September 28, 2020

Is bigger actually better

Many think that in the land of pharmacy benefits there are only three major players – CVS/Caremark/Aetna, Express Scripts/Cigna and OPTUMRx/United Healthcare.

While it’s true, they do own a big share of the market. They control somewhere between 70-85 percent of the total market for prescription benefits.

But is bigger always better?

There are many solutions to managing the pharmacy benefit—far beyond three.

One of the most frequently asked questions we receive at Apex and Kinetiq Health in pharmacy benefits is, “Do you have a preferred vendor you work with for pharmacy benefits?”

Our answer to this question is a resounding no.

We have a growing stable of nearly 50 pharmacy benefit managers that we work with when serving our clients. While we know that other healthcare and pharmacy insurance brokers do have a limited group of “preferred” PBM vendors, we at Apex realize and appreciate that one size or type of PBM solution does not fit all. That is why we work not with a handful of vendors, but many.

It’s important to have a broker who will aggressively go to market for you with your pharmacy and healthcare benefits. If you’re not happy with your service and answers from your PBM, maybe it is time to consider moving to a broker who can work with a variety of PBMs and find the best solution for you and your hard-working employees? And, even if you’re happy with your current broker, we have consulting expertise and solutions at Kinetiq Health for going to market with your pharmacy benefit that other brokers do not offer.

Bigger isn’t always better. We strive to find the right, unique PBM for the unique needs of each and every one of our clients.