Anthem Establishes New Pharmacy Benefits Manager

One of the largest health insurers is launching a new pharmacy benefit manager.

Anthem recently announced plans to launch IngenioRx, a new pharmacy benefit manager (PBM). IngenioRx will begin operations in 2020 when Anthem’s current contract with Express Scripts expires on December 31, 2019, according to a press release.

“As a company, we continuously seek bold, innovative solutions that achieve consumer access to high quality, affordable healthcare,” said Joseph R. Swedish, chairman, president and chief executive officer, Anthem. “During the past 2 years, we have been very clear that we can strengthen the value offered to the marketplace with an improved and aligned PBM model.”

Previously, Express Scripts disclosed Anthem’s search for a new PBM service provider in their first-quarter results from 2017. Express Scripts said the insurer was uninterested in discussing potential price concessions or other negotiations to continue their relationship.

“Through the process of evaluating many PBM options in preparation for the expiration of our current contract, we determined that our scale and experience best position us to deliver an innovative solution, and the launch of IngenioRx will allow us to break through what is now a complex and fragmented landscape,” Swedish said. “It also positions Anthem to take advantage of a unique opportunity to grow and diversify our business within our existing footprint as well as nationally.”

IngenioRx will manage pharmacy benefits for patients insured through Anthem, as well as non-Anthem patients. The insurer reports that the PBM’s leadership team has more than 100 years of combined experience in the industry, which will lead to a seamless transition, according to the release.

Additionally, Anthem has signed a 5-year contract with CVS Health that begins on January 1, 2020. IngenioRx will integrate its member and provider engagement initiatives and pricing with CVS’ vast expertise, according to the release. CVS will be responsible for filling prescriptions and processing claims.

“This combination, paired with the clinical expertise, deep provider relationships and focus on customer centricity of Anthem’s affiliated health plans, will create a holistic, integrated approach to managing health and driving better outcomes,” said Brian T. Griffin, executive vice president, Commercial and Specialty Division, Anthem. “In partnership with CVS, transitioning members seamlessly to our new solution will remain Anthem’s top priority.”