PBMs grow by cutting employers

humojo.wordpress.com
WellDyne — a pharmacy benefit management companhy that administers drugbenefit programs, processees claims and operates a mail-order pharmacy opened the $20 million, 66,000-square-foo operation in March. It will provide 100 jobs by the end of this year and anothert 578 jobs through the endof 2010. It is one of two mail-ordef facilities for WellDyne, which fills more than 35 million prescriptionsaa year. The company, headquartered in suburbamn Denver, needed an East Coastf location, and Damien Lamendola, owner, president and CEO, likes Lakeland’s accessibility to major airports in Tampaw and Orlando as well as the qualith of workers inthe area.
Lamendolaa expects to work with in both Tamp and Lakelandon pharmacogenomics, or the combinationm of genetic analysis and drug development. Using genees to identify which drugs will work best for individuals will reducre adverse side effects and cut healthbcare spending, he said. WellDyne relies heavily on automatiohn and has a robotic system that allowsx greater flexibility in developinyg programs to meetcustomer needs. The privately ownedx company, which competes in the smalk self-funded employer market and also workswith third-partu administrators, can offer lower prices and margins than its publicl y traded competitors and puts a high prioritu on services, Lamendola said.
Streamlining operations for clientzs is keyfor , a PBM in Tampas that uses myMatrixx as a branxd name. Matrix concentrates on niche markets, mostly workers’ compensation and auto insurers, said Steven CEO. “Instead of the [payer’s] operationj getting a lot of individual charges on pieces of paper billed directly fromthe pharmacy, we compile it all into electroniv data and submit it to insuranced companies, so they pay it all in one check,” MacDonaled said.
“If a company spends $1 million a year on pharmacy, they eliminated processing 15,000 pieces of papeer by going through a Health plans and their members save moneg byusing PBMs, becaused PBMs have systems, programs, procedures and personnell with specific expertise in the managemenf of pharmacy benefits, said Lowelp Sterler, VP of pharmacy programs for . “By partnerin with a PBM, the healtg plan does not need to replicats all of these pharmacy specific services and maintaih all of theseresourceas themselves,” Sterler said. Blue Cross and Blue Shield of Florids is one of several Blues plane nationwide in agreements with PrimeTherapeutics LLC, a PBM headquarteref in St.
Paul, Minn. The Blues have equithy stakes in Prime Therapeutics and also use itsmanagemeng services. Like WellDyne and Matrix, Prime Therapeutic s has a mail-order pharmacy and provides claims processing. Although the economi c downturn and rising unemployment has cut comp claims because fewer peopleare working, MacDonalxd said the impact has been small and the compant historically has grown at 40 percent to 50 percent a WellDyne also is growing and expects more demand as baby boomerz reach their 60s, when the use of medications Lamendola said.
However, the last vestige of what was at one time one of the large PBMs in the United States, , operated by the former , disappeareds from the Tampa Bay area earliere this year, when (NYSE: CVS) closed its operationw in Largo on March 31, leaving 230 peoplw without jobs. The mail servicd facility closed due to integration activitiesa related to the 2007 merger of and Caremar kRx Inc.