I want to get continuous structured data on emerging prescription drug formularies, reimbursement changes, and clinical trial results from competitor insurance provider websites, regulatory databases, and pharmaceutical news outlets.
Access real-time insights on drug formularies and reimbursement trends — automated intelligence without the manual effort
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Goal
I want to get continuous structured data on emerging prescription drug formularies, reimbursement changes, and clinical trial results from competitor insurance provider websites, regulatory databases, and pharmaceutical news outlets.
Source coverage
- cms.gov
- fda.gov
- clinicaltrials.gov
- drugchannels.com
- pharmacytimes.com
- healthaffairs.org
- biopharmadive.com
- aishealth.com
- medpage.com
- managedcaremag.com
- pmlive.com
- statnews.com
Sample data
Illustrative sample data from the original configuration, not live or verified results.
| id | Source | Provider | Formulary | Drug | Reimbursement | Coverage Effective | Last Updated | Status |
|---|---|---|---|---|---|---|---|---|
| 1 | cms.gov | BlueCross BlueShield of MA | MA Preferred Rx Tier 3 | tirzepatide (Zepbound) 5 mg | $850.00 per 30-day supply (prior auth required) | 2026-02-01 | 2026-02-03 | Prior Authorization |
| 2 | fda.gov | UnitedHealthcare | UHC National Rx List 2026 | aducanumab (Aduhelm) 100 mg | Medicare Part B reimbursement referenced; patient coinsurance varies | 2026-01-30 | 2026-02-02 | Limited Coverage - CMS Guidance |
| 3 | clinicaltrials.gov | Cigna | Cigna Specialty Preferred 2026 | lecanemab (Leqembi) 10 mg/mL | $1,200.00 infusion admin fee + drug billed under medical benefit | 2026-02-01 | 2026-02-04 | Medical Benefit |
| 4 | drugchannels.com | Humana | Humana Commercial Rx 2026 | oral semaglutide (Rybelsus) 14 mg | $420.00 per 30-day; mail-order discount $380.00 | 2026-02-02 | 2026-02-04 | Preferred |
| 5 | pharmacytimes.com | Aetna | Aetna Open Choice 2026 | amivantamab (Rybrevant) 350 mg | $9,500.00 per cycle (case-by-case review) | 2026-01-29 | 2026-02-03 | Case-by-Case Review |
| 6 | healthaffairs.org | Kaiser Permanente | KP Permanente Formularies 2026 | inclisiran (Leqvio) 284 mg | $600.00 per dose (q6 months) | 2026-02-01 | 2026-02-03 | Preferred Specialty |
| 7 | biopharmadive.com | Anthem | Anthem Blue Cross Rx 2026 | olaparib (Lynparza) 150 mg | $3,200.00 per 30-day (oncology carve-out) | 2026-02-02 | 2026-02-04 | Specialty Coverage |
| 8 | aishealth.com | WellCare | WellCare Medicare Rx 2026 | sotagliflozin (Zynquista) 200 mg | $0.00 copay for select tier members; otherwise $45.00 | 2026-02-01 | 2026-02-03 | Preferred Tier 1 |
| 9 | medpage.com | Centene | Centene Medicaid Rx 2026 | voretigene neparvovec (Luxturna) 1 dose | Single-dose payment negotiated: $480,000.00 (outcomes-based contract) | 2026-01-31 | 2026-02-02 | Restricted - Outcomes Contract |
| 10 | managedcaremag.com | CareFirst | CareFirst Commercial Rx 2026 | teplizumab-mzwv (Tzield) 14-day course | $8,400.00 per course; step therapy applies | 2026-02-03 | 2026-02-04 | Step Therapy |
| 11 | pmlive.com | State Farm Health | State Farm Rx Select 2026 | pirtobrutinib 100 mg | $6,750.00 per 30-day (prior auth required) | 2026-02-02 | 2026-02-04 | Prior Authorization |
| 12 | statnews.com | BCBS of NJ | NJ Commercial Specialty 2026 | donanemab 700 mg | $16,500.00 per infusion course; limited network sites | 2026-02-01 | 2026-02-03 | Limited Network |
| 13 | cms.gov | Highmark | Highmark Medicare Rx 2026 | evinacumab (Evkeeza) 15 mg/kg | $25,000.00 per infusion (medical benefit) | 2026-02-01 | 2026-02-03 | Medical Benefit - Prior Auth |
| 14 | fda.gov | Molina Healthcare | Molina Medicaid Rx 2026 | risankizumab (Skyrizi) 150 mg | $1,100.00 per 90-day injection; PA for biologics | 2026-02-02 | 2026-02-04 | Prior Authorization |
| 15 | clinicaltrials.gov | Harvard Pilgrim | HPHC Commercial Rx 2026 | mounjaro (tirzepatide) 15 mg | $960.00 per 30-day; step edit from GLP-1 naïve | 2026-02-03 | 2026-02-04 | Step Edit |
| 16 | drugchannels.com | Oscar Health | Oscar Marketplace Rx 2026 | nadofaragene firadenovec 1 dose | $9,750.00 per instillation (urology outpatient setting) | 2026-01-31 | 2026-02-02 | Specialty Procedure |
| 17 | pharmacytimes.com | GuideWell (Florida Blue) | Florida Blue Rx 2026 | tepotinib 450 mg | $7,200.00 per 30-day (oncology prior auth) | 2026-02-02 | 2026-02-04 | Oncology Prior Auth |
| 18 | healthaffairs.org | EmblemHealth | EmblemHealth Commercial Rx 2026 | ubrogepant 50 mg | $120.00 per 30-day (retail) | 2026-02-03 | 2026-02-04 | Preferred |
| 19 | biopharmadive.com | Capital BlueCross | Capital Rx Advantage 2026 | pegunigalsidase alfa 1 mg/kg | $65,000.00 per infusion; medical policy requires genetic confirmation | 2026-02-01 | 2026-02-03 | Restricted - Genetic Confirmation |
| 20 | aishealth.com | Independence Blue Cross | IBC Commercial Formularies 2026 | casirivimab/imdevimab (REGEN-COV) 1 dose | Covered under EUA guidance; variable reimbursement by site | 2026-02-02 | 2026-02-04 | EUA Guidance |
| 21 | medpage.com | Devoted Health | Devoted Medicare Rx 2026 | bimagrumab 100 mg | $4,200.00 per infusion (investigational coverage policy) | 2026-02-01 | 2026-02-03 | Investigational Coverage |
| 22 | managedcaremag.com | BlueCross BlueShield of IL | BCBS IL Specialty 2026 | aclidinium bromide 400 mcg | $85.00 per 30-day (preferred inhaler) | 2026-02-03 | 2026-02-04 | Preferred |
| 23 | pmlive.com | Premera Blue Cross | Premera Rx Standard 2026 | tebentafusp (Kimmtrak) 20 mcg | $110,000.00 per course; limited to melanoma centers | 2026-02-01 | 2026-02-03 | Center of Excellence Only |
| 24 | statnews.com | BlueShield of CA | Anthem Blue Shield Rx 2026 | vutrisiran (Amvuttra) 25 mg | $1,050.00 per 30-day; specialty pharmacy distribution | 2026-02-02 | 2026-02-04 | Specialty Pharmacy |
| 25 | cms.gov | Geisinger Health Plan | Geisinger Rx 2026 | niraparib 300 mg | $2,900.00 per 30-day with oncology prior auth | 2026-02-01 | 2026-02-03 | Oncology Prior Auth |
| 26 | fda.gov | Tricare | TRICARE National Formulary 2026 | molnupiravir 800 mg | Covered under antiviral policy; $0 copay for active duty dependents | 2026-02-03 | 2026-02-04 | Covered - Limited Indication |
| 27 | clinicaltrials.gov | Regence | Regence Commercial Rx 2026 | sutimlimab 60 mg/mL | $14,500.00 per infusion; utilization management applies | 2026-02-02 | 2026-02-04 | Utilization Management |
| 28 | drugchannels.com | MVP Health Care | MVP Rx Select 2026 | fexinidazole 100 mg | $1,200.00 per treatment course (rare disease policy) | 2026-02-01 | 2026-02-03 | Rare Disease Coverage |
| 29 | pharmacytimes.com | Oscar Health NY | Oscar NY Marketplace Rx 2026 | ubrogepant 25 mg | $95.00 per 30-day; quantity limits apply | 2026-02-03 | 2026-02-04 | Quantity Limit |
| 30 | healthaffairs.org | Harvard Pilgrim Health Care | HPHC Medicare Rx 2026 | zasurlimab 150 mg | $2,400.00 per dose (awaiting final LCD) | 2026-02-02 | 2026-02-04 | Pending LCD |
Insights and analytics
- Total Formularies Monitored (metric)
- Total Clinical Trials Recorded (metric)
- Reimbursement Changes by Type (donut)
- Emerging Drug Trends Over Time (line)
- Top Competitor Formularies (bar)
- Most Common Drug Class Changes (horizontal_bar)
- Recent Clinical Trial Results (table)
- Latest Reimbursement Changes (table)
- Volume of New Drug Approvals (area)
- Key Observations on Market Changes (insights)
- Sources of Drug Information (pie)
- Reimbursement Change Trends (line)
Change notifications
- New Listing Appears — new formulary detected cms.gov
- Reimbursement Change Detected — reimbursement rate updated drugchannels.com
- Availability Change — is now enrolling participants clinicaltrials.gov
- Coverage Gap Identified — missing from insurance plans healthaffairs.org
- Clinical Trial Results Updated — new results published medpage.com
Integrations and delivery
- api
- snowflake
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