Radar on Drug Benefits

Blue Shield of California Rolls Out New PBM Model as Other Plans Mull Similar Option

  • Jan 09
    Popup Image

    Jan 09, 2025

    Blue Shield of California on Jan. 1 rolled out a pharmacy benefits model that uses five vendors to handle various duties, representing a major shift from using CVS Caremark as the insurer’s sole PBM. Pharmacy benefit experts tell AIS Health that other health plans are considering a similar unbundled approach, although they say the switch from one PBM to multiple vendors can be time-consuming and complex. 

    Blue Shield announced the transition in August 2023 for its commercial and Medicare lines of business. The company is contracting with four new vendors: Amazon.com Inc.’s online pharmacy manages online and mail-order fills; Mark Cuban Cost Plus Drug Co. manages retail pharmacy pricing and payment; Abarca Health LLC handles claims management and rebate processing; and Prime Therapeutics LLC negotiates with manufacturers. Meanwhile, Caremark continues to administer specialty medications under the medical benefit. 

    Read more
      • Radar on Drug Benefits
    © 2024 MMIT

    • Tim Casey

    Tim has been a reporter and editor for newspapers, websites and magazines for more than 20 years, including 10 years covering health care business topics. He has a deep knowledge of the managed care industry and pharmacy benefit management. He also has experience covering medical conferences and clinical and legislative health care issues. In 2014, the Society for Advancing Business Editing and Writing selected Tim as one of 15 journalists to participate in a national symposium on the Affordable Care Act. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.

    Back to Radar on Drug Benefits

Related Posts

The Latest
Premium Categories
Meet Our Reporters

Lauren Flynn Kelly

Executive Editor, AIS Health, and Managing Editor, Radar on Medicare Advantage

View Lauren Flynn Kelly's Profile

Angela Maas

Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

View Angela Maas's Profile

Leslie Small

Managing Editor, Health Plan Weekly and Radar on Drug Benefits

View Leslie Small's Profile

Tim Casey

Reporter, Health Plan Weekly and Radar on Drug Benefits

View Tim Casey’s Profile

Carina Belles

Reporter, Radar on Medicare Advantage and Spotlight on Market Access

View Carina Belles's Profile

Jinghong Chen

Reporter, Health Plan Weekly and Radar on Drug Benefits

View Jinghong Chen's Profile

Jill Drachenberg

Reporter, Health Plan Weekly and Radar on Drug Benefits

View Jill Drachenberg's Profile

Meet Our Reporters

Lauren Flynn Kelly

Executive Editor, AIS Health, and Managing Editor, Radar on Medicare Advantage

View Lauren Flynn Kelly's Profile

Angela Maas

Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

View Angela Maas's Profile

Leslie Small

Managing Editor, Health Plan Weekly and Radar on Drug Benefits

View Leslie Small's Profile

Tim Casey

Reporter, Health Plan Weekly and Radar on Drug Benefits

View Tim Casey’s Profile

Carina Belles

Reporter, Radar on Medicare Advantage and Spotlight on Market Access

View Carina Belles's Profile

Jinghong Chen

Reporter, Health Plan Weekly and Radar on Drug Benefits

View Jinghong Chen's Profile

Jill Drachenberg

Reporter, Health Plan Weekly and Radar on Drug Benefits

View Jill Drachenberg's Profile

Tags
PBMs/Pharmacy Benefit Managers
Contract Awards
Specialty Pharmacy
Drug Rebates
Benefit Management
×

PREMIUM CONTENT AND PREMIUM INSIGHTS

To gain access to this article you need to have a Premium Subscription.
Click the link below to access today!