DRUGS; HEALTH INSURANCE; PHARMACISTS;

INSURANCE - HEALTH;

OLR Research Report


December 24, 2003

 

2003-R-0903

PHARMACY BENEFIT MANAGERS

By: Janet Brierton, Associate Legislative Attorney

Negotiated Prices

Generic Substitution

Formularies

Disease Management

Utilization Review

• Medco Health Solutions, the largest with 2002 sales of $ 33 billion and managing prescriptions for 65 million covered members;

• AdvancePCS, $ 14 billion in sales, 75 million members;

• Express Scripts, $ 13 billion in sales, 50 million members; and

• Antitrust issues regarding PBMs that are owned by drug manufacturers;

• Force health plans and health care consumers to pay inflated prescription drug prices through patterns of illegal, secret dealings with drug companies;