Centene announced Oct. 26 that it will begin using a third-party pharmacy benefits manager for its $30 billion in annual spending — a move that CFO Drew Asher said will be "a huge opportunity for an external PBM."
The move comes after a turbulent few years for Centene and its current PBMs.
Below is a timeline of some of the key stories about Centene's PBMs since 2018.
March 15, 2018: Centene took a significant step in fleshing out its modern PBM approach as it partnered with RxAdvance. The investment and subsequent collaboration paired its cloud platform with Centene's Envolve health solutions division. The move came during a year when payers were aligning themselves with PBMs — like in Cigna's merger with Express Scripts and Aetna's acquisition by CVS Health, pairing it with CVS Caremark.
Feb. 20, 2019: During an earnings call, CVS Health announced that Centene notified the company of its decision to move on from using CVS Caremark as its PBM. Executives said the multiyear transition would make RxAdvance Centene's new PBM.
Oct. 17, 2019: Walgreens Boots Alliance, Centene and RxAdvance announced the trio would be partnering on a new cloud-based pharmacy benefits platform.
March 11, 2021: The state of Ohio sued Centene for allegedly using its PBMs — Envolve Health Solutions and Health Net Pharmacy Solutions — to misrepresent costs and inflate payments. Centene responded to the lawsuit April 2, saying that the allegations could be "easily explained away," but later settled for $88 million.
March 23, 2021: Centene is investigated by Mississippi, the second state accusing it of using its PBMs to overcharge the state's Medicaid program. The insurer later settled for $55 million.
Sept. 30, 2021: Arkansas and Illinois announced that they settled overpayment allegations involving Envolve. Payouts totaled $72 million.
Oct. 26, 2021: Centene announced during a third quarter earnings call that it is looking to outsource its PBM business. The announcement means another business will help the insurer manage its $30 billion in annual drug spending. Its current in-house PBM contract expires at the end of 2023.