May Video On PBM Selling Season (CVS, ESRX, MHS)

I just came across this video from May of Lisa Gill from JP Morgan talking about the 2011 PBM selling season. My couple of takeaways were pretty basic:

  • Price is not the #1 decision factor in choosing a PBM.  (I don’t believe that no matter how many surveys there are.)
  • The model is creating differentiation.  People like consumerology or the Medco clinical programs or the CVS Caremark 90-day program (Maintenance Choice). 

I liked her quote from Florida relative to the CALPers issue at Medco that if they didn’t deal with people under investigation then there wouldn’t be anyone to do business with.  (A little jaded perhaps!)

The key question here is the success that the smaller PBMs have been having especially SXC and Catalyst, but even more interesting would be her take on what will happen as Prime and OptumRx focus more outside of their traditional payer markets. 

Everyone always talks about the 9x% of companies that don’t move PBMs, but the question really should be about lives that move.  It only takes a few big clients – Walmart, GE, BCBS, … to make a difference in a selling season.

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