2 new PBM launches aim to bring greater transparency to the market

Drug prices
Two new pharmacy benefit managers are looking to rethink the industry's traditional operation. (Getty/Tero Vesalainen)

Two new pharmacy benefit management startups are aiming to inject greater price transparency into the market.

The Purchaser Business Group on Health has announced Emsana Health, with its first business arm launching as EmsanaRx, a PBM. As PBGH is a coalition of 40 large employers, the company says its PBM solution is "built by employers, for employers."

Emsana Health aims to serve as an "innovation studio" that will develop new products and solutions designed with input from PBGH's employer members.

“Our members have asked us to use our unique position in the market and deep expertise with large employers to help them develop solutions for the pain points that aren’t being addressed by the status quo and to reshape the health care market so it delivers for them and the employees they cover,” said Elizabeth Mitchell, president and CEO of PBGH and chair of the Emsana Health board, in a statement.

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“Emsana Health and its first business unit, EmsanaRx, are a natural outgrowth of PBGH’s 30-plus years of work redesigning health care markets to reflect our members’ priorities," Mitchell said.

EmsanaRx is designed to offer employers greater clarity into pricing for pharmaceuticals and will set a fixed price per prescription. In addition, it will offer guidance from a dedicated clinical pharmacist to serve as account manager, who will partner with employers to design pharmacy networks and update formularies.

PBGH noted that the current PBM landscape is highly concentrated, with 80% of business held by three companies: Optum, Express Scripts and CVS Caremark.

Greg Baker, a clinical pharmacist who served most recently as a senior pharmacy consultant with Blue & Co., will lead EmsanaRx. 

“The pharmaceutical supply chain is broken. An opaque third-party payment system creates a profit haven for intermediaries whose interests are not aligned with their clients,” Baker said in a statement. “PBMs have leveraged their solutions to weave interdependent revenue streams that are built into the price of drugs paid for by employers, employees and their families.”

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In addition to EmsanaRx, the Mark Cuban Cost Plus Drug Company PBC also launched its own PBM this week, The Wall Street Journal reported.

Cuban's company aims to sell generic drugs at a transparent, fixed rate, and to achieve this united manufacturing, distribution and pharmacy services under one roof, according to the article. Cuban, a billionaire investor, told the WSJ he agreed to back the venture after receiving a pitch via email from its now-CEO, Alex Oshmyansky M.D., Ph.D.

The PBM will begin to bid for clients next year and aims to be fully up and running by 2023, Oshmyansky told WSJ.

“The supply chain for distributing pharmaceuticals to patients is so cumbersome and broken,” he told the outlet. “We decided the only way to get our drugs to the people who need them is to build a parallel supply chain where we have control of all the intermediary players and ensure the same level of transparency at every level.”