As criticism of pharmacy benefit managers intensifies, CVS Caremark (CVS) plans to roll out a new prescription-drug pricing model next month for health plans that the company maintains will “simplify” costs and simultaneously add a dose of transparency to a highly opaque system.
In short, the PBM will offer so-called guaranteed net pricing for average prescription claims, whether medicines are purchased by mail or from retail or specialty pharmacies. CVS says it will pass through all rebates and administrative fees to its clients while assuming responsibility for manufacturer price hikes and shifts in the mix of brand and generic drugs.
“The model that relies on rebates is a thing of the past,” Derica Rice, president of CVS Caremark, told us. “We want to provide drug cost predictability. And this allows us to get the lowest net cost and help (health) plans lower premiums for their members.” He added that “we’re on the hook for getting lowest-cost opportunity.”
The silverscript allure with pass thru rebates more than makes up their margin with 10X pricing on generics. One customer with 9 generics averaged $128 more per rx than the plain silverscript plan.
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