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Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2]
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. [1] Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication (a resource closer to what would be referred to as a pharmacopoeia ...
CVS denied 13% of such requests while Elevance's Anthem Blue Cross Blue Shield denied 4.2%. UnitedHealthcare denied 8.7%. ... rising 31% in 2024 from 2022, according to a 2024 survey by credit ...
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Anthem reversed the decision the day after Thompson’s killing. The fury directed at UnitedHealth is emblematic of America’s broader inability to reform its patchwork health care system.
In 1982, Blue Shield merged with The Blue Cross Association to form the Blue Cross and Blue Shield Association (BCBS). [11] Prior to 1986, organizations administering BCBS were tax exempt under 501(c)(4) as social welfare plans. The Tax Reform Act of 1986 revoked the exemption, however, because the plans sold commercial-type insurance.
Pharmacy and Therapeutics (P&T) is a peer-reviewed journal of hospital formulary management. Established in 1990 by CORE Medical Journals , it has been published monthly since 2008 by MediMedia . All issues since 2008 are freely available electronically on PubMed Central after a one-month embargo.
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