CVS To Dominate Pharmacy Networks


It doesn’t get much more saturated than this: 99.9% of Medicare Part D beneficiaries are enrolled in prescription drug plans with preferred pharmacy networks, according to pharmacy markets expert Adam J. Fein of Pembroke Consulting. Fein writes on his pharma blog, Drug Channels, that “as long as pharmacies accept lower reimbursements in exchange for increasing or maintaining store traffic, preferred networks will continue to dominate the marketplace.”

The winners among the Part D preferred pharmacy networks are willing to trade lower prescription profit margins for larger market share.

Walmart and Walgreens still dominate the market of Part D plans with preferred pharmacy networks, but CVS is catching up.

CVS pharmacies are preferred in plans that enrolled 8.5 million people in 2018, compared with fewer than 300,000 people enrolled in CVS retail pharmacies in 2017.

That puts it just behind Walgreens, which has 8.7 million people signed up for its preferred pharmacy network. Walmart still leads, with 11.5 million people enrolled in its plans.

Then, there is what Fein refers to as “poor Rite Aid,” which is playing a “losing hand.”

“For 2018, it is preferred only in the plan sponsored by EnvisionRx, the PBM that it acquired in 2015,” Fein writes. The EnvisionRx-sponsored plan enrolled fewer than 500,000 members, though its enrollment grew by 65% over 2017.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

Subscribe to Our Newsletters

Monthly table of contents

Be notified as each issue of Managed Care is available online.

Biweekly newsletter

Recent topics have included:

PTCommunity news

New drug approvals, clinical trials, drug management. Three times per week.

UP NEXT