We are disappointed to inform you that Express Scripts (ESI) has made the decision to stop covering PRALUENT on its insurance plans effective on January 1, 2021.
What does this mean for me?
- If you are covered through an Express Scripts plan or employer, you may be asked to switch from PRALUENT to another medication. You may receive a letter from Express Scripts to notify you of this change
- There are several health plans and employer plans associated with Express Scripts that are still covering PRALUENT, so you may not be affected
Are there options to continue my treatment on PRALUENT?
- If your doctor determines it is in your best interest to continue treatment with PRALUENT, he/she can submit a medical exception form
Medical Exception Form
If your doctor determines it is appropriate, he/she can request a medical exception form for you to continue your treatment on PRALUENT, either through Cigna or Express Scripts depending on your prescription benefit. Your doctor would need to fill out and submit the medical exception form in its entirety, stating all relevant clinical details and the medical rationale, and provide appropriate documentation to support the use of PRALUENT.
If you have any questions, please contact us at 1-844-PRALUENT (1-844-772-5836).