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Livinity pitches transparent PBM model; LDH/LSU draft finds independents can absorb closures
Summary
Livinity described a pass-through PBM model that discloses rebates and charges a flat per-claim fee; an LDH/LSU draft report summarized a survey finding most independent pharmacies could absorb additional volume if chain locations closed and reviewed federal PBM reforms and PDABs.
Steve Boyd of Livinity told the council Livinity runs a pass-through PBM that discloses revenue, returns rebates to clients and charges a flat per-claim service fee rather than profiting from spread pricing. Boyd said the company updated rates after Directive 2-57 was released and cited a Terrebonne Parish contract where the employer accepted higher pharmacy payments while realizing net plan savings in the first year.
Boyd described Livinity's business model as fee-for-service (historically about $4 per claim when founded, now in a higher range reflecting inflation) and said the firm is a 100% pass-through for pricing and rebates; he argued transparent models can compete with traditional PBMs and help control total plan costs.
LDH/LSU draft report: Jared Lorenz, working with LDH and LSU, summarized a draft final report requested under Senate Resolution 209. The draft survey of independent pharmacies (161 respondents, roughly 50% of LIPA membership) found about 80% of respondents said they could absorb 500 or more new weekly prescriptions if a nearby CVS closed; 82% said they could scale staffing within 30'60 days. The draft also reviews federal developments (Consolidated Appropriations Act 2026 PBM reforms, recent FTC actions and consent agreements) and notes state-level alternatives such as prescription drug affordability boards (PDABs) and PBM ownership bans under consideration elsewhere.
What to watch: The Livinity testimony provides a concrete example of an alternative PBM model being used in Louisiana; the LDH draft report suggests independents report spare capacity but would need staffing and inventory financing to absorb large closures. Both presentations bear on legislative discussions of whether to legislate dispensing-fee floors, ban PBM-pharmacy vertical integration, or incentivize pass-through PBM models.
