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Tag: Express Scripts

#Healthin2Point00, Episode 157 | The phrase is “Takeout Speculation”!

Today on Health in 2 Point 00, Jess and I gossip about the wild rumor that UnitedHealthcare is acquiring Amwell. On Episode 157, we discuss Lark raising $55 million in a Series C along with a deal with Anthem to be their preferred DPP provider, Medicare Advantage plan Clover going public with a valuation of $3.7 billion, NOCD raising $12 million in a Series A providing specialized CBT and virtual OCD treatment, Cerebral raising $35 million in a Series A for its comprehensive digital mental health offerings, and Express Scripts adding to their digital health formulary with offerings targeting things like women’s health, tobacco cessation, muscle and joint pain, and more. —Matthew Holt

What’s Ahead for Livongo & the Health Tech Market in 2020? | Glen Tullman, Livongo

By JESSICA DaMASSA, WTF HEALTH

What does Glen Tullman, Chairman of Livongo, expect from the health tech market in 2020? Livongo may have started a “race for the exits” in digital health with its 2019 IPO, and Glen says he “wants a healthy, consumer-facing digital health market” to help his own business thrive. Does that mean he anticipates more IPOs from the health tech sector this year? We get Glen’s predictions after we catch up on Livongo’s recent moves to partner with DexCom and test a new pathway to reimbursement via Express Scripts’ Digital Health Formulary.

Filmed at J.P. Morgan Healthcare Conference in San Francisco, January 2020.

What’s the next way PBMs will make money?

Yesterday Medco offered itself up to smaller competitor Express Scripts, creating an entity with more than 50% of the PBM market. PBMs originated as specialized claims processors that supposedly were able to reduce drug costs. But in the 1990s  drug costs soared. Somehow PBMs didn’t lose employer clients, further confirming that employers are dumb about how they buy health care. Most employers didn’t understand that PBMs made much of their profits on rebates they were paid by drug companies to keep particular drugs on formulary. Almost none of that money went back to the employer. After that game ended, PBMs replaced almost all those profits by making huge margins on generics until Walmart showed that it could make a profit by charging only $4 a fill. Now it looks like extracting a bigger piece of the pie from pharmacies and charging more to employers may be the only game left for PBMs. And that’s probably the driver behind the merger.