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HR Policy Association is pleased to announce the recertification of nine pharmacy benefit managers (PBMs)
that have agreed to the Association’s Transparency in Pharmaceutical Purchasing Solutions (TIPPS)SM standards for 2011.
The TIPPS standards promote contracting that makes it easier for employers, their beneficiaries and dependents to understand the
true price of a drug. These standards are designed to ensure that pharmacy benefit services are structured to encourage the use
of the most clinically appropriate and cost-effective drugs available. Effective 2011, the Association will recognize two levels
of transparency. The highest level of transparency for PBMs is for those that are willing to provide actual average inventory
cost (AAIC) for mail order drugs. AAIC allows employers to benefit from the PBM's actual inventory cost for drugs, and provides
the most accurate picture of the true cost of a drug available today.
Five of the recertified PBMs have agreed to the AAIC level of certification for 2011:
Humana Pharmacy Solutions
MedImpact Healthcare Systems, Inc.
Prescription Solutions
Prime Therapeutics, LLC
RESTAT LLC
Four PBMs are willing to provide Wholesale Acquisition Cost (WAC) pricing for mail order drugs. WAC is a nationally tracked index
shown to have advantages over Average Wholesale Price (AWP) in its ability to more closely reflect drug pricing dynamics.
Four of the recertified PBMs have agreed to provide WAC pricing:
CVS Caremark
Express Scripts
UnitedHealth Pharmaceutical Solutions
Walgreens Health Initiatives, Inc
The HR Policy Association Pharmaceutical Coalition is comprised of nearly 60 association member companies. These large
employers purchase pharmacy benefits for more than five million Americans. Since 2005, through the Coalition’s TIPPS
initiative, employers have formulated a uniform definition of transparency and have certified organizations that agree
to TIPPS standards. The nine recertified PBMs have agreed to the Coalition’s 2011 standards, which provide employers
with the most rigorous level of drug purchasing transparency available in the marketplace.
Each year the Coalition issues a market-wide request for proposal, and PBMs that respond must verify that they will
comply with the Coalition's transparency standards and agree to rigorous audit rights to guarantee compliance.
The 2010 certified and recertified PBMs were Aetna Pharmacy Management; CVS Caremark; Express Scripts.; Humana Pharmacy;
Medco Health Solutions; MedImpact Healthcare Systems, Inc.; Prescription Solutions; Prime Therapeutics, LLC; UnitedHealth
Pharmaceutical Solutions; and Walgreens Health Initiatives, Inc.
Additionally, in 2010 Aetna, Humana Pharmacy Solutions, MedImpact, Prime Therapeutics, and RESTAT agreed to provide AAIC for mail order drugs.
The 2009 certified and recertified PBMs were Aetna Pharmacy Management; Blue Cross and Blue Shield of Alabama; CVS Caremark;
Express Scripts; Humana Pharmacy; informed Rx, an SXC company; Medco Health Solutions, Inc.; MedImpact Healthcare Systems,
Inc.; Prescription Solutions; Prime Therapeutics, LLC; ProCare Rx; UnitedHealth Pharmaceutical Solutions; RESTAT LLC;
Walgreens Health Initiatives, Inc.; and WellPoint NextRx.
The 2008 certified and recertified PBMs were Aetna Pharmacy Management; Blue Cross and Blue Shield of Alabama;
CatalystRx, A HealthExtras Company; CIGNA Pharmacy Management; CVS Caremark; Express Scripts; Humana Pharmacy;
Medco Health Solutions, Inc.; Prime Therapeutics, LLC; RESTAT LLC; SXC Health Solutions, Inc.; Walgreens Health
Initiatives, Inc.; and WellPoint NextRx.
The 2006-2007 certified and recertified PBMs were Aetna Pharmacy Management; Blue Cross and Blue Shield of
Alabama; CatalystRx, A HealthExtras Company; Caremark Rx, Inc.; CIGNA Pharmacy Management; CVS Caremark; HealthTrans;
Medco Health Solutions, Inc.; MedImpact Healthcare Systems, Inc.; RESTAT LLC; and Walgreens Health Initiatives, Inc.
In 2005, 3 PBMs were the first organizations certified for meeting TIPPS standards: Aetna Pharmacy Management;
MedImpact Healthcare Systems, Inc.; and Walgreens Health Initiatives, Inc.
To learn more, please contact Steve Wetzell, Executive Vice President, Health Care Policy Roundtable LLC,
at swetzell@healthcarert.com, or (202) 789-8636.
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