Drug prices in the U.S. are, on average, 2.5 times higher than 32 other countries, according to a 2021 study. Most countries regulate pharmaceutical companies’ drug prices; the U.S. doesn’t, with a few exceptions, such as CMS.

In 2024, Cigna Group’s Express Scripts, one of the most prominent pharmacy benefit managers in the U.S., will launch a new drug price service that sells medications based on their acquisition, pharmacy dispensing, and service costs. The service, called ClearNetwork, will be available for its pharmacy network, which has handled more than 1.1 billion prescriptions in the first nine months of 2023.

UnitedHealth Group’s Optum Rx rolled out a price-matching tool reminiscent of Target and Best Buy. The service scans drug prices and automatically provides the lowest available pricing. Elevance Health is also set to launch a digital and home delivery pharmacy subsidiary in 2024, which allows users to compare medication costs.

CVS CostVantage is a pharmacy reimbursement model that accounts for a drug’s cost, a pharmacy services fee, and a set markup. The new service will be available in 2024. Caremark, CVS Health’s PBM, will also launch TrueCost in 2025, which aims to increase transparency in administrative fees by including the net cost of prescription drugs.

From “Shark Tank,” Mark Cuban launched an online pharmacy in January 2022 that priced 100 medications by their manufacturing fee, a 15% markup, and a shipping and handling fee. Less than two years later, Express Scripts and CVS are following suit.

Marsha Marrullier, REBC
Sr Employee Benefits Consultant