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ESI to Try Cost-Plus Model

Mark Cuban can now be called a pharmacy trend setter. 

We’ve read about his cost-plus drugs model….. and it seems that Express Scripts (ESI) feels that offering a similar pricing model to their clients is a great idea. 

Yeah, one PBM may not qualify as a trend….. but it is a start.

ESI has begun to offer a product called ClearNetwork to clients using Wholesale Acquisition Cost, Predictive Acquisition Cost, or National Average Drug Acquisition Cost to decide on the ‘’estimated’ price for each drug in their formulary. A pharmacy fee and a second fee of 15% then added (not clear if that is a combined 15% or two separate fees). ESI has been quoted as saying that the fees will be transparent to clients and pharmacies (no mention of patients, however).

According to the article below, “The option will apply to a plan sponsor’s list of covered generic, branded and specialty medications.” This model is being offered to the 65,000 retail pharmacies in its network. It is not clear is participation is part of the recontracting going on where pharmacy reimbursements are being cut significantly.

ESI will add fees onto each prescription to cover its cost for providing its package of PBM services.


Express Scripts’ New Option Models Mark Cuban’s Cost Plus Drugs

This is the latest offering by Express Scripts that aims to bring transparency to prescription drug costs.

CLICK HERE to read the full article


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