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Board reviews PBM and dental RFPs amid steep pharmacy cost increases driven by GLP‑1 drugs
Summary
Keenan and SJVIA staff reported five PBM and five dental proposals; consultants said plan pharmacy costs rose ~22% year over year with GLP‑1 drugs and specialty prescriptions a major driver, and the board discussed mail-order and step-therapy options.
Keenan consultants and SJVIA staff told the board on May 20 that proposals for dental and pharmacy benefit management (PBM) services are under review and that prescription costs have risen sharply, driven in part by GLP‑1 weight‑loss and diabetes drugs.
Eddie Barfield of Keenan said the RFP for dental coverage received five proposals by the May 12 deadline — from Anthem, Delta Dental, MetLife and Guardian — and Cigna declined to quote. The PBM RFP received five proposals by the May 19 deadline — from Empiricx Health, Express Scripts, CVS Caremark, MedImpact and Carillon Rx — while OptumRx declined to quote. Barfield said the proposals will be scored and finalists…
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