Smaller market, less flexibility: What integrated PBMs mean for clients

Employee Benefit Advisor April 12, 2019
Steven Schwartz

Consolidation in the insurance industry — integrating pharmacy benefit managers into carriers — is bringing change to the way employers buy insurance and how employees and consumers use it.

Carriers and PBMs are merging because, carriers claim, integrating a PBM with a carrier can help employers save money and assist patients who are on complex drug regimens. These PBMs, including CVS Caremark and Express Scripts, both employ pharmacists that specialize in specific diseases.

Carriers also could roll out new types of formularies and products to provide more options for employers. Carriers say that integrating PBMs will give them more negotiating power with manufacturers. But there is plenty of reason to be skeptical of the coming changes, too.

Here’s how these...

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