BUSINESS INSURANCE DIRECTORY OF PRESCRIPTION BENEFIT MANAGERS: M, N
Posted On: Aug. 2, 1998 12:00 AM CSTM
Merck-Medco Managed Care L.L.C.
100 Summit Ave., Montvale, N.J. 07645; 201-358-5400; fax: 201-358-5783
www.merck-medco.com
1997 revenues
PBM gross revenues$12,000,000,000
PBM clients
Total1,300
Lives covered
Group Health:
Total51,000,000
Retail network
Pharmacy locations55,000
Staff
Total11,000
Includes: 1,500 registered pharmacists
PBM services since: 1983.
Parent: Merck & Co. Inc.; primary business: drug manufacturer.
Services: Retail pharmacy network, mail-order distribution, claims processing, online claims processing, concurrent utilization review, disease management, retrospective utilization review, benefit design consulting, formulary management/review, monitoring of physician prescribing practices, patient education, demand management.
Formularies offered: Open, closed, restricted/customized.
Pharmacies contracted: Independently owned; retail chains.
Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization, custom reports.
Service area: Nationwide; also serves Puerto Rico and certaininternational regions.
Billing methods: Capitated rate, fee per claim. Volume discounts to employers.
Officers: Per Lofberg, president.
MIM Health Plans Inc.
1 Blue Hill Plaza, 15th Floor, Pearl River, N.Y. 10965; 888-818-3939; fax: 914-627-6614
www.mimcorp.net
1997 revenues
PBM gross revenues$75,000,000
PBM clients
Total59
Employer/group plans with direct service18
Lives covered
Group Health:
Total1,700,000
Active enrollees1,200,000
Workers Compensation:
Active enrollees50
Through employers100%
Retail network
Pharmacy locations39,000
Mail-order services
Percent of prescription volume1%
Generic usage
Percent of prescription volume66%
Staff
Total185
Professionals170
Includes: 29 registered pharmacists
PBM services since: 1993.
Parent: MIM Corp.; primary business: pharmacy management.
Services: Retail pharmacy network, mail-order distribution, claims processing, online claims processing, concurrent utilization review, disease management, retrospective utilization review, benefit design consulting, formulary management/review, monitoring of physician prescribing practices, patient education, pharmacy auditing.
Formularies offered: Open, closed, restricted/customized.
Pharmacies contracted: Independently owned; retail chains.
Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization.
Service area: Nationwide.
Billing methods: Capitated rate, fee per claim, shared savings.
Officers: Richard H. Friedman, CEO; Scott Yablon, president/COO; Rick Pellokat, vp-sales/marketing; Barry Posner, executive vp/general counsel.
Contact: Joe DeMarte, vp-marketing/sales operations.
N
National Pharmaceutical Services
14748 W. Center Road, Omaha, Neb. 68144; 800-546-5677; fax: 800-458-1646
1997 revenues
Total gross revenues$28,000,000
PBM gross revenues$5,000,000
PBM unbundled revenues$5,000,000
PBM clients
Total700
Employer/group plans with direct service700
Lives covered
Group Health:
Total300,000
Active enrollees110,000
Through employers100%
Workers Compensation:
Active enrollees30,000
Through employers100%
Retail network
Pharmacy locations45,000
Mail-order services
Percent of prescription volume10%
Generic usage
Percent of prescription volume83%
Staff
Total20
Professionals13
Includes: 7 registered pharmacists
PBM services since: 1992.
Parent: Pharmaceutical Technologies Inc.; primary business: software.
Services: Retail pharmacy network, mail-order distribution, claims processing, online claims processing, concurrent utilization review, disease management, retrospective utilization review, benefit design consulting, formulary management/review, monitoring of physician prescribing practices, patient education, demographic trends for group analysis.
Formularies offered: Open, closed, restricted/customized.
Pharmacies contracted: Independently owned; retail chains, including Albertsons, Kmart, Med Man, Rite Aid, Walgreens and Wal-Mart.
Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization, explanation of benefits.
Service area: Nationwide, principally western and southwestern states.
Billing methods: Capitated rate, fee per claim. Volume discounts to employers.
Officers: Douglas M. Pick, CEO/president; Angela Pieper, CFO; Cindy Waterman, network director; Mike Heskin, vp-mail order; Dan Cutler, information director.