Help

BI’s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.

To search specifically for more than one word, put the search term in quotation marks. For example, “workers compensation”. This will limit your search to that combination of words.

To search for a combination of terms, use quotations and the & symbol. For example, “hurricane” & “loss”.

Login Register Subscribe

BUSINESS INSURANCE DIRECTORY OF PRESCRIPTION BENEFIT MANAGERS: P

Reprints

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.