Express Scripts plans to shell out $3.6 billion to buy eviCore Healthcare from a group of investors. It’s a deal that will see the company break free from the prescription drug benefits manager and expand into the wider realm of medical benefit management for insurers, media reports noted.
EviCore Healthcare pre-approves scans and other pricey tests for health plans covering 100 million people, according to Bloomberg. Of course, there is the flipside of saving health plans money, as Saurabh Jha, a radiologist with the Hospital at the University of Pennsylvania, noted on Twitter:
Pharmacy benefit managers, among other things, negotiate prices of covered drugs with pharma companies, use financial incentives to steer patients to lower-cost generics and manage high-cost specialty medications.
The deal could be a way for Express Scripts to protect itself against the intimidating competition Amazon could offer if it would move into the PBM sector, as CNBC reported earlier this year. But in a statement from Express Scripts CEO Tim Wentworth, it wasn’t clear that the move by the PBM was a reaction to Amazon, although he did suggest the deal would consolidate its power in the patient benefit management market.
“By further strengthening our independent model and creating numerous opportunities for growth, the acquisition of eviCore will deliver value for our clients, patients, providers, and shareholders,” he said in the statement.
In support of its medical benefits management business, eviCore acquired QPID Health last year. The business, which functions as a subsidiary of eviCore, produced a clinical decision support tool that works on top of providers’ electronic medical record systems. Its Q-Guide is designed to be used before high-cost, high-volume medical procedures to give physicians a better way to assess the need for a procedure with the patient’s risk factors.
The acquisition is expected to close by the end of year.
Photo: StockFinland, Getty Images
You may be interested
Arcus Biosciences closes $107M Series C round as industry hunts for blockbuster immunotherapy combinationsFrank - Nov 20, 2018
Imagine cancer as a fugitive, hiding in a rundown warehouse. The police (aka the immune system) patrol the surrounding streets,…
Health Technology Briefs from the ITF Demo FloorFrank - Nov 20, 2018
Medgadget was recently invited to attend the imec Technology Forum (ITF) conference in Antwerp, Belgium. One of the highlights of…
Why Tesla’s Autopilot Can’t See a Stopped FiretruckFrank - Nov 20, 2018
On Saturday August 25, a Tesla Model S crashed into a stopped firetruck in San Jose, California. The two occupants…