I want to get continuous structured data on emerging pharmaceutical drug pricing, formulary changes, and utilization management criteria from competitor payer websites and pharmaceutical manufacturer regulatory filings.
Gain continuous insights on drug pricing and formulary shifts — automated intelligence that outpaces manual research efforts
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Goal
I want to get continuous structured data on emerging pharmaceutical drug pricing, formulary changes, and utilization management criteria from competitor payer websites and pharmaceutical manufacturer regulatory filings.
Source coverage
- cms.gov
- fda.gov
- drugs.com
- goodrx.com
- epocrates.com
- clinicaltrials.gov
- patientslikeme.com
- marketwatch.com
- statnews.com
- pharmacytimes.com
- drugbank.ca
- biopharma-reporter.com
Sample data
Illustrative sample data from the original configuration, not live or verified results.
| id | Source | Drug | NDC | Price | Original Price | Formulary Status | Utilization Management | Last Updated |
|---|---|---|---|---|---|---|---|---|
| 1 | cms.gov | Tresiba (insulin degludec) | 0006-0687-01 | $389.00 | $422.00 | Preferred | Prior Authorization for new starts; Quantity Limit 1 vial/month | 2026-02-02 |
| 2 | fda.gov | Leqvio (inclisiran) | 0007-1223-10 | $3,200.00 | $3,400.00 | Non-Preferred | Step Therapy after statin + ezetimibe; Prior Auth required | 2026-02-03 |
| 3 | drugs.com | Zeposia (ozanimod) | 0012-3456-88 | $3,100.00 | $3,250.00 | Tier 4 | Prior Authorization; Initial Rx limit 1 month | 2026-02-01 |
| 4 | goodrx.com | Ozempic (semaglutide) 1.0 mg | 0034-5678-20 | $899.99 | $1,049.99 | Not Covered (cash alternative) | Quantity Limit 1 pen/28 days; Savings coupons available | 2026-02-04 |
| 5 | epocrates.com | Xanax (alprazolam) | 0045-1122-11 | $12.50 | $15.00 | Preferred Generic | Generic substitution allowed; Quantity Limit 60 tablets/30 days | 2026-02-03 |
| 6 | clinicaltrials.gov | BNT162b4 (mRNA COVID booster) | 0055-9900-01 | $0.00 | $0.00 | Not Listed (investigational) | Clinical trial only; Not for routine formularies | 2026-02-02 |
| 7 | patientslikeme.com | Keytruda (pembrolizumab) | 0066-2233-77 | $12,450.00 | $12,950.00 | Major Therapeutic Class - Restricted | Prior Authorization; Oncology pathway review required | 2026-02-01 |
| 8 | marketwatch.com | Humira (adalimumab) biosimilar | 0077-4411-02 | $5,200.00 | $6,100.00 | Preferred Biosimilar | Step Therapy preferred biosimilar before originator; PA for dosage >40 mg q2w | 2026-02-04 |
| 9 | statnews.com | Aduhelm (aducanumab) | 0088-5566-33 | $11,600.00 | $13,000.00 | Excluded | Restricted to registry-enrolled patients; Prior Auth + cognitive assessment required | 2026-02-03 |
| 10 | pharmacytimes.com | Eliquis (apixaban) | 0099-6677-10 | $480.00 | $530.00 | Preferred Brand | PA for patients with mechanical heart valves; Quantity Limit 30 tablets/30 days | 2026-02-02 |
| 11 | drugbank.ca | Sotagliflozin | 0100-7788-55 | $375.00 | $425.00 | Tier 3 | Prior Authorization; Must have documented T1D with inadequate control | 2026-02-04 |
| 12 | biopharma-reporter.com | Tirzepatide (new GLP-1/GIP) | 0111-8899-66 | $1,250.00 | $1,350.00 | Non-Preferred Brand | Step Therapy requires metformin + GLP-1 trial; PA for BMI <30 | 2026-02-03 |
| 13 | cms.gov | Remdesivir (Veklury) | 0122-9900-21 | $2,800.00 | $3,150.00 | Covered Under Medical Benefit | Facility-level authorization; Limited to hospitalized patients | 2026-02-02 |
| 14 | fda.gov | Zynteglo (gene therapy) | 0133-1010-01 | $2,800,000.00 | $2,900,000.00 | Specialty/Rare | Outcomes-based contract recommended; Prior Authorization and registry enrollment | 2026-02-03 |
| 15 | drugs.com | Dupixent (dupilumab) | 0144-2020-44 | $3,980.00 | $4,200.00 | Tier 4 (Specialty) | Prior Authorization; Step therapy for atopic dermatitis alternatives | 2026-02-01 |
| 16 | goodrx.com | Synthroid (levothyroxine) 50 mcg | 0155-3030-50 | $18.99 | $24.99 | Preferred Generic | Generic substitution allowed; No prior authorization | 2026-02-04 |
| 17 | epocrates.com | Imbruvica (ibrutinib) | 0166-4040-60 | $9,600.00 | $10,200.00 | Restricted Oncology | PA with documented diagnosis and prior chemo failure; Quantity Limit per cycle | 2026-02-03 |
| 18 | clinicaltrials.gov | Nivolumab combo (trial) | 0177-5050-02 | $0.00 | $0.00 | Investigational | Clinical trial only; Not eligible for formulary coverage | 2026-02-02 |
| 19 | patientslikeme.com | Trikafta (elexacaftor/tezacaftor/ivacaftor) | 0188-6060-77 | $340,000.00 | $350,000.00 | Specialty - Limited Access | PA with genotype confirmation; Prior Authorization and specialty pharmacy dispensing | 2026-02-01 |
| 20 | marketwatch.com | Xeljanz (tofacitinib) | 0199-7070-11 | $2,100.00 | $2,350.00 | Non-Preferred | Prior Authorization; TB screening required before initiation | 2026-02-04 |
| 21 | statnews.com | Adagrasib (KRAS inhibitor) | 0200-8181-33 | $21,500.00 | $23,000.00 | Restricted Oncology | PA with molecular test confirmation; Limited to labeled indications | 2026-02-03 |
| 22 | pharmacytimes.com | Metformin ER 1000 mg | 0211-9191-99 | $14.00 | $18.00 | Preferred Generic | No PA; Quantity Limit 90 tablets/90 days | 2026-02-02 |
| 23 | drugbank.ca | Vyvgart (efgartigimod) | 0222-0202-20 | $8,750.00 | $9,200.00 | Specialty | PA; Must document autoantibody-mediated disease and prior therapies | 2026-02-04 |
| 24 | biopharma-reporter.com | BCMA CAR-T autologous therapy | 0233-1313-01 | $465,000.00 | $495,000.00 | Hospital Only / Excluded from pharmacy benefit | Center-of-excellence referral; Outcomes-based reimbursement suggested | 2026-02-03 |
| 25 | cms.gov | Fluad Quadrivalent (seasonal influenza) | 0244-2424-08 | $22.00 | $28.00 | Covered Vaccine | No PA for adults 65+; Quantity limits per season | 2026-02-02 |
| 26 | fda.gov | Nirsevimab (RSV monoclonal) | 0255-3535-05 | $445.00 | $495.00 | Preferred for infants | Age/weight-based dosing restrictions; Prior Authorization for high-risk infants | 2026-02-03 |
| 27 | drugs.com | Biktarvy (bictegravir/emtricitabine/tenofovir) | 0266-4646-30 | $1,400.00 | $1,575.00 | Tier 2 | PA for HIV-2 or resistance; Quantity limit 30 tablets/30 days | 2026-02-01 |
| 28 | goodrx.com | Albuterol HFA inhaler | 0277-5757-01 | $34.99 | $39.99 | Preferred Brand | Allowed OTC alternatives; Quantity Limit 1 inhaler/30 days | 2026-02-04 |
| 29 | epocrates.com | Zolgensma (onasemnogene abeparvovec) | 0288-6868-01 | $2,150,000.00 | $2,200,000.00 | Rare/Specialty | Single-dose gene therapy; PA, registry enrollment, outcomes-based contract | 2026-02-03 |
Insights and analytics
- Total Products Tracked (metric)
- Average Price Change (%) (metric)
- Average Price Over Time (line)
- Top 10 Drugs by Price Increase (bar)
- Formulary Changes by Category (donut)
- Competitor Payers with Most Changes (horizontal_bar)
- Recent Drug Pricing Updates (table)
- Utilization Management Criteria Summary (table)
- Drug Utilization Trends (area)
- Pricing Sources Breakdown (pie)
- Key Insights on Drug Pricing (insights)
- Formulary Changes Over Time (line)
Change notifications
- Price Change Detected — is now $100 (+$20) goodrx.com
- New Listing Appears — now available on formulary cms.gov
- Availability Change — is now unavailable drugs.com
- Coverage Gap Identified — missing from current formulary fda.gov
- Utilization Management Update — criteria updated epocrates.com
Integrations and delivery
- api
- snowflake
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