The next generation in online publishing...
Sign up to read the digital versions of Managed Care, P&T, and Biotechnology Healthcare. These digital editions are free, searchable, and can be downloaded and read offline. To read a sample of the digital version of Managed Care, follow this link:
Click here for this month's digital edition.
Register for a free digital subscriptionArchive issues of Managed Care:
2009
2008
MANAGED CARE EXECUTIVE EDITION November 2002. ©MediMedia USA
NEWS AND COMMENTARY
Aetna may be moving into PBM territory
Aetna's decision to end its contract with Express Scripts and move its mail-order pharmacy business in-house could be the start of Aetna's incursion into the PBM industry.
The thinking, according to some analysts, is that what Aetna does for itself, it can do for other HMOs as a contractor.
Aetna spokesman Fred Laberge hastens to add that no such decision has been made at the nation's second-largest for-profit HMO.
Still, he points out to the Hartford Courant, the company may consider offering its pharmacy management services to other insurers and to employers who aren't Aetna customers.
For the most part, financial analysts view Aetna's decision to sever its Express Scripts contract as one that will pay off.
Chris Sergeant, an analyst with Stifel Nicolaus, tells Reuters that the move presents an even broader question for the HMO industry: "Will additional managed care companies follow?"
He answers that only the "biggest of the big" HMOs would contemplate following suit because of the huge capital costs involved in moving pharmacy management in-house.
Josh Raskin, an analyst for Lehman Brothers, points out that other health plans have already made the transition to in-house. WellPoint, for instance, runs its own PBM.
Mail order prescriptions, which Express Scripts manages for Aetna, accounts for about 10 percent of Aetna's pharmacy business, valued at about $4 billion.
The Aetna/Express Scripts contract will expire in the second quarter of 2003. Aetna is in negotiations to acquire a modest-sized mail-order company, which company officials at press time declined to name.
