In October of 2017, Anthem Inc. announced its launching of IngenioRx, an in-house pharmacy benefits manager (PBM). Expectations were for the new PBM to launch in 2020, but Anthem recently announced that they are accelerating the launch of IngenioRx and expect to begin transitioning members by the second quarter of 2019. This transition is starting 10 months sooner than the industry expected.
Anthem currently partners with Express Scripts for their PBM services, but due to the recent acquisition of Express Scripts by Cigna, Anthem will exercise its contractual rights to terminate the PBM Agreement earlier than the original expiration date of December 31, 2019.
The PBM agreement with Express Scripts will now terminate on March 1, 2019 and they will incrementally migrate their business over to IngenioRx over the next 12 months. The transitions will happen in waves and commercial clients are expected to be migrated over to IngenioRx first. Medicaid and Medicare clients will transition during later waves.
CVS Health will support IngenioRx by providing the back-end prescription fulfillment and claims processing services. IngenioRx will also leverage the CVS Pharmacies and MinuteClinics to provide members with enhanced point-of-sale engagement to improve health care outcomes.
Anthem believes the launch of IngenioRx will provide a gross annual savings of greater than $4 billion and they note more than 20% of that amount will benefit shareholders.
Truveris is working with Anthem to understand when their clients’ will be transitioned to IngenioRx and will provide client support throughout the process once the timelines are determined. Clients enrolled in TruGuard will have every claim validated during this transition to ensure all prescription claims are processed accurately.
- Anthem is leaving Express Scripts 10 months sooner than expected
- Anthem clients will be transitioned to IngenioRx in waves starting 2nd quarter 2019
- Truveris will provide affected clients with transition support
- Clients enrolled in TruGuard will have 100% of their prescription drug claims reviewed to ensure accurate billing and contract guarantees are met