Drug Channels
OCTOBER 24, 2023
In upcoming articles, I’ll delve into chain and independent pharmacies’ participation in the major 2024 preferred networks. The 2024 data provide early evidence of a shrinking PDP market. I also update our analysis of the prevalence of preferred networks in three different types of MA-PD plans.
Drug Channels
APRIL 12, 2023
For 2022, pharmacy benefits managers (PBMs) and insurers expanded their dominance over specialty dispensing, though both hospitals and physician practices are growing their share of the market. The top three PBM-owned specialty pharmacies accounted for nearly two-thirds of prescription revenues from pharmacy-dispensed specialty drugs.
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Drug Channels
JANUARY 23, 2024
Plans from Aetna, Humana, WellCare, and UnitedHealthcare will not have any independent pharmacies participating via PSAOs as preferred pharmacies. Smaller pharmacies' ability to navigate away provides more bad news for stand-alone Part D market—and another unexpected consequence of the Inflation Reduction Act of 2022.
Perficient: Drug Development
FEBRUARY 20, 2024
Among these, pharmacy benefit managers (PBMs) play a crucial role, handling reimbursements and negotiations with drug manufacturers and pharmacies. Three major PBM players – CVS Caremark, Express Scripts, and OptumRx – collectively command a significant 79% market share , orchestrating much of the industry’s dynamics.
Drug Channels
FEBRUARY 23, 2021
For background, see Express Scripts + Prime Therapeutics: Our Four Takeaways From This Market Changing Deal. Payer-owned specialty pharmacies—via white, brown, and clear bagging—are trying to displace buy-and-bill distribution channels for provider-administered specialty drugs. The battle for specialty drug margin rages on.
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