Express Scripts' preferred formulary doesn't cover 44 drugs and supplies, a move that's driven in part by drugmakers' increasing use of copay coupons as a tactic to lure consumers away from more cost-effective treatments. "If you look across our industry, there is broad and growing acknowledgment ... that not all drugs need to be covered," said company spokesman David Whitrap. "Drug choices in some classes are larger than ever, with many products costing more with no additional health benefit."

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