Five Blue Cross Blue Shield plans fund pharmacy solutions start up

Incorporating evidence and outcomes-based models of care, a privately funded startup aims to improve medication costs in the pharmacy sector. Denver-based Evio received funding from five Blue Cross Blue Shield plans: Blue Cross Blue Shield of Massachusetts, Blue Cross Blue Shield of Michigan, Blue Shield of California, Highmark Inc., and Independence Blue Cross. Together, the five plans provide health care coverage to over 20 million members in the United States.

 

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Evio will initially offer services that complement the benefits of each of the five health plans. It will focus on gathering data and evidence of patients’ experiences with certain medications, from migraines to cancer treatment. The data will serve as an analysis of how effective the different treatments are based on a wide range of patient types. Evio will also focus on developing partnerships between pharmacy, technology, and other sectors, and improving value-based care contracting in the pharmacy industry. 

Brand name prescription drugs amount to severe costs, particularly for older Americans, who take an average 4.7 drugs per month, according to the June 2021 AARP Rx Price Watch Report. The report says the annual cost of drug therapy is over $31,000, which exceeds the median income of Medicare beneficiaries ($29,650). 

Sandra Clarke, Evio board chair and chief financial officer of Blue Shield California, described the benefits of a new venture focused specifically on reducing prescription costs.

“Evio has a real opportunity to change the trajectory of pharmacy costs, improve clinical outcomes and make it easier for patients to access the medications and treatments they need. We are investing in this innovative venture as part of our ongoing efforts to reduce costs and improve patient experience, and we will continue working alongside our local providers to achieve these goals.”

Newly appointed president and CEO Hank Schlissberg said the need for new approaches to medication affordability is more important than ever.

“Patient frustration with the system and disparities in health equity are higher than ever. And the price of virtually every prescription drug is roughly double by the time a patient pays for it at the pharmacy counter than it was when the drug was shipped from its manufacturing site — without transparent benefits to the patient.”

Schlissberg brings 20 years of experience of value-based health care consulting to Evio, first as a partner at McKinsey and Company and most recently serving as the executive lead for DaVita Nephrology Practice Solutions and Nephrology Care Alliance.