Privately held pharmacy-benefit manager Prime Therapeutics LLC said Thursday it has won the Medicare prescription-drug plan business at Blue Cross Blue Shield of North Carolina, the largest health insurer in that state, from Express Scripts Holding Co.ESRX +0.53% .
Prime, which is owned by several Blue Cross and Blue Shield plans, previously won business for managing pharmacy benefits for commercial members at the North Carolina insurer. Prime began handling the commercial business in April and will take on the Medicare business Jan. 1.
Blue Cross Blue Shield of North Carolina has more than 3.6 million members. The nonprofit insurer is a legacy client of Medco Health Solutions, which Express Scripts bought earlier this year to create the industry’s largest pharmacy-benefit manager by prescription claims.
These companies, known as PBMs, manage drug benefits for health plans and corporate clients. They use their buying power to help secure rebates from drug manufacturers and also push use of generic drugs, which tend to deliver higher profit margins for PBMs.
Express Scripts recently made some cautious comments about the year ahead by saying Wall Street expectations for the year looked “overly aggressive.” The company mainly blamed pressure from the sluggish U.S. economy, which can mute how much patients use health services and fill prescriptions. Express Scripts acknowledged that its retention rate for 2013, a measure of prescription volume expected to carry over into the new year, is a little lighter at 94% than the company previously expected.