SPS Health Announces Growth Investment from Nautic Partners

SPS Health, a leading value-based care solutions provider serving post-acute pharmacies and pharmacy benefit managers, announced a strategic growth investment from Nautic Partners (“Nautic”). Nautic Partners is a private equity firm with deep healthcare experience and invested in SPS out of its tenth fund, which has over $3 billion of committed capital. This partnership will support SPS Health’s further investment in innovative technology and clinical and operational solutions supporting its pharmacy and PBM clients.

Centene Completes Acquisition of Magellan Health, Establishing a Leading Behavioral Health Platform at a Critical Time

Centene Corporation (NYSE: CNC) today announced that it has completed its acquisition of Magellan Health, Inc. The acquisition enables Centene to provide whole-health, integrated healthcare solutions to deliver better health outcomes at lower costs for complex, high-cost populations. “Magellan will expand Centene’s reach to provide increased access to behavioral healthcare for our members at a time when so many Americans are struggling with mental or behavioral health issues,” said Michael Neidorff, Chairman and Chief Executive Officer of Centene. Magellan Health will operate independently under Centene’s Health Care Enterprises umbrella.

Centene and Magellan Satisfy All Regulatory Approvals for Completion of Acquisition Agreement

Centene Corporation (NYSE: CNC) and Magellan Health, Inc. (NASDAQ: MGLN) announced that they have obtained all required regulatory approvals necessary to close Centene’s pending acquisition of Magellan Health. Subject to the satisfaction of customary closing deliveries, the parties anticipate closing the acquisition on or about January 4, 2022.

PBMs’ Profit Swells as Sector Consolidates, Report Shows

Pharmacy benefit managers are more profitable as the sector consolidates, new research shows. PBMs, which negotiate rebates from drug manufacturers on behalf of payers, create networks of pharmacies and determine reimbursements to those pharmacies, have been joining forces with large insurers and pharmacies. That has helped boost PBMs’ gross profit from PBM-owned mail order and specialty pharmacies to $10.1 billion in 2019, up 13% from $8.9 billion in 2017, according PBM Accountability Project’s analysis of financial records, government reports, studies and surveys.

6 Takeaways from 2021 PBMI Annual National Conference

The three-day 2021 Annual National Conference of the Pharmacy Benefit Management Institute® last week featured more than a dozen speakers discussing everything from interoperability to digital therapeutics to preparations for switching PBMs to the COVID-19 pandemic. Here are six takeaways from the meeting.

Anthem, Humana Drop Nearly $140M to Launch New PBM

Anthem and Humana have invested nearly $140 million to form a new pharmacy benefit manager, as criticism over traditional PBMs’ operations kickstarts business at startups that promise transparency. The insurers will hold a minority stake in the new joint venture, named DomaniRx, which is being championed by SS&C Technologies. The Windsor, Conn.-based fintech company owns approximately 80% of the new business, according to a filing submitted to the U.S. Securities and Exchange Commission on July 15.

Navitus Health Solutions Continues Growth with Acquisitions of EpiphanyRx and Quality Drug Clinical Care

Navitus Health Solutions, a full pass-through pharmacy benefit manager (PBM), today announced that it has acquired EpiphanyRx, a next-generation PBM solution headquartered in Brentwood, TN, strengthening Navitus’ ability to serve the unique needs of employers. Lumicera Health Services, Navitus’ wholly-owned specialty pharmacy, has also purchased Quality Drug Clinical Care, a specialty pharmacy serving patients with HIV in Irvine, CA, to better serve patients located in the western United States.

EmpiRx Health Announces Strategic Growth Investment from Nautic Partners

EmpiRx Health (“EmpiRx”), the industry’s only value-based pharmacy benefit manager, is pleased to announce a strategic growth investment from Nautic Partners (“Nautic”). The new partnership will further EmpiRx’s investment in tech-enabled clinical innovation and care models, while expanding its reach in the market to those who need differentiated pharmacy solutions that drive improved patient quality and access, while lowering the total cost of healthcare.

FTC Antitrust Investigations Eye Hospitals, PBMs and Drug Companies

The Federal Trade Commission is focusing its antitrust sights on the healthcare industry, primarily hospitals, drug companies and pharmacy benefit managers. The agency on Thursday voted to prioritize investigations into healthcare, tech and digital platforms over the next decade and authorized the use of subpoenas and other “compulsory” methods to obtain information. No further details were announced about specific companies it would investigate.

States Probe Business Practices of Pharmacy Benefit Managers

Several states are investigating pharmacy benefit managers, with some saying they are focused on whether the companies fully disclosed details about their business and potentially received overpayments under state contracts, according to state officials and documents. States including Ohio, Oklahoma, Georgia, New Mexico, Kansas, Arkansas and Mississippi, as well as the District of Columbia, are scrutinizing PBMs, according to the offices of state attorneys general and auditors, as well as public documents including state contracts and securities filings.