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The Dose

Welcome to The Dose, which tackles the business and economics inside the turbulent world of health care and life sciences in Indiana. Your host is John Russell. To contact me call 317-472-5383.

Suddenly, Anthem finds itself in strange threesome with CVS, Aetna

December 4, 2017

Well, this is a little awkward for Anthem Inc.

Just two months ago, the Indianapolis-based health insurer announced plans to team up with drugstore chain CVS to set up a pharmacy-benefits management unit.

The unit, called IngenioRx, would run a prescription drug plan for customers, with the goal of saving everyone money by using purchasing power to negotiate drug prices.

Now, in a major plot twist, CVS has rolled out a big announcement of its own: It plans to buy one of Anthem’s biggest competitors, Aetna Inc., in a deal worth $67 billion.

It’s sort of like your fiance announcing—surprise!—he’s getting married to someone else, but, you know, don’t worry about our earlier arrangement on this other thing.

You'd need a find a way out of this whole situation. And Anthem just might be working on that.

In response to the CVS-Aetna deal, Anthem sent IBJ a statement:

"Anthem’s new PBM IngenioRx will be able to combine our scale, deep provider relationships, and holistic approach to managing the total cost of health care with significantly improved pharmaceutical pricing to offer a competitive and truly integrated product that will resonate well in a very competitive market. As part of our work to develop IngenioRx, Anthem considered various strategic possibilities and prioritized flexibility in structuring our contract to maintain the ability to adapt to a changing and dynamic marketplace if appropriate."

Did you catch the key words? Anthem has built flexibility into its contract with CVS to allow it to adapt to a changing and dynamic marketplace if appropriate.

Anthem isn’t saying what that means, but it sounds a lot like the company has found a way to wriggle out of the CVS deal if it wants to.

When Anthem announced the PBM plan on Oct. 18, the company said it would use CVS’s “expertise in point-of-sale engagement,” such as member messaging and MinuteClinic, along with CVS’s ability to fill prescriptions and manage claims processing.

“In partnership with CVS, transitioning members seamlessly to our new solution will remain Anthem’s top priority,” the company said.

The two companies secured a five-year deal that goes into effect after Anthem’s current contract with Express Scripts expires at the end of 2019. Now, Anthem’s message is flexibility and adapting to changing and dynamic marketplace.

CVS CEO Larry Merlo said the Anthem deal is still on track. "This announcement (to buy Aetna) really has no bearing in terms of the capabilities that we have to bring to the Anthem business," he said in an interview on CNBC's "Squawk Box."

We'll see if Anthem agrees, or whether it wants more flexibility.

Investors are watching too. Anthem's shares fell about 2 percent on news of the CVS-Aetna deal, trading at about $226 Monday afternoon.

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