Ohio Medicaid names a single, state-controlled PBM

Ohio's Medicaid program has named Gainwell Technologies as its sole pharmacy benefit manager in a $158 million contract, The Columbus Dispatch reported Jan. 11.  

Gainwell will replace multibillion dollar conglomerate PBMs such as CVS Caremark and Express Scripts. 

Ohio's Medicaid Director Maureen Corcoran told the Dispatch that switching to a single, state-controlled PBM will save the state $150 million to $200 million per year. But it will cost the state some revenue, such as $23 million from a tax on health insurance corporations that it can no longer collect, according to the Dispatch

"We will have a very good quality, experienced manager of these medications that will save the state money and will allow transparency about the care and the expenditures for this program that did not exist in the past," Ms. Corcoran told the Dispatch.

Restructuring Ohio's PBM won't be complete for another year, as it still has several steps to go through, such as hiring a pharmacy operational support vendor to monitor Gainwell's performance. 

Ms. Corcoran told the Dispatch the state chose Gainwell because "they are not like CVS or Express Scripts or whatever; they are more of an entity that has specialized in IT, clinical support, not like traditional PBMs focus on drug market."

Gainwell will be paid $158.2 million if it remains for the whole 7.5 years of the state's contract and if the deal is approved by the bipartisan state Controlling board, according to the Dispatch

Read the full article here.

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