- Insurance giant Anthem's CEO on Tuesday called out benefits manager Express Scripts for not passing on sufficient savings from negotiating price discounts from drugmakers.
- The CEO, Joseph Swedish, went so far as to threaten a breakup with the major PBM, which services the prescription drug benefits portion of Anthem members' plans.
- A breakup with Express Scripts would be a major blow for the PBM, and cede market power to CVS Health, another large PBM in the U.S.
"We are entitled to improved pharmaceutical pricing that equates to an annual value capture of more than $3 billion," said Swedish during an investor presentation at the JP Morgan Healthcare Conference. "To be clear, this is the amount by which we would be overpaying for pharmaceuticals on an annual basis."
Express Scripts had a very different take on the matter, retorting that the company has "acted in good faith" and that "Anthem is not entitled to $3 billion" or any amount of precise mandated savings as part of the two firms' agreement.
Still, if Anthem does wind up ditching its partnership with Scripts, that would be a huge blow the PBM's business and would likely catapult CVS Health into the top spot for U.S. benefits managers.
Anthem's threat also did seem to spook investors a bit. Express Scripts shares are down 7% in Wednesday trading.