The Pharmaceutical Care Management Association (PCMA) recently commissioned Milliman to assess the financial impact of proposed frozen formulary legislation on fully insured commercial health insurance market payer costs. Frozen formulary legislation refers to a set of regulations proposed by state legislators that would limit the ability of pharmacy benefit managers (PBMs) and payers to implement negative formulary changes to prescription drugs. In this report, our findings include discussion of:

• New generic/biosimilar drug launch
• New brand drug launch
• Established brand changes
• State-specific estimates
• Other considerations

This report was commissioned by Pharmaceutical Care Management Association.