2027 Express Scripts National Preferred Formulary

Excluded medications/products at a glance

AQVESME* ARANESP* ARBLI ARIMIDEX^ ARKRAY PEN NEEDLES AND SYRINGES ARNUITY ELLIPTA ARYNTA ASCENSIA (CONTOUR) ATACAND^, ATACAND HCT^ ATMEKSI ATOMOXETINE SOLUTION ATONCY ATORVALIQ ATRALIN^ ATROPINE PF 1% DROPPERETTE

BLENREP* BLUJEPA BOMYNTRA* BONJESTA BORUZU* BOSAYA* BOTOX* BREKIYA* BRENZAVVY BRILINTA^ BRIUMVI*

A ABILIFY^ ABRILADA* ABSORICA LD

ACANYA^ ACIPHEX^ ACTEMRA IV*, ACTEMRA SC* ACUVAIL

ADALIMUMAB-AACF* ADALIMUMAB-AATY* ADALIMUMAB-BWWD* ADALIMUMAB-FKJP* ADALIMUMAB-RYVK (by Teva)* ADCIRCA*^ ADDERALL^, ADDERALL XR^ ADDYI ADMELOG ADTHYZA 16.25MG, 32.5MG, 65MG, 97.5MG, 130MG ADVAIR DISKUS^ AFINITOR*^, AFINITOR DISPERZ*^ AFREZZA AGAMREE* AIRDUO RESPICLICK AKEEGA* AKYNZEO CAPSULES ALBUTEROL SULFATE HFA (by Prasco) ALCORTIN A ALINIA TABLETS^ ALKINDI SPRINKLE ALOGLIPTIN ALOGLIPTIN/METFORMIN ALOGLIPTIN/PIOGLITAZONE ALREX^ ALTOPREV ALVAIZ*

BROMSITE^ BRUKINSA* BRYNOVIN BUCAPSOL BUPROPION XL 450MG BUSPIRONE 2.5MG AND 12.5MG

ATTRUBY* AUBAGIO*^ AUKELSO* AUSTEDO*, AUSTEDO XR* AVALIDE^, AVAPRO^ AVASTIN* AVEED* AVERI

BUTRANS^ BYNFEZIA* BYOOVIZ* BYQLOVI BYSANTI BYSTOLIC^

AVGEMSI* AVLAYAH* AVODART^ AVTOZMA SC* AXTLE azelastine/fluticasone

C CABTREO CALCIPOTRIENE FOAM

CAMCEVI* CANASA^ CARAC CARAFATE CARBIDOPA/LEVODOPA ER CAPSULES CARBINOXAMINE ER 4MG/5ML SUSPENSION CARDIZEM LA

AZMIRO AZOPT^ AZOR^

B BALCOLTRA^ BANZEL^ BARACLUDE TABLETS^ BASAGLAR, BASAGLAR TEMPO BEIZRAY*^ BEIZRAY/ALBUMIN* BENICAR^, BENICAR HCT^ BEPREVE^ BERINERT* BESIFLOXACIN BESIVANCE BESREMI* BETIMOL BEVESPI AEROSPHERE BIDIL^ BIGFOOT UNITY PROGRAM KIT BIJUVA BISOPROLOL 2.5MG TABLETS BKEMV*

CAROSPIR^ CELEBREX^ CELEXA^ CETRAXAL CHORIONIC GONADOTROPIN 10,000 UNITS* CIALIS^ ciclopirox 8% treatment kit CILOXAN OINTMENT

ALVESCO ALYMSYS* AMBIEN^, AMBIEN CR^ AMITIZA^ AMJEVITA* AMONDYS 45* AMPYRA*^ AMRIX^

CINQAIR* CINVANTI CIPRO HC^ CIPROFLOXACIN/FLUOCINOLONE OTIC CITRANATAL clemastine CLENIA PLUS CLENPIQ CLIMARA PRO

AMVUTTRA* ANDROGEL^ ANTIVERT ANUSOL-HC^ APHEXDA* APIDRA APLENZIN APOKYN* APTENSIO XR^

© 2026 Evernorth Health Services. All rights reserved. All trademarks are the property of their respective owners. CRP1584203A 204612 NP Excl (08/01/2026)

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