Humana is likely to gain if transparent, low-cost pharmacy models spread, since it already works with Cost Plus Drugs through SwiftyRx to steer members to cheaper prescriptions.
Humana is positioned to benefit because the source says it already partners with Cost Plus Drugs via SwiftyRx to steer members to lower-cost prescriptions; greater policy and market pressure for PBM transparency favors insurers that can adopt transparent, lower-cost pharmacy solutions.
Greater PBM transparency and a shift toward cash/Cost-Plus distribution could pressure CVS's traditional PBM-related economics tied to negotiating rebates and spread pricing.
UnitedHealth/Optum Rx may see pressure on its PBM revenue model as transparency and Cost Plus-style alternatives gain traction.
Cigna's Express Scripts business could face margin pressure if reforms curb spread pricing, rebate opacity, and PBM-driven economics.
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