The nation’s largest mail-order pharmaceutical company, Express Scripts, has reported their plans to no longer continue to carry 64 formerly covered prescription drugs, due to a recent spike in cost. Some popular brands such as Pfizer’s Xeljanz, a pill that treats rheumatoid arthritis; the injectable diabetes drug that is a product of Novo Nordisk; and the inhaler by GlaxoSmithKline, Breo Elipta. This change will even affect older brands such as Bayer’s Betaseron which treats multiple sclerosis.

Express Scripts’ closing down of certain brand name drugs is the result of the PBM’s rise in power over the pharmaceutical industry. Express Scripts has already deleted 46 brand name drugs along with their generic competitors, taking less expensive versions of an older product.

For instance, osteoporosis patients will now have to take an alternative treatment for their weakened, deteriorating bones. The newest treatment of osteoporosis for 2018 was going to be Amgen’s Neupogin (filgrastin), but that brand is being dropped, and to be replaced with the bio-similar Zarxio (filgrastin-sndz) and the brand Forteo (teriparitide) will be dropped completely.

What is this going to do to all the osteoporosis sufferers whom have taken and trusted those drugs for years? Will the new, cheaper brands have the same potency of the old product lines? These are all questions consumers and stockholders alike have.

PBM sent a letter to the CEO of Gilead, John Milligan, asking for a reduction in the hepatitis C treatment, to bring down the cost of treatments to $50,000. Milligan states that prices are kept high because it makes it easier for management to negotiate rebates and discounts in exchange for favorable coverage.

Consumers do not realize how much their drugs really cost, because they only pay what the insurance agencies choose to charge them as their co-pay cost.

Radius Health recently won approval of the drug Tymlos, for treating osteoporosis, with the wholesale price of $19,500 in comparison to Forteo’s price of $35,500. Express Scripts has several generic treatments to use as alternatives to Forteo to treat the bone disorder, and by excluding Forteo, should help Tymlos to gain momentum in the market share.

However pharmacies decide to handle the loss of these brand names, we as the consumer of these drugs must trust that our health is a priority when they are choosing to go with cheaper, or generic brand names. The people with chronic or debilitating conditions, such as osteoporosis, rheumatoid arthritis, multiple sclerosis, and even cancer, have lives that are dependent on the drugs they must take to control their conditions and/or to keep it in remission.