The PBM field is about to become a little more crowded. Anthem announced that it is starting its own PBM, IngenioRx, which will begin offering services in 2020.
In April, Anthem announced that it would be leaving PBM giant Express Scripts when its contract runs out in 2019. The health insurer sued Express Scripts in 2016, alleging that the PBM overcharged for its pharmacy services by failing to pass on savings it obtained through drug price negotiations.
“We have been very clear that we can strengthen the value offered to the marketplace with an improved and aligned PBM model,” said Joseph R. Swedish, Chairman, President and Chief Executive Officer at Anthem, in a statement. “Through the process of evaluating many PBM options in preparation for the expiration of our current contract, we determined that our scale and experience best position us to deliver an innovative solution, and the launch of IngenioRx will allow us to break through what is now a complex and fragmented landscape.”
According to Market Watch, Anthem believes that the deal will save more than $4 billion a year.
Beginning January 1, 2020, IngenioRx will partner with CVS Health in a 5-year agreement. CVS will provide, among other services, claims processing and prescription fulfillment. According to a statement, CVS Pharmacy and MinuteClinic will “allow the company to apply its expertise in patient messaging and engagement at the point-of-sale to support IngenioRx, broadening the scope of clinical services offered at the pharmacy counter to drive better outcomes.” CVS declined to comment on how this point-of-sale support will be implemented.
"We believe that this agreement further validates the important role that CVS Health's integrated and innovative pharmacy care model plays in today's health-care system and we look forward to working with Anthem and IngenioRx to provide services to help ensure coordinated, holistic care for their PBM members," said Larry Merlo, President and Chief Executive Officer at CVS Health, in a statement.
IngenioRx will serve both Anthem-affiliated health plans and non-affiliated plans. Until the transition occurs, Anthem members will be able to use their benefits in the same way, and Anthem is reportedly focusing on ensuring continuity of member coverage during the transition process.