PBM Alliance with Retail Pharmacy Chain Seeks to Lower Costs, Improve Outcomes

Walgreens and pharmacy benefit manager (PBM) Prime Therapeutics recently announced plans to create a strategic alliance between the companies.

The long-term alliance combines the pharmacy network and associated expertise of Walgreens and the PBM expertise of Prime to provide cost control and improve patient outcomes, according to a press release from Prime.

The alliance will provide a novel retail pharmacy network agreement, in addition to combining both companies’ specialty and mail-order pharmacy businesses. The partnership, which aligns retail pharmacy, PBM, and health plans, is expected to coordinate care, improve outcomes, and deliver cost of care opportunities, according to the press release.

Walgreens is among the largest drugstore chains, while Prime is the fourth largest PBM, and is owned by 14 Blue Cross and Blue Shield health plans. This dynamic allows Prime’s 22 million members to receive access to Walgreens’ large network.

Personalized pharmacy services and cost savings will also be available for Prime’s members. The central specialty and mail services aspect of the alliance is expected to be able to compete with industry leaders, according to the PBM.

“The prescription drug needs of consumers are often changing, and this unique collaboration will help us deliver value, care and service to our patients and the communities we serve,” said Alex Gourlay, co-chief operating officer, Walgreens Boots Alliance, Inc. “Walgreens has a long history of working with our business partners to create new solutions to help improve access and patient care, and we look forward to providing a differentiated and patient-led pharmacy experience to more Prime members.”

PBMs have been both heavily scrutinized and praised for their current cost controlling tactics, namely formulary exclusion lists. Critics believe that the lists actually increase drug costs while limiting patient access, while supporters believe the opposite.

With this alliance, and the large customer base it includes, cost control will likely be a large benefit, according to the press release. The integration of both companies will now allow payers to leverage medical and pharmacy data for improved cost control.

The combined specialty and mail service company will be able to use Walgreens omni-channel services and resources to improve medication adherence and patient outcomes, Prime wrote. While Prime will support client-specific network choices for health plans, Walgreens will be the main participant in their preferred pharmacy network starting in 2017.

“With costs rising at unsustainable rates, we must take strong and decisive action to make health care more affordable,” said Jim DuCharme, CEO and president of Prime. “We’re trying to apply the brakes to this run-away freight train of rising drug costs by aligning the cost control expertise of the trusted Blue + Prime model with Walgreens supply chain capabilities and sending a message that we are on board with finding a solution to this issue. We believe that the care, value and commitment that we will deliver together will create benefits to our Blue Plan clients and members.”