On April 9, CareSource announced that effective Wednesday, January 1, 2020, CVS Caremark will no longer serve as the pharmacy benefit manager (PBM) for CareSource. Medicaid clients served by CareSource will have their prescriptions handled by Express Scripts. CareSource is by far Ohio’s largest Medicaid managed care provider serving 1.2 million Medicaid clients in the state.
According to an April 10th The Columbus Dispatch article, a study found that in 2017, CVS charged taxpayer-funded companies such as CareSource as much as almost $200 million more for prescription drugs than it reimbursed pharmacists. CareSource paid CVS’ PBM $1.4 billion a year, with CVS keeping $114 million.
Big PBMs such as CVS, Express Scripts, and OptumRX have come under fire for a lack of transparency as the cost of prescription drugs has become the fastest-growing part of health casts generally.