Exhibit A-8 - Top 50 Drugs Report.xlsx

This is a Top 50 Drugs Report for Central Health, a Texas healthcare organization, documenting pharmaceutical utilization and costs for the period covering February 2025 through June 2026. The report provides detailed information on the highest-cost medications within the plan's formulary, listing fifty drugs by National Drug Code (NDC), including specialty pharmaceuticals, biologics, and vaccines. The drugs are ranked by total plan paid amounts, with costs ranging from approximately $685,946 for Hemlibra (a hemophilia treatment) down to approximately $38,000 for various medications including Eliquis and Zenpep. The report tracks member counts and prescription counts for each medication, providing visibility into utilization patterns across the covered population.

The report includes critical formulary management information such as drug tier assignments (tiers 1-3), special universe flags indicating specialty drug status, and prior authorization (PA) and step therapy requirements. Notable high-cost medications include multiple formulations of Mounjaro, Ozempic, Skyrizi, and Dupixent, which represent significant cost drivers for the organization. The secondary data section contains an extensive Aetna download file cross-referencing products by GPI code and Aetna DL numbers, covering medications across therapeutic categories including psychiatry, sleep disorders, migraine treatment, and ophthalmology. This comprehensive formulary data supports Central Health's medication management strategy and cost containment initiatives.