Estimated cost of potential “frozen formulary” legislation

“Frozen formulary” legislation refers to regulations proposed by state legislators that would prohibit a pharmacy benefit manager (PBM) or health plan from making certain changes to a prescription formulary midyear.

Based on a recent analysis, Milliman estimates the proposed “frozen formulary” legislation could increase payer prescription drug costs in the fully insured commercial health insurance market by approximately $4.3 billion to $7.1 billion over five years (from 2021 through 2025) on a nationwide basis.

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