PBM Drug Exclusion List Changes for 2026

IPD Analytics has released a new report, “PBM Drug Exclusion List Changes for 2026,” analyzing the 2026 formulary exclusion lists from the three largest pharmacy benefit managers (PBMs), CVS Caremark, Express Scripts, and Optum Rx.

The review identified notable changes in immunology, oncology, and rare diseases, including evolving biosimilar strategies for products such as Humira and Stelara, while examining the balance between clinical value and rebate economics in PBM decision-making.