Costco just announced Medicare Advantage plans with SCAN Health Plan targeting 5 million enrollees. The warehouse club is now a plan sponsor.
Their discount card already works at Walgreens and runs on pharmacy benefit administrator infrastructure. The anti-PBM insurgent built PBM-shaped rails.
But a discount card can’t extract drug rebates. Rebates are purchased with covered lives. Cash customers aren’t covered lives. That’s the whole thing.
The SCAN partnership changes the mechanism. A Medicare Advantage plan files a formulary. Once Costco acquires enrollees, it’s playing the covered lives game. Mechanisms compound.
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