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A recent decision by one of the largest pharmacy benefit managers in the U.S. to exclude several HIV medicines from its list of drugs eligible for insurance coverage has angered AIDS advocacy groups, which argue the move may harm patients.

In two separate actions over the past few months, Express Scripts excluded seven HIV medicines for anyone starting treatment. The pharmacy benefit manager explained that less expensive alternatives are available and its decisions were supported by clinical guidelines. The company also noted the drugs remaining on its national formulary appear on federal guidelines for most patients.

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