Anthem Drops Express Scripts To Form In-House PBM and Partner with CVS

US health insurer Anthem Inc has announced new plans to set up its own pharmacy benefits management unit. That means it will probably be severing ties with Express Scripts Holdings Co, which Anthem has accused of charging several billion dollars more than they should have.

For Anthem, of course, this means a move towards a more fully-optimized system they can control. For Express Scripts, however, this means the loss of its biggest client and new competition; at least, once Anthem launches its new IngenioRx.

And when is this launch?  Well the nation’s second-largest health insurer said that IngenioRx will partner with CVS Health starting in January of 2020.

Anthem CEO Joseph R Swedish comments “The launch of IngenioRx will allow us to break through what is now a complex and fragmented landscape. It also positions Anthem to take advantage of a unique opportunity to grow and diversify our business within our existing footprint as well as nationally.”

The partnership will include a five-year agreement to “combine its member and provider engagement initiatives and market leading pricing with CVS’ point-of-sale engagement, such as member messaging and Minute Clinic.”

Now, CVS Health does have its own PBM—which is called Caremark—but Anthem assures that IngenioRx will remain as a separate partnership with its own management team that can service more than the 14 states where Anthem is presently operates their Blue Cross and Blue Shield health insurance plans.

Express Scripts, of course, does not see this new PBM offering as a better solution. Accordingly, Express Scripts said, in a statement: “While it is disappointing that Anthem has decided to work with another PBM, we know that no other PBM will offer Anthem the combination of savings, member and client stability, and clinical expertise that Express Scripts represents.”

Furthermore, the PBM adds, “Since 2009, Express Scripts has proudly served Anthem members and clients. Express Scripts will continue to serve Anthem and its members for the remainder of the contract term which runs through December 31, 2019, and through any additional transition period that may follow. We are committed to working together with Anthem to facilitate a smooth transition to the new PBM provider.”

Leave a Reply

Your email address will not be published. Required fields are marked *