Tuesday, December 19, 2017

CVS-Aetna Merger Will Influence Employers’ Benefits Decisions: Aon

CVS Corp.’s proposed purchase of Aetna Inc. will affect decision-making by a majority of large and mid-size U.S. corporations on employee health benefits, a survey by benefits consultant Aon Plc found.

The new Aon survey, which included responses from decision makers at 450 medium and large-size corporations, provided additional insight into how CVS and Aetna customers may view the deal.
  • Sixty-one percent of survey respondents, including ones that are not customers of CVS or Aetna, said the deal would affect their decision-making process on health benefits, with 23 percent saying it would accelerate a reassessment of healthcare strategy and 38 percent saying it would delay any such moves until the transaction’s impact could be understood.
  • Among a smaller group of 210 respondents, 52 percent surveyed by Aon said they planned to keep their pharmacy benefits separate from medical coverage. An additional 15 percent said they are considering separating those contracts.
If integrating the medical and pharmacy benefit requires that you relinquish flexibility and cost controls, the disadvantages of integration far outweigh the advantages. Disadvantages may include:
  • Plan members may pay U&C (usual and customary) prices, which are higher than discounted prices
  • Formulary and rebate arrangements may not be available or are significantly limited
  • Plan sponsors lack authority and flexibility and are typically unable to adjudicate plan limitations, plan exclusions, enforce generic dispensing mandates or validate appropriate drug pricing
There’s already a lack of transparency when it comes to drug prices and employers may have even less information if the insurer and the pharmacy benefit manager are the same entity. It’s going to be harder to get behind the curtain.

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