Blue Shield Promising a Simpler, Cheaper Pharmacy Benefits Model
Carrier Updates
Thursday, November 09 2023
Blue Shield of California wants to replace its middleman. The health insurer, one of the largest in the nation’s most populous state, revealed in August it will drop CVS Caremark as the sole manager of its pharmacy benefits. In Caremark’s place, Blue Shield of California will contract out the job to five separate companies.
To those in the industry, it’s an audacious plan that cuts to the center of controversy over the role that pharmacy benefit managers like CVS play in the U.S. Blue Shield of California, or BSCA, expects to save $500 million a year from the move, calling it a “milestone” for a “broken prescription drug system.”
It’s still not clear whether BSCA can make the arrangement work, though. Big questions loom: Can the insurer coordinate pharmacy benefits across different vendors and actually generate meaningful savings? Will it lose employer clients along the way? How will other payers and PBMs react?
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To those in the industry, it’s an audacious plan that cuts to the center of controversy over the role that pharmacy benefit managers like CVS play in the U.S. Blue Shield of California, or BSCA, expects to save $500 million a year from the move, calling it a “milestone” for a “broken prescription drug system.”
It’s still not clear whether BSCA can make the arrangement work, though. Big questions loom: Can the insurer coordinate pharmacy benefits across different vendors and actually generate meaningful savings? Will it lose employer clients along the way? How will other payers and PBMs react?
Click Here To Read More