Express Scripts, in expanding PBM reach, agrees to buy WellPoint’s NextRx unit
ST. LOUIS In a huge boost to its potential reach and marketing clout, pharmacy benefit management giant Express Scripts has agreed to buy the PBM operation of insurance carrier WellPoint Inc. for $4.68 billion.
The deal, announced by both companies, would shift a massive potential customer base to Express Scripts, the nation’s third-largest PBM behind CVS Caremark and Medco. WellPoint insures a reported 35 million members, some 25 million of whom also are covered by the company’s NextRx PBM drug benefit plan. WellPoint also manages drug benefits for some smaller health plans, according to a report from The Wall Street Journal.
The purchase, for a mix of cash and Express Scripts stock, is expected to close in the latter half of 2009. It also includes an exclusive 10-year contract under which the St. Louis-based PBM would provide pharmacy benefits to WellPoint’s members. Express Scripts said the addition of those members will pump as many as 265 million more prescriptions into its pharmacy benefit portfolio, boosting the total number of prescriptions it either manages through contracts with other pharmacy providers or fills through its own mail-order facilities to roughly 750 million scripts a year.
“Now more than ever, as the nation focuses on health care reform, this collaboration between Express Scripts and WellPoint represents a shared commitment to achieving optimal health outcomes while driving out wasteful spending,” said Express Scripts chairman and CEO George Paz.
The merger of WellPoint’s PBM into Express Scripts could be a boon for generic drug makers, since the acquiring company heavily promotes me-too medications. In a statement, Paz also indicated the deal would mean a heavier commitment to specialty drugs and personal services for the former members of NextRx. It’s also certain the combination of both companies’ PBM memberships will boost Express Scripts’ clout with pharmaceutical companies when negotiating prices and programs.
Nevertheless, the merger of NextRx with Express Scripts could have an impact on the retail pharmacy industry. NextRx relies more heavily on retail pharmacies than do the largest PBMs like Express Scripts, according to press reports; the WSJ estimates that only about 10% of prescriptions managed by WellPoint’s PBM were filled via mail order, compared with an average of as much as 40% by the largest PBMs with their own major mail operations.