Tag Archives: rebates

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 […]

PBM P&T Practices The HEAT Initiative Is Gaining Momentum

Care outside the hospital, like P&T committee responsibilities outside the hospital, is necessarily different. New processes and solutions, such as cloud computing, can help improve performance and transparency of benefit management for purchasers or users of health care services. The current role of PBMs includes concurrent improvement in health outcomes, so the take-home message is […]

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 […]

Contracting With Specialty Pharmacies (SPs) At Your Own Peril

How a company works with and contracts with SPs will have to be rethought as a result of the initial Department of Justice (DoJ) settlement with BioScrip and ongoing investigation of Novartis in their marketing practices. When Novartis launched Exjade, it created a limited distribution network, including BioScrip and two other specialty pharmacies selected by […]