferred, clinically appropriate alternatives.
What's changing
Previous updates
2026 mid‑year formulary updates
Effective July 1, 2026, Express Scripts is introducing mid‑year formulary enhancements across National Preferred, Flex, Basic, and High‑Performance formularies. These updates focus on excluding high‑cost products that do not demonstrate additional clinical value, while preserving access to preferred, clinically appropriate alternatives.
What's changed
As previously communicated, STELARA® SC will be excluded from the National Preferred Formulary effective July 1, 2026, and will transition to non‑preferred status on the Basic Formulary. This aligns with a broader strategy to improve affordability and access through biosimilar options.
Client and member support:
No action is required from consultants
Clients were notified of these changes on March 17, 2026
Members required to switch medications will receive individualized communications, including alternative options and transition guidance
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.
What you need to know
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.
Source
- Express Scripts® National Preferred Formulary and National Preferred Flex Formulary members claim utilization, April – August 2026.