ESBD_540156_1784577531883_Exhibit A-6 Top 50 Drugs Report.xlsx

This file is a Top 50 Drugs Report for Central Health, a healthcare organization or insurance plan administrator, detailing pharmaceutical utilization and costs for the period March 2025 through February 2026. The report identifies the 50 most utilized and costly medications across the plan's membership, including injectable biologics, oral medications, and specialty pharmaceuticals. The drugs listed range from high-cost specialty medications such as Hemlibra (coagulation disorder treatment) at $685,946 total plan paid for one member across 14 prescriptions, to more commonly used medications like Ozempic (diabetes treatment) used by 33 members with 153 total prescriptions. The report captures critical information including National Drug Codes (NDCs), drug names, dosage forms, member counts, prescription counts, total plan-paid amounts, drug tier classifications (ranging from tier 1 to tier 3), specialty drug designations, and prior authorization or step therapy requirements.

The financial data reveals significant expenditures concentrated among injectable specialty pharmaceuticals, with the top 50 drugs representing substantial plan costs driven by both high-unit costs and volume. Medications are stratified by formulary tier, with many requiring prior authorization (PA) or step therapy protocols, while others employ smart logic tools for coverage determination. The report includes an additional grid section cross-referencing Aetna download numbers, generic product identifiers (GPI codes), and specific NDC product names, suggesting integration with Aetna's pharmaceutical management systems or formulary database. This document serves as a utilization analysis tool for plan management, enabling Central Health to assess drug spending patterns, identify high-cost therapeutic categories, and potentially negotiate rebates or implement additional utilization management strategies.