Eric Percher, Nephron Research

After several weeks of exploration and analysis, we have concluded that the new PBM contract design announced by Express Scripts and the National Drug Purchasing Coalition on October 23rd represents a significant evolution of the PBM model that could point to the future of pharmacy benefit management in a world without rebates.

Key Topics:

• Where does the money go?   
  • We quantify the factors that account for the $153bn gap between brand gross and net and segment PBM profit pools 

• Total Performance Management model mechanics 
  • Who is NDPC and what makes the model developed by Express and NDPC different from previous acquisition cost-plus models? 

• Implications of a transparent model 
  • We consider the potential impact on PBMs, Pharma, payors/employers and benefit managers with an eye on the JPM, Amazon, Berkshire partnership 

Kaiser Permanente (Walt Meyers, Exec. Director Strategic Market Planning), Humana/Conviva (Eric Jenkins, VP of Care Delivery Operations, Conviva), Collective Medical (Ben Zaniello MD MPH, Chief Medical Officer), Premier Inc. (Blair Childs, SVP Public Affairs)

Stephen Rosenthal, SVP Pop Health Management, Montefiore Health System and Allen Miller, CEO COPE Health Solutions.

Clover Health (Dr. Mark Spektor, Chief Medical Officer) Agilon Health (Ron Kuerbitz, CEO)

Dr. Rob Fields, SVP, Chief Medical Officer Pop Health and Lauren Lisher, VP Commercial Product.

Blair Childs, SVP Public Affairs at Premier

Marc-David Munk MD, Chief Medical Officer MinuteClinic and Assoc. Medical Officer at CVS Health