Express Scripts Exclusions Target 25 Drug Classes 12/5/2018 Health Strategies Group Author/Artist Express Scripts Exclusions Target 25 Drug Classes Express Scripts indicated that rebates, along with lower list prices, drove its exclusion decisions. 22 With the addition of the 48 new exclusions, the total number of Express Scripts exclusions increase to 242 for 2019. Have low-cost generic alternatives, even when brand drugs include rebates, the generic drugs have a better value 12 11 10 9 Instances of brand-to-brand competition, where drugs have the same active ingredient, but the excluded drug has a higher net cost Specialty drugs with a lower-cost brand or biosimilar alternative and a lower list price Drugs that are multisource brands with direct generic equivalents. Short-term therapies, such a topical creams and ophthalmic treatments . Source: Express Scripts, 2019 National Preferred Formulary: Better Access Better Value. Retrieved from http://lab.express-scripts.com/lab/insights/drug-options/2019-national-preferred-formulary-better-access-better-value. Accessed August 8, 2018; Health Strategies Group, Leading Health Plans and PBMs, August 2018.