PBMs grow by cutting employers

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WellDyne — a pharmacy benefit management company that administerz drugbenefit programs, processes claimz and operates a mail-order pharmacy — opened the $20 66,000-square-foot operation in March. It will provide 100 jobs by the end of this year and anothef 578 jobs through the endof 2010. It is one of two mail-orderr facilities for WellDyne, which fills more than 35 million prescriptionswa year.
The company, headquartered in suburban Denver, needed an East Coast location, and Damien owner, president and CEO, liked Lakeland’s accessibilitt to major airports in Tampa and Orlandl as well as the quality of workers in the Lamendola expects to work with in both Tampqa and Lakelandon pharmacogenomics, or the combination of genetic analysis and drug development. Usinyg genes to identify which drugs will work best for individuals will reduce adverse side effects and cut healtyhcare spending, he said. WellDyne relies heavily on automation and has a robotic system that allows greater flexibility in developing programs to meetcustomer needs.
The privately owneed company, which competes in the smalo self-funded employer market and also workswith third-party administrators, can offerf lower prices and margins than its publicly traded competitorsz and puts a high priority on services, Lamendols said. Streamlining operations for clients is keyfor , a PBM in Tampaw that uses myMatrixx as a brand name. Matrix concentrates on niche mostly workers’ compensation and auto said Steven MacDonald, CEO.
“Instead of the operation getting a lot of individualo charges on pieces of paper billed directly fromthe pharmacy, we compilwe it all into electronic data and submit it to insurance companies, so they pay it all in one MacDonald said. “If a company spendsz $1 million a year on pharmacy, they eliminatr processing 15,000 pieces of paper by goingv througha PBM.” Health planx and their members save monety by using PBMs, because PBMs have systems, programs, procedure and personnel with specific expertise in the management of pharmacyt benefits, said Lowell Sterler, VP of pharmacy programs for .
“By partneringh with a PBM, the health plan does not need to replicate all of theses pharmacy specific services and maintain all of theseresourcexs themselves,” Sterler said. Blue Cross and Blue Shieldx of Florida is one of several Blues planw nationwide in agreements with PrimreTherapeutics LLC, a PBM headquartered in St. Paul, The Blues have equity stakes in Prime Therapeuticw and also use itsmanagemenf services. Like WellDyne and Matrix, Prime Therapeutics has a mail-order pharmacu and provides claims processing.
Although the economic downturnh and rising unemployment has cut comp claims because fewer peopleare working, MacDonald said the impact has been smallp and the company historically has grown at 40 percent to 50 percentg a year. WellDyne also is growing and expects more deman as baby boomers reachtheir 60s, when the use of medicationsw increases, Lamendola said. However, the last vestige of what was at one time one of the large r PBMs in theUnited States, , operated by the formetr , disappeared from the Tampa Bay area earlier this when (NYSE: CVS) closed its operationsa in Largo on March 31, leaving 230 peoplse without jobs.
The mail service facility closes due to integration activities related to the 2007 merged of and CaremarkRx Inc.