Feb 5, 2019
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A new major PBM is on the horizon

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Anthem has announced a launch of its own PBM – IngenioRx. The decision came shortly after Cigna’s acquisition of Express Scripts, which provided pharmacy services to Anthem’s members since 2009. Due to the merger, Anthem decided to terminate the contract with Express Scripts. It anticipates that operating its own PBM will result in annual savings of more than $4 billion.
Anthem had already operated its own PBM company, which it sold to Express Scripts in 2009. But with a trend of in-house PBMs, Anthem decided to reconsider the move. For example, United Health operates its own PBM, and Aetna and Cigna also process pharmacy claims internally. Reportedly, these moves result in multi-billion dollar savings to the plans and patients. And controlling health care cost is a new mantra in the healthcare arena. Also, controlling, maintaining, and collecting health data is an invaluable tool, which major payors do not want to share with outside companies. They claim that in-house health data can help manage care and improve health outcomes.
CVS Health will help Anthem administer the program by processing claims through its own PBM for the initial five years.



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