The tensions between Express Scripts and Anthem exemplify the market problems created by PBMs. These costs can be reduced by lowering informational barriers, improving pricing transparency, and promoting greater competition.
Express Scripts, the largest pharmacy benefit manager (PBM) in the nation, is discovering just how much customer service matters. It may also be discovering that suing your biggest customer in court is generally not considered good customer service.
Should Anthem Inc. withdraw its business from Express Scripts as it has indicated, then clearly the largest for-profit health insurance company will have made the determination that the value provided by its current PBM is not worth the costs.
