Printed from BusinessInsurance.com

BUSINESS INSURANCE DIRECTORY OF PRESCRIPTION BENEFIT MANAGERS: P

Posted On: Aug. 2, 1998 12:00 AM CST

PCS Health Systems Inc.
9501 E. Shea Blvd., Scottsdale, Ariz. 85260-6719; 602-391-4600
www.pcshs.com
1997 revenues
PBM gross revenues*$1,792,000,000
PBM clients
Total1,208
Employer/group plans with direct service930
Lives covered
Group Health:
Total56,000,000
Through employers30%
Through third-party vendors70%
Retail network
Pharmacy locations54,000
Generic usage
Percent of prescription volume40%
Staff
Total2,400
PBM services since: 1969.
Parent: Eli Lilly & Co.; 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.
Formularies offered: Open, closed, restricted/customized.
Pharmacies contracted: Independently owned; retail chains, including CVS, Eckerd, Walgreens, Wal-Mart.
Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization, claims history, drug utilization review, network performance, customized reports.
Service area: United States, Puerto Rico.
Billing methods: Capitated rate, fee per claim.
Officers: Jean-Pierre Millon, president/CEO; John Voris, executive vp; Thomas Garrity, executive vp/CFO; Elizabeth Dichter, executive vp-strategic marketing; Mitch Henry, executive vp/chief information officer.
Contact: Public relations, 602-391-4501.
* BI estimate.
Pharmacy Services Group
1100 N.E. 51st St., Oakland Park, Fla. 33334; 800-774-2002; fax: 954-938-7984
www.rxmail.com
1997 revenues
Total gross revenues$23,000,000
PBM gross revenues$4,000,000
PBM unbundled revenues$2,300,000
PBM clients
Total362
Employer/group plans with direct service164
Lives covered
Group Health:
Total483,000
Active enrollees338,000
Through employers53%
Through third-party vendors40%
Through Medicare/Medicaid7%
Workers Compensation:
Active enrollees72,000
Through employers35%
Retail network
Pharmacy locations40,000
Mail-order services
Percent of prescription volume40%
Generic usage
Percent of prescription volume59%
Staff
Total41
Professionals11
Includes: 5 registered pharmacists
PBM services since: 1983.
Parent: Managed Healthcare Systems Inc.; primary business: PBM and mail order prescription services.
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, liquid unit dosage for institutions.
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.
Billing methods: Fee per claim. Volume discounts to employers.
Officers: Ken Sack, CEO; Stan Freedman, pharmacy director; Gina Hunt, PBM director; Cathy Cox-customer service director; Martin Duberstein, marketing director.
ProVantage Inc.
13555 Bishops Court, Suite 201, Brookfield, Wis. 53005; 800-784-0881; fax: 414-641-3770
www.provantageinc.com
1997 revenues
Total gross revenues$56,500,000
PBM gross revenues$50,100,000
PBM clients
Total3,500
Employer/group plans with direct service750
Lives covered
Group Health:
Total4,500,000
Active enrollees750,000
Through employers35%
Through third-party vendors60%
Through Medicare/Medicaid5%
Retail network
Pharmacy locations50,463
Mail-order services
Percent of prescription volume5%
Generic usage
Percent of prescription volume45%
Staff
Total370
Professionals280
Includes: 28 registered pharmacists
PBM services since: 1994.
Parent: Shopko Stores Inc.; primary business: retail/health services.
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, clinical prior authorization, health care theurapeutics management, ProVRx online decision support tool.
Formularies offered: Open, closed, restricted/customized.
Pharmacies contracted: Independently owned; retail chains, including CVS, Eckerd, Longs, Osco, Rite-Aid, Shopko and Walgreens.
Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization.
Service area: Nationwide.
Billing methods: Fee per claim, gainshare, per month per member. Volume discounts to employers.
Officers: Jeffrey Jones, executive vp/COO-ProVantage Inc.; Glen C. Laschober, executive vp/COO-ProVantage PBM/VMB; Lee Morse, president-PharMark Inc.; Joseph A. Coffini, vp-managed care services; Dr. Peter Hoffman, vp/chief medical officer-ProVantage Inc..
Contact: Matthew J. Zirpoli, vp-sales.