Health insurer creates its own pharmacy benefit manager, IngenioRx

WOONSOCKET, R.I. — CVS Health has signed a five-year agreement to provide services to support IngenioRx, a new pharmacy benefit manager formed by Blue Cross Blue Shield health insurer Anthem Inc.

CVS said Wednesday that its CVS Caremark PBM division will manage certain services for IngenioRx, including claims processing and prescription fulfillment.

In addition, CVS will leverage its integrated health care assets — including CVS Pharmacy and MinuteClinic — to apply its patient messaging and engagement expertise at the point-of-sale to support IngenioRx, expanding clinical services offered at the pharmacy counter to drive better outcomes.

The agreement goes into effect on Jan. 1, 2020, and runs to Dec. 31, 2024.

“We believe that this agreement further validates the important role that CVS Health’s integrated and innovative pharmacy care model plays in today’s health care system, and we look forward to working with Anthem and IngenioRx to provide services to help ensure coordinated, holistic care for their PBM members,” CVS Health president and chief executive officer Larry Merlo said in a statement.

Merlo noted that nearly 5 million Americans walk into a CVS Pharmacy daily, making the company a “front door of health care.”

“Given our presence in the community, our pharmacists and nurse practitioners are able to engage in face-to-face personalized counseling and clinically effective interventions that will enable us to help improve health outcomes and lower overall health care costs for Anthem and its members,” he added.

CVS said it expects to incur implementation costs related to the transition of members, and these costs aren’t expected to impact its 2017 financial results.

“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,” stated Brian Griffin, executive vice president of the commercial and specialty business at Anthem.

Griffin, who oversees Anthem’s pharmacy business, will continue to be the executive leader through the transition to IngenioRx. “In partnership with CVS, transitioning members seamlessly to our new solution will remain Anthem’s top priority,” he added.

IngenioRx, which will serve customers of Anthem-affiliated health plans as well as non-Anthem customers, will become Anthem’s PBM upon the end of its current contract with Express Scripts. Anthem had filed a lawsuit against Express Scripts last year, claiming the PBM charged it higher than competitive benchmark pricing for pharmaceuticals.