Shortly after a brand new survey revealed that well being plans’ satisfaction with pharmacy profit managers (PBMs) is down, Centene introduced this week that it’s switching to Specific Scripts from CVS Caremark.
St. Louis-based Specific Scripts is the PBM of Cigna’s well being providers unit Evernorth. Specific Scripts and Centene said in a Tuesday information launch that the 2 entities fashioned the strategic partnership “to make prescription drugs extra accessible and reasonably priced for purchasers.”
Beginning January 2024, Specific Scripts will serve about 20 million Centene members, who will be capable to attain the PBM’s community of retail pharmacies, in addition to obtain 24/7 entry to its pharmacists, mentioned Amy Bricker, president of Specific Scripts.
“We’re proud to be chosen by Centene to ship higher prescription drug financial savings and entry for his or her members,” Bricker wrote in an electronic mail. “Specific Scripts has a protracted observe report of delivering worth for those who use government-sponsored well being plans and this is a vital alternative to additional prolong our best-in-class providers to extra Individuals.”
An October 19 survey by Pharmaceutical Methods Group confirmed that general satisfaction of PBMs reached 7.8 factors out of 10 in 2022, down from 8.2 factors in 2021. The probability that those that responded would advocate a PBM was 7.6 factors out of 10 in 2022, in comparison with 8.1 in 2021. The survey obtained responses from 236 respondents, principally from employers and well being plans.
“This decline isn’t a surprise,” the report said. “One of many drivers of a buyer’s notion of their PBM is drug development, which is on the rise for a lot of plan sponsors. Moreover, whereas PBMs obtained some constructive public consideration in the course of the Covid-19 pandemic, most of their public visibility has been destructive of late.”
Centene declined MedCity’s request for touch upon why it was abandoning CVS Caremark for Specific Scripts. However the report could maintain some clues.
Specific Scripts carried out higher than CVS Caremark on general satisfaction, with 7.9 factors out of 10 in comparison with CVS Caremark’s 7.7 factors. Specific Scripts was rated the best out of the person PBMs listed, tied with OptumRx. Particular person PBM rankings had been solely offered for PBMs with not less than 10 survey responses. Specific scripts obtained 74 responses, whereas CVS Caremark obtained 46 and OptumRx obtained 54.
Along with general satisfaction, the survey additionally checked out over 40 PBM features, through which it discovered that the areas with the bottom satisfaction included “willingness to combine with different pharmacy options” and “customizable choices.” The areas with the best satisfaction included “retail community choices” and “aggressive conventional drug reductions.”
General satisfaction was completely different based mostly on respondent sort. Well being plans’ satisfaction in PBMs averaged 6.9 factors out of 10 in 2022, in comparison with 7.5 in 2021. Employers’ satisfaction, in the meantime, was 8.1 factors in 2022, in comparison with 8.5 in 2021.
When requested for causes for leaving a present PBM, a number of respondents talked about price. One nameless respondent said, “Value financial savings with different PBMs and extra flexibility in managing price of specialty medicine.” One other mentioned, “Value financial savings offered service ranges had been the identical.”
Value financial savings are simply what Specific Scripts goals to deliver to Centene’s members, Bricker mentioned.
“We stay up for working with Centene to create modern well being providers that assist folks stay more healthy lives and unlock significant financial savings for these we serve,” Bricker mentioned.
Photograph: bong hyunjung, Getty Photographs
