Anthem Sues Express Scripts, Proves Managed Plans Better

By Howard Danzig

Let’s not read too much into it that the week “Batman v Superman” opens at the movie theater the Wall Street Journal reports that Anthem is Suing Express Scripts Over Drug Pricing. It is being alleged that the pharmacy-benefit manager is overcharging to the tune of $15 BILLION – the amount of the suit.

Managed Plans Save Money.
Managed Plans Save Money.

I am not surprised. As President of ECCHIC, I have known for years that the system is set up against many, particularly small town business owners trying to do right by their employees. I travel the Midwest speaking to  business, organizations, local government communities, and independent pharmacist explaining how they are paying premium prices – retail – while bigger companies in urban areas get discounts. The ECCHIC team has been advocating to “cut out the middle man” and get your pharmaceutical needs from a local, independent pharmacist (thus keeping the money in your community as opposed to sending it off to New York or LA or who knows where). It can be done, because we do it all the time for our cache of clients.

anthemThis lawsuit seeks damages tied to “unduly high pricing for drugs.” Anthem is also asking to terminate its deal with Express Scripts which at the moment they are bound to until 2019. Of course Express Scripts is saying this case is “without merit” but I am telling you, if you’re in a traditional insurance plan that is not a managed care situation, you are being way, way overcharged. To quote from the article:

The insurer said it believes the gap between current pricing and what it believes to be appropriate is about $13 billion over the rest o fits contract, plus $1.8 billion covering a post-termination wind-down period. Anthem has previously said it should be getting more savings partly because of lower generic-drug costs.  Anthem alleged that Express Scripts delayed negotiations, and the PBM‘s counteroffer in the talks was about $13 billion less than what the insurer sought … Anthem also alleges that Express Scripts had operational problems … “

So often I see small and medium independent companies watching their pennies on every invoice they pay out, yet have no idea what the real costs are when they write that big check to their insurance company every month. The ECCHIC Team gets in and find out, and save companies up to 40 percent doing it.  (For a video about this, go here.)Express

Let’s watch this case carefully because this could blow the lid off what we have believed for a long time is the biggest scam going. “Dawn of Justice” Indeed!


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