Radar on Drug Benefits

  • Prime-Express Scripts Merger Looks Unlikely Despite New Deal

    Prime Therapeutics, the PBM jointly owned by 18 Blue Cross Blue Shield plans, recently entered an agreement with Cigna Corp.-owned PBM Express Scripts to offer Blues plans the option of using Express Scripts’ mail order and specialty pharmacy services. Though experts say a merger of the two PBMs is unlikely, the deal deepens the trend of integration and consolidation across the PBM space and between the two firms, which have shared some joint operations since the end of 2019.

    Kyle Skiermont, Pharm.D., Prime’s senior vice president for specialty pharmacy and home delivery, tells AIS Health that the deal’s purpose is to offer Blues plans a choice between Prime’s specialty and mail order pharmacy operations and Express Scripts’ specialty branch, Accredo. Prime has an existing mail order and specialty joint venture with Walgreens Boots Alliance Inc., called AllianceRx Walgreens Prime.

  • News Briefs

     Manufacturer prices for insulin in the United States were “considerably” — often five or 10 times — higher than those in other Organisation for Economic Co-operation and Development countries, according to a new report from researchers at RAND Corp. The average price per unit across all types of insulin in the United States was $98.70, the report said, while other countries would have paid a fraction of that for the same insulins. In addition, “the analysis suggests that U.S. insulin prices would still have been considerably higher — about four times higher — than those in other countries even when accounting for potential rebates,” researchers wrote. View the report at https://bit.ly/3izlH6k.

     CVS Health Corp. is offering Whil — a “digital training platform” focused on workplace mindfulness, stress resilience, sleep, and mental and emotional wellbeing — to its PBM clients as part of its Points Solutions Management offerings for employers. “Employers and other plan sponsors are increasingly looking for innovative tools to help people manage their mental health, especially in light of the COVID-19 pandemic,” Sree Chaguturu, M.D., CVS Caremark’s chief medical officer, said in an Oct. 1 news release. “Whil’s commitment to clinical evaluation and research aligns with our focus on helping our clients include clinically effective digital point solutions as part of their benefits packages.” Visit https://bwnews.pr/3d8T8vB.

  • UnitedHealth Reportedly Moves to Buy PillPack Competitor

    More than two years after Amazon Inc. unveiled its plan to acquire PillPack, which specializes in pre-sorted dose packaging and home delivery of prescription drugs (RDB 7/13/18, p. 1), UnitedHealth Group has reportedly purchased a very similar startup.

    CNBC reported on Sept. 29 that UnitedHealth bought the firm, divvyDOSE, for just over $300 million, citing a person familiar with the deal. UnitedHealth declined to comment about the transaction to either CNBC or AIS Health when asked to confirm the news.

  • Experts Slam Trump’s $200 Medicare Drug Card Proposal

    Experts say a last-minute proposal by President Donald Trump to distribute $200 prescription drug credits to Medicare Part D enrollees on preloaded debit cards faces many unanswered questions and will be difficult to implement, especially in the short time before the Nov. 3 election. The proposal, the latest in a series of proposals and executive orders from the administration that are intended to reduce drug prices, would do little to help seniors with high out-of-pocket drug costs, they say.

    “I’ll be the point guard for the Knicks before this happens,” says Joe Paduda, principal of Health Strategy Associates. “This is just another of the president’s many off-the-cuff promises, one it appears none of his staff knew about before he made it in a campaign speech.”

  • CVS, Optum Exclude Inhalers, Switch Diabetes Supplies for ’21

    Editor’s Note: A previous version of this article misstated how OptumRx is covering Tecfidera, Ruxience, Rituxan and Truxima. This version has been corrected.

    CVS Health Corp.’s Caremark will exclude 57 medications from its 2021 formulary and add six back. Meanwhile, UnitedHealth Group’s OptumRx subsidiary will exclude 19 medications and products while adding back five and implementing restrictions on others.

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