WellCare ditches UnitedHealth in PBM scuffle, opts for CVS
- WellCare Health Plans, a health insurer, switched its pharmacy benefit manager to CVS Health Corp. Previously, WellCare used UnitedHealth Corp's Optum Rx to oversee prescription benefits.
- WellCare has roughly 3.8 million members enrolled through Medicare, Medicaid and prescription drug plans, who will now have access to CVS' pharmacy network.
- The deal is effective as of January 1. Prior to the switch, WellCare members were sent letters informing them of the switch, as well as new prescription ID cards.
Generally insurers switch PBMs to improve their terms and costs, or secure potential savings. In a statement, WellCare's chief pharmacy officer, Laura Hungiville, pointed to CVS' large network of pharmacies and its clinical programs designed to boost medication adherence.
CVS Health is the second largest PBM (after Express Scripts) and has an extensive network of pharmacies. PBMS have been pushing back on drug prices in the wake of increasing plan costs, as insurers become more price-sensitive. This trend looks set to continue with the growth of value-based pricing.