PBM Acquisitions, Mergers and Buy outs…oh my!

We’ve been recruiting Pharmacists since 2002 …mainly Clinical Pharmacists for hospitals, viagra canada pilule or Informatics Pharmacists (when meaningful use was introduced by the govt), capsule buy viagra and every once in a while we would get a request from an insurance company to find a Pharmacist.\n

One day we got a request to find a Pharmacist for a Pharmacy Benefits Management Company…well that was a new concept to us in the early 2000’s.

\nWhat's a PBM??\n\nWe quickly learned a PBM is a middleman, or 3rd party administrator, between drug manufacturers and patients. They work for health plans and employers managing the pharmacy benefits and negotiating better prices with pharmaceutical companies and drugstores.\nFast forward 12 years and the PBM market has become a major player in the healthcare industry and making the Fortune 100 companies list. In 2014 according to Forbes, the PBM market was a $263 BILLION industry—more than half of that was controlled by TWO companies (CVS and Express Scripts).\n\nThe latest news: (as of the writing of this blog)\nAnthem announced a plan to acquire Cigna, then it’s off, now it’s back on. Earlier this year, the retail chain Rite Aid entered the PBM industry, as well.\n\nQuick and Dirty on the PBM Acquisitions:\n

  • 2012, when the largest acquisition took place in the PBM industry --Express Scripts acquired Medco Health for $29 billion
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  • 2012, SXC Health Solutions bought Catalyst for $4.4 billion (now Catamaran)
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  •  3/2015 OptumRx (part of United Health Group) and Catamaran announced they were merging (2016 expected)
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\nAll these changes, leave us with FOUR national PBMs by Market Share:\n1.EXPRESS SCRIPTS-stand alone, carve-out PBM services\n2.CVS CAREMARK-PBM/Retail Services\n3.OPTUMRx-carve-in PBM services via UnitedHealthcare\n4.PRIME THERAPEUTICS—carve-in via Blue Plans.\n\nWhat’s next??\n\n• Will Aetna decide to start an in house PBM, once they complete their contract with CVS Health in 2019?\n\n• Will the acquisition with Humana get approval from the US Dept of Justice?\n\n• Will a deal between UnitedHealth Group and Catamaran happen?\n

What do these acquisitions/mergers mean to YOU?


As a PBM Professional, are you being squeezed out with these changes?\nWe’re here to help and would love to speak to you confidentially.   Contact us


Be proactive….let us know who you are and what you do, so we can keep you in mind as we learn about new opportunities.

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