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In a previous article , I highlighted the largest pharmacy chains that will participate in the 2024 Medicare Part D prescription drug plans (PDP). Plans from Aetna, Humana, WellCare, and UnitedHealthcare will not have any independentpharmacies participating via PSAOs as preferred pharmacies. Look out below!
Our exclusive analysis of Center for Medicare & Medicaid Services’ (CMS) data reveals that preferred cost sharing pharmacy networks will maintain their dominance as a component of Part D benefit design. In upcoming articles, I’ll delve into chain and independentpharmacies’ participation in the major 2024 preferred networks.
In this issue: Payers confess: Patients lose from copay accumulators Humana joins the Express Scripts GPO Hospitals vs. PBMs over specialty pharmacy white bagging Let’s all follow the Buy-and-Bill Dollar! Plus, entrepreneurial pharmacy owner Dave Marley demonstrates the power of innovation. Sometimes, the little guy wins big.
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.
Last week, we examined the growing concentration of specialty drug dispensing revenues among the largest pharmacies. See The Top 15 Specialty Pharmacies of 2024: How PBMs, Health Systems, and Independents Are Shaping the Market. Today, we dive deeper. Drawing from DCIs new 2025 Economic Report on U.S.
Small pharmacies have ghosted Medicare Part Ds preferred networksno farewell party, no breakup text, just a quiet exit. A few months ago , DCI highlighted how the largest pharmacy chains are participating as preferred cost sharing pharmacies in the 2025 stand-alone prescription drug plan (PDP) networks. Abracadabra!
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