Tag Archives: pharmacy benefit manager

Capital Rx Expands Transparency Model to Specialty and Mail Prescriptions

Capital Rx works to increase cost transparency and consistency for its clients by using the government-maintained National Average Drug Acquisition Cost database, which aims to provide accurate, upfront costs of drugs across pharmacies to health plans

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

What’s Next for Diplomat Pharmacy After Poor Results in Q2 2019?

Diplomat’s core specialty pharmacy performance is being negatively impacted by increased competition

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 […]

Pharmacy Benefit Manager Market Continues to Evolve

Pharmacy Benefit Manager Market Continues to Evolve. Recent consolidation in the pharmacy benefit manager (PBM) industry has resulted in major market share divided by the three market leaders: Express Scripts, CVS Health (Caremark), and OptumRx (UnitedHealth Group). PBMs remain searching for a value proposition beyond drug distribution with their employer clients. As long as PBMs […]

Current PBM Model Threatened by New-Entity PBMs

Changes are happening in the PBM market. Traditional services offered by PBMs will be supplanted by new PBM entities that will develop formularies among the services they offer. The new entity PBMs manage and supplement PBM services as an advocate for health care payers. Services include prescription claims analysis and consultation, drug coverage management, PBM contracts […]