TBG Insights

Once seen as allies, more and more health plans and pharmacy benefit managers (PBMs) are in tough PR and even legal battles with each other, as described in our recent blog. It seems every week one is on the tough side of antitrust laws as the other is hurling price gouging accusations.

The industry-wide impact of this and other battles could be seismic.

For starters, there is a strong trend toward value-based contracts as well as both vertical integration and horizontal consolidation. Additionally, some insurers are being left out of prescription coverage altogether by these innovative PBMs that are working with manufacturers to sell to consumers directly. This is a new market-based solution to the problems of high deductible health plans and lack of access to medication.

Understanding these market drivers for change, the structure and distribution of insurance enrollment, and the evolving competitive structure of the drug market are essential for your client facing teams to pivot their strategy with the changing tides of the healthcare industry.

The Brooks Group Primer: Health Plans and Pharmacy Benefit Managers

To gain deep knowledge on these trends and more, access the Brooks Group Primer on Health Plans and PBMs. This resource offers a review of the healthcare structure, the role of each key player, the trends and the market drivers that anyone in strategic roles in the healthcare sector can benefit from.

Learn more at https://thebrooksgrouponline.com/healthcare-primers/ or contact Peter Haines at peter.haines@thebrooksgrouponline.com for more.

Let’s Work Together