Express Scripts beat out pharmacy benefit competitors to manage one of the largest prescription drug contracts in recent years.
In its third-quarter earnings call Tuesday, Centene announced Express Scripts will manage more than $35 billion in drug spend covering prescriptions for nearly all of its members starting on Jan. 1, 2024. Centene is the largest Medicaid managed care company in the U.S., working with states to provide insurance to low-income residents.
Express Scripts’ win comes on the heels of another major victory last year when the company was awarded a seven-year contract to manage prescriptions for the Department of Defense.
In 2017, a year before Express Scripts was acquired by Cigna, the PBM lost its largest client, Anthem, which later launched its own PBM in-house, furthering the trend of insurers acquiring PBMs in a bid to cut costs by controlling both medical and pharmacy benefits.
Healthcare Dive sat down with Express Scripts President Amy Bricker to discuss what the win means for the PBM.
Editor’s note: This interview has been edited for clarity and brevity.
INDUSTRY DIVE: This is a big win for Express Scripts. How does this contract win rank compared with other clients like the Department of Defense?
AMY BRICKER: This will be our largest client at 20-million-plus customers served. At Express Scripts, we service over 100 million Americans today. But, in and of itself, as one single client, yes, this will be our largest.
What does this mean for the number of prescriptions you will dispense moving forward? Last year, you all dispensed about 1.6 billion prescriptions. Total adjusted script growth has climbed in recent years, growing 22% year over year in 2020 and 10% in 2021.
I think we’re going to have to divert to what we’ve put out publicly on that.
Centene CEO Sarah London noted how competitive the bidding process was. Can you tell us how many companies you competed against and what put Express Scripts over the top? Was it that you promised to deliver the biggest savings?
I certainly can't speculate as to what happened in their process and how many companies came to the table. What we know, based on our conversations with them, was that our approach to partnership was truly one of partnership.
It wasn’t just about the price point, which I won’t discredit. I’m sure that’s important as well. What we also heard was just a cultural alignment, a willingness by Express Scripts to partner differently and more strategically. Don’t discredit the proximity of our companies, our cultures and our both being here in St. Louis.
We also talked about how we can be thinking about additional boots on the ground to ensure that their method within the states or the federal government is resonating. We just talked a lot about how our teams will work together.
Cigna’s announcement says it will cover 20 million Centene members. Centene provides coverage to nearly 27 million members, who does this contract exclude?
They list out TRICARE and TRICARE pharmacy is already covered by Express Scripts. All of those [TRICARE] lives are medical lives to them. [TRICARE is a military health program for active-duty service members, National Guard and Reserve members, retirees and their families].
There are some lives that they’ve already noted that they are carving out from Centene. They’ve had some losses in some states so based on what they know today, that’s the number.
We were awarded the full contract. That’s the main point.