WHAT IT MEANS AND WHY IT'S IMPORTANT — Walgreens is running the ball straight down the middle of the field in its bid to mitigate any lost Express Scripts prescriptions once the retailer is removed from that benefit manager's pharmacy network at the end of the year — and that seems increasingly likely with each passing day. And if Walgreens achieves 97% to 99% of its 2011 prescription volume of 819 million prescriptons next year, as the pharmacy retailer maintains, then it will be the Chicago-based Walgreens doing an end-zone shuffle of sorts by the end of next year.
(THE NEWS: Walgreens breaks down Express Scripts business in 8-K filing. For the full story, click here.)
In conjunction with that 8-K filing last week, Walgreens and three pharmacy benefit manager partners hit the turf with an ad campaign letting employers know what the impact a pharmacy network with one of the largest pharmacy operators sitting the bench would have — their employees may face disruptions in pharmacy care and, in some cases, "employers without Walgreens in their pharmacy network could end up paying higher overall medical costs."
And earlier in the month, PMSI announced Walgreens would continue to be a critical part of that PBM's pharmacy network. At least as far as Express Scripts' competition goes, having Walgreens be a part of their pharmacy networks is becoming a key point of differentiation, especially for those employers that are shopping PBM's right now.
For those employers, Walgreens put on the record that most healthcare payers are willing to pay out a fair reimbursement (i.e., a reimbursement that exceeds acquisition and adjudication costs) in an effort to keep Walgreens in the pharmacy network mix. The general gist of the 8-K document suggests those payers who can keep Walgreens in the fold are keeping Walgreens in the fold, and those who can't on account of Express Scripts' contract restrictions still want to keep Walgreens in the fold.
"Employers, plans and payers recognize that Walgreens delivers significant value to pharmacy benefit plans by providing patients with convenience, choice, customer service and low-cost prescriptions," the chain stated. "Our competitive rates, combined with our superior performance on generics, 90-day at retail and other health services, create significant value for consumers, employers and health plans." Patients who visit Walgreens are offered more than a bag of pills and medical reading material; they can avail themselves of "flu shots, health testing, coordinated wellness care, work-site health centers and medication adherence assistance that help patients get well and stay well, and keep employees on the job."
The Walgreens/Express Scripts break down in contract negotiations may have placed some pressure on Express Scripts in finalizing its merger with Medco, especially since completion of that mega-merger could be a game-changer in Express Scripts favor. Express Scripts recently reduced the termination fee — the fee either party would have to pay the other if they walked away from the deal. According to analysts, that may have been done to tamp critics of the deal who have been complaining that Medco is selling itself too cheaply to Express Scripts.