PBGH launches PBM for large employers
The pharmacy benefits market is heating up, as billionaire investor Mark Cuban’s drug company also introduces its own PBM.
The Purchaser Business Group on Health (PBGH) has launched Emsana Health — an independent company established to create health care products to meet the needs of large companies and their employees. Emsana Health will serve as an “innovation studio” to develop products designed with and for PBGH member organizations — which include Walmart, Costco, Tesla, and Microsoft. The new company’s first business unit is EmsanaRx, a pharmacy benefit manager (PBM) that was built by employers for employers and seeks to lower health care costs and boost transparency.
Related: Study: Costco offers better prices than Medicare 50% of the time
“Our members have asked us to use our unique position in the market and deep expertise with large employers to help them develop solutions for the pain points that aren’t being addressed by the status quo and to reshape the health care market so it delivers for them and the employees they cover,” Elizabeth Mitchell, PBGH president and CEO, who also is chair of the Emsana Health board, said in a statement.
Officials at PBGH, a nonprofit coalition of nearly 40 large, private employers and public institutions seeking ways to improve health care quality and control costs, say EmsanaRx is structured to address the lack of accountability of the PBM industry to its employer clients. Developed by PBGH with the backing of its members, EmsanaRx’s business incentives are structured to align with the interests of the large employers paying the bills.
“The pharmaceutical supply chain is broken,” said Greg Baker, a clinical pharmacist who was named EmsanaRx’s first CEO. “An opaque third-party payment system creates a profit haven for intermediaries whose interests are not aligned with their clients. PBMs have leveraged their solutions to weave interdependent revenue streams that are built into the price of drugs paid for by employers, employees, and their families.”
He added that EmsanaRX offers large employers a level of transparency, flexibility, and control not currently available in the market, with a fixed price per prescription and direct guidance from a dedicated clinical pharmacist account manager partnering with employers to design their own pharmacy network.
“Customers will know exactly what they are paying for and can make strategic adjustments in real-time,” Baker said. “For the first time, employers will own their own data and have the information and tools and clinical resources dedicated exclusively to their unique needs and patient populations.”
Another PBM launches
Mark Cuban Cost Plus Drug Company, a generic drug firm launched by its billionaire investor namesake, also introduced a PBM company on the same day that EmsanaRx was announced.
“We decided the only way to get our drugs to the people who need them is to build a parallel supply chain where we have control of all the intermediary players and ensure the same level of transparency at every level,” Alex Oshmyansky, CEO of the Mark Cuban Cost Plus Drug Company, told The Wall Street Journal.
PBMs are under recent fire for being “middlemen … hiding behind opaque and complex contracts with health plans, government agencies, and other parties to inflate drug prices and drive out competitors,” HeathcareDive.com notes. PBMs also are an increasing target of legislation and regulation.
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