Feb. 6, 2019
A handful of powerful companies will have a huge impact on American healthcare, according to Bob Herman of Axios.
Starting this spring, five corporate giants — Anthem, Cigna, CVS Health, Humana and UnitedHealth Group — will control health insurance and pharmacy benefits for more than 125 million Americans.
Anthem has been working for over a year to create its own pharmacy benefit manager, called IngenioRx, so it could sever ties with Express Scripts. Anthem’s new prescription drug negotiator is now ready to go live by March, 10 months ahead of schedule, the company recently said.
These five companies will handle both drug and medical bills for millions of people across Medicare, Medicaid and employer-based insurance:
UnitedHealth Group is the largest entity combining health insurance and pharmacy benefits, with UnitedHealthcare and OptumRx (a PBM that got significantly bigger after it absorbed Catamaran in 2015).
CVS acquired Aetna to pair with its existing PBM, Caremark.
Cigna now owns Express Scripts.
Anthem will be moving millions of people onto IngenioRx this year.
Humana also has its own PBM, and it’s the fourth-largest by prescription volume.
It’s worth noting that Blue Cross Blue Shield plans also own a PBM, Prime Therapeutics.