Cigna Group’s Express Scripts announced plans to offer a “cost-plus” drug pricing model for its clients next year amid growing scrutiny of pharmacy benefit managers.
Employers, health plans and government organizations will have the option to pay for prescription medications at their estimated acquisition costs, plus a fee of up to 15% of the drug’s cost and a flat pharmacy dispensing fee, through the pharmacy network option Express Scripts ClearNetwork, Express Scripts said in a news release Tuesday. Express Scripts is the PBM business of Cigna subsidiary Evernorth Health Services.
The company touts the model as an alternate option for clients looking to simplify drug pricing. It contrasts with PBMs' typical practices of negotiating reimbursement rates with pharmacies on clients' behalf.
The dispensing fee, which the company did not disclose, will go to the pharmacy and the percent markup fee is shared by Express Scripts and its pharmacy partners. The reimbursement model will apply to all brand, generic and specialty drugs on a plan sponsor’s formularies and will be available to more than 65,000 retail pharmacies nationwide.