Express Scripts Holding Co.'s 2015 formulary exclusions offer hope that companies can renegotiate once-excluded drugs back into coverage. But the pharmacy benefits manager appears to be expanding the number of drugs and drug classes it scrutinizes.

Express Scripts released its 2015 formulary on Aug. 1. The list adds 10 drug classes and 25 product exclusions for a total of 66 products excluded from the formulary. The changes to the new list suggest new drugs could get excluded for lack of time to negotiate, even if they are priced competitively. And with the PBM continuing to add therapeutic categories to its list, old drugs aren't necessarily safe either (see "Express Scripts Exclusions Update," page 9).