Category Archives: Pharmacy Benefit Managers

SSM Health Repositioning as a Fully Integrated System

SSM Health has been moving from a combination of facilities and states to a fully integrated health system

Will Diplomat Pharmacy Survive?

Diplomat found that competing successfully with large specialty pharmacies owned by Cigna/ESI, CVS Health/Caremark and UnitedHealth/OptumRx has been more difficult than projected

Rebates? Strategy from The Football Playbook – The End Around

I failed to discern the implication of the actions proposed by the HHS-FDA Safe Importation Action Plan and the magnitude of its impact to rebates.

EnvisionRxOptions a Large Part of Rite Aid’s New Strategy

Rite Aid has embarked on what it is calling the “Path to the Future” to position the company for years to come. Rite Aid  is taking actions to use its unique capabilities to help payors deliver a high level of care to patients, to re-imagine its front end to offer the selection of products and […]

OptumRx Selected by HealthTrust as Exclusive Pharmacy Services Provider

HealthTrust recently selected OptumRx as its exclusive pharmacy care services partner for its member organizations. OptumRx and HealthTrust, through its CoreTrust division, will partner to deliver transparent pharmacy benefit solutions intended to support better health outcomes, improved consumer experiences and lower costs. OptumRx will provide custom programs, tools and mobile technology that will improve how […]

Anthem Accelerating IngenioRx Roll-Out

Anthem, Inc. established a new pharmacy benefits manager called IngenioRx in October 2017 and entered into a five-year agreement with CVS Health’s Caremark subsidiary to begin offering PBM solutions. In January 2019, Anthem terminated the Express Scripts PBM Agreement earlier than the original expiration date of December 31, 2019 due to the recent acquisition of […]

States Begin to Take Action Against Copay Accumulator Programs

The CMS recently finalized a rule that would allow health insurers to implement copay accumulator programs to prevent drug manufacturer coupons from applying to a patient’s annual limit on out-of-pocket costs in situations where a generic drug is available. The copay “accumulator” program tracks employee use of a copay coupon and ensures the money does […]