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    Top 7 Challenges (and Opportunities) for Pharmacy in 2018

    What’s the difference between a challenge and an opportunity? In 2018, for pharmacy, they may be the same thing.


    Merging a business together

    Consolidation and Vertical Integration

    The pharmacy world seems to believe that bigger is more profitable: Manufacturers are consolidating, pharmacy chains are consolidating, payers and insurers are consolidating, PBMs are consolidating. The industry is integrating vertically as well, with pharmacy chains acquiring PBMs and insurers acquiring PBMs.

    The latest step is CVS’ proposed acquisition of Aetna. If approved by regulators, the deal would integrate one of the largest pharmacy chains, CVS—which has one of the largest PBMs, Caremark—and one of the largest health insurance companies, Aetna.

    Related article: Pharmacy Is Dead

    “We did a double take,” said Joe Hill, Director of Government Relations for the ASHP. “This is one more step in a continuing trend of the big players getting both bigger and fewer. At this point, it’s hard to predict the outcome, but it is clearly an important question for five-year strategic planning.”

    Industry analyst Adam Fein, PhD, noted that the deal could help CVS protect itself from other vertically integrated PBMs, including OptumRx (part of UnitedHealth), Humana (with an internal PBM), and Prime Therapeutics (owned in part by 14 Blue Cross and Blue Shield plans).

    Hill added that vertical integration could offer opportunities for pharmacy to highlight their growing role in patient care.

    Moore isn’t convinced. “Patients are being limited more and more in where they can go,” he said. “People want to come here, but it’s a challenge when they have to pay more. Growing consolidation and ever more-restricted networks is frustrating for patients and frustrating for us.” 

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    Fred Gebhart, Contributing Editor
    Contributing Editor Fred Gebhart works all over the world as a freelance writer and editor, but his home base is in San Francisco.


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