The Total Care Package

Charting the course that has led to payer vertical integration and what it may mean for pharma manufacturers With the emerging and now well-chronicled shift in healthcare from one based on rewarding volume of services to one focused on the value of services provided, the pharmaceutical industry is searching for varying methods and formulas it can leverage to best adapt to the changes. According to a recent physician survey conducted by the American Medical Association, 2016 marked the first year that less than 50% (47.1%) of practicing physicians owned their own clinical practice.1 The need for greater alignment, less variation, improved outcomes, risk diversification, and cost containment were clear driving factors. Anthem's decision to break with Express Scripts and go its own way in the pharmacy benefit manager (PBM) space with the creation of IngenioRx represents another significant move in vertical integration.