Will Your Prescription Meds Be Covered Next Year? Better Check! : Shots - Health News Insurers have released the latest lists of prescription drugs they won't cover in 2017. Express Scripts is excluding 85 drugs and CVS Caremark, 131. Some drugs for diabetes and asthma are out.
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Will Your Prescription Meds Be Covered Next Year? Better Check!

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Will Your Prescription Meds Be Covered Next Year? Better Check!

Will Your Prescription Meds Be Covered Next Year? Better Check!

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DAVID GREENE, HOST:

If you're regularly taking prescription medication, you might want to check with your insurance company to see if those medications will be covered next year. The two biggest prescription insurers have released their 2017 lists of the drugs they will no longer pay for. Here's NPR's Alison Kodjak.

ALISON KODJAK, BYLINE: It's an ongoing battle between drug companies trying to make as much money as possible and insurers who don't want to pay. Come January, consumers are going to have to figure it out. That's because the companies that pay for the drugs have added to the lists of medications they won't cover next year. Lisa Gill of Consumer Reports says that can surprise some patients.

LISA GILL: We've talked to dozens and dozens of people who find themselves at the pharmacy counter shocked to find out that the drug is no longer covered.

KODJAK: CVS Caremark and Express Scripts cover more than 150 million people. Together, they've excluded about 200 medications, from diabetes medications to skin cream, that they say aren't worth the price. The companies say the strategy cuts their drug costs and eventually saves consumers' money by reducing insurance premiums. Jack Hoadley's a professor at Georgetown University's Institute for Health Policy.

JACK HOADLEY: For the consumer, it's a tradeoff. Am I getting enough of a discount to offset the inconvenience or the problems I'll face if that particular drug isn't the best drug for me to use?

KODJAK: Some of the medications on the list don't have generic alternatives which pharmacists can substitute without a doctor's approval. So consumers may have to go back to their doctor to get a prescription for a new medication. Hoadley says the new drug might be cheaper for consumers, but it may not work as well.

HOADLEY: And you end up having to switch to a drug that your prescriber thinks is less optimal for treating your particular health condition.

KODJAK: Consumers can appeal to have their preferred drugs covered, but that's not guaranteed. Alison Kodjak, NPR News.

GREENE: I know after hearing that, you're probably wondering if the drugs you take will no longer be insured. Well, you can find links to the lists on NPR's Shots blog at npr.org.

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