Managed Care


New Standards Assure PBM Transparency

MANAGED CARE December 2010. © MediMedia USA
News and Commentary

New Standards Assure PBM Transparency

MANAGED CARE December 2010. ©MediMedia USA

The HR Policy Association, an organization of chief human resource officers, announced the recertification of nine pharmacy benefit managers that have agreed to the association’s standards of business transparency. The association recognizes two levels of transparency. The highest level identifies PBMs that are willing to provide actual average inventory cost (AAIC) for mail order drugs. Four of the nine adhere to these higher standards:

  • Humana Pharmacy Solutions
  • MedImpact Healthcare Systems
  • Prime Therapeutics
  • Restat

The lower level applies to PBMs that are willing to provide wholesale acquisition cost (WAC) pricing for mail order drugs. WAC is a nationally tracked index shown to have advantages over average wholesale price (AWP) in its ability to more closely reflect drug pricing dynamics. The five on this level are CVS Caremark, Express Scripts, Prescription Solutions, UnitedHealth Pharmaceutical Solutions, and Walgreens Health Initiatives.

Marisa L. Milton, executive director of the pharmaceutical coalition, says, “When plan sponsors start the bidding process, they want to feel confident [that they know] which PBMs are willing to provide this level of transparency.”


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