Employers want greater transparency in their pharmacy benefits, with many viewing a model that eschews rebates as a key way to get there, according to a new survey.
The Penta Group surveyed 300 benefits decision-makers, half of whom hailed from companies with 1,000 to 4,999 workers and half from companies with more than 5,000 employees, for Evernorth. Most (92%) of those surveyed said a model that passes savings directly to members rather than uses rebates would improve transparency.
In addition, 90% of those surveyed said PBM models without rebates would boost employee satisfaction and would make it easier for them to afford their medications.
The survey comes as Evernorth is embarking on an effort to remake its pharmacy benefit management unit—Express Scripts, one of the industry’s “Big Three”—with its Signature Pharmacy Benefit Services model. The new approach shifts away from rebate- and network-based models toward a more transparent, fee-based structure.
Ashley Holzworth-Nash, vice president of retail network product strategy and solutions at Evernorth Health Services, said in a press release that the change reflects that the healthcare system “is rapidly evolving to become transparent and consumer-centric.”
“This data confirms employers want pharmacy benefits that are easier to understand, easier to budget for, and designed around the experience of the people they cover,” Holzworth-Nash said. “That’s exactly why we created Evernorth Signature Pharmacy Benefit Services—a transparent, rebate-free, fee-based model that delivers a better experience for employees while bringing greater predictability and renewed trust to pharmacy benefits.”
The survey also found that 87% believe a model without rebates would better align with their organization’s needs and 86% said they anticipate a rebate-free model would make it easier for employers to predict pharmacy spending.
Evernorth said when it announced the new model that it expects the approach could save members an average of 30% per month on branded prescriptions. The PBM also said it will adopt a cost-plus reimbursement model for pharmacies, which will make their payments more predictable.
Express Scripts also intends to offer additional reimbursement to pharmacies for clinical services they provide.
The company expects to roll out the model across its fully insured commercial clients in 2027, and it will be the standard offering for all of its pharmacy benefits clients in 2028.