Wait a minute… Anybody remember this, Anthem Partners With CVS Health To Launch New PBM , basically CVS (Caremark) will be Anthem’s backroom PBM meaning “CVS will process claims and handle related ‘prescription fulfillment.'” Now, CVS is allegedly closing in on a deal to Buy Aetna. Let’s lay out some facts:
- CVS Health – Caremark = Pharmacy Benefit Manager
- Anthem = Insurance Company
- Aetna = Insurance Company
- CVS Partnered with Anthem to be backroom PBM
- CVS Closing in on Deal with Aetna
- CVS + Aetna = PBM and Insurance Company
- CVS ‘Partnered’ with Anthem = PBM Partnered with Insurance Company
- CVS Aetna Partnered with Anthem = PBM and Insurance Company Partnered with Insurance Company
- Conflict of Interest – A situation in which a party’s responsibility to a second-party limits its ability to discharge its responsibility to a third-party.
CVS Health is in retail healthcare, owns a Pharmacy Benefit Manager (Caremark), partnered with Anthem to be their backroom Pharmacy Benefit Manager for IngenioRx, and closing in on a deal to purchase Aetna. Think for yourself, but definitely seems like there might be a conflict of interest there.