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View Poll Results: Should consumers worry about CVS buying Aetna?
Yes 7 38.89%
No 11 61.11%
Voters: 18. You may not vote on this poll

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  #11  
Old 12-05-2017, 02:41 PM
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PBMs have copay card programs already that detect these and allow their use, but don't allow the "assistance" amount to count toward deductibles and OOP maxes. Some programs actually assist the patient in finding copay assistance.
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Old 12-05-2017, 02:43 PM
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Originally Posted by Sredni Vashtar View Post
This was already happening. My company recently dropped coverage from all but one of the big pharmacy chains (I forget which).
What you are describing sounds like mandatory mail. You can use the mail order pharmacy or certain retail outlets for long-term 90 days fills. Acute meds should be covered in the normal network (which may exclude certain pharmacies but not all but one)

For CVS, it's CVS (duh) and ESI I think is Walgreens?
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Old 12-05-2017, 02:47 PM
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Originally Posted by DataDan View Post
my first thought was 'what will happen to the Aetna PBM contracts?'. Then I read that CVS is the Aetna PBM. So now CVS has the Insurer, the PBM, the Pharmacy, and if i read this right they are starting some non-rx medical services. Seems like a good leverage combo to negotiate with manufacturers.

Id say the biggest losers here are the stand alone PBMs and Big Pharma companies. For consumers, it just means walking into a different cattle shoot to get medical care.
What's the difference, going forward? Aetna has used CVS for a while and switched over Coventry's ESI business when they bought them. Aetna already has a pharmacy department and gets all the data it needs from CVS.

Now, it may spell trouble for folks wanting to use Aetna and carve out pharmacy to another PBM besides CVS, or not use whatever standard discount terms (probably lousy) they'll propose.

It may very well mean tighter care management but I sincerely doubt the systems will be merged anytime soon. They're two completely different platforms. ESI took forever to merge with Medco and they ran the same business.
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