As PBM services have traditionally been dominated by large companies such as CVS Caremark, Express Scripts and OptumRx, health systems are starting to create alternatives.
Here are four more things to know:
- A significant factor driving health systems to bring PBM services in house is the escalating cost of prescription drugs. By managing PBMs internally, health systems are able to negotiate prices directly with drug manufacturers and pharmacy networks. For example, Salt Lake City-based Intermountain Health has entered a partnership with the Mark Cuban Cost Plus Drug Co. with the goal of offering its members access to affordable medications through transparent pricing.
- Health systems have also been looking to offer more transparency around drug pricing.
For instance, Chapel Hill, N.C.-based UNC Health launched its own pharmacy benefit management platform called UNC Health Pharmacy Solutions in August. The platform offers a transparent model for drug cost management, claiming up to 32% savings on annual prescription costs alongside a 25% boost in medication adherence.
- St. Louis-based SSM Health is another system that has turned to an alternative PBM model that focuses on transparency and affordability. The health system partnered with Navitus Solutions. Navitus has grown to serve more than 11 million people, with a focus on reducing prescription drug costs through strategic partnerships and innovations.
- In-house PBMs also allow health systems to design tailored drug management solutions for their patients. For example, UNC Health’s platform not only focuses on cost savings, but includes personalized consultations with clinical pharmacists.
