ICYMI: CVS drugstores were booted from the pharmacy networks of Blue Cross and Blue Shield of Alabama. It's more evidence for preferred and limited pharmacy networks in commercial plans. But how many payers are adopting these new narrow network models?
As far as I know, the only public answer comes from the Pharmacy Benefit Management Institute’s (PBMI) new 2016 Trends in Drug Benefit Design report. (Free download with registration.) Drug Channels again thanks Takeda Pharmaceuticals U.S.A. for having sponsored the research.
According to the PBMI’s survey data, almost half of all employers have a narrow pharmacy network. The chart below tracks the growth in different network designs. Many interrelated factors support the continued adoption of narrow networks. The savings to payers from narrow networks come primarily from pharmacies, which offer or must accept lower per-prescription margins. That’s what makes narrow networks so controversial—but also highly pro-competitive. Caveat venditor!
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