Publications

March 2016 (Revised March 2022)
Teaching Note

Express Scripts: Promoting Prescription Drug Home Delivery (A) and (B)

By: John Beshears

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. The case associated with this teaching note follows Bob Nease, chief scientist at Express Scripts, as he... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Consumer Behavior; Distribution Channels; Health Care and Treatment; Service Industry; Pharmaceutical Industry

February 2016 (Revised March 2022)
Case

Express Scripts: Promoting Prescription Drug Home Delivery (B)

By: John Beshears, Patrick Rooney and Jenny Sanford

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Health Care and Treatment; Service Delivery; Decision Choices and Conditions; Order Taking and Fulfillment; Compensation and Benefits

Article

A Blueprint for Pharmacy Benefits Managers to Increase Value

By: William Shrank, Michael E. Porter, Sachin H. Jain and Niteesh K. Choudhary

Pharmacy benefits managers (PBMs) have a unique opportunity to promote public health and generate value in the healthcare system. However, PBMs are largely evaluated on their ability to control costs rather than improve health. PBMs should be evaluated along three... View Details

Keywords: Opportunities; Health; System; Cost Management; Partners and Partnerships; Motivation and Incentives; Value; Innovation and Invention; Performance Effectiveness; Health Industry; Pharmaceutical Industry

Find at Harvard

October 2022 (Revised August 2024)
Case

Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?

By: Leemore Dafny

In Fall 2019, Cigna Corporation – a global health services company with a significant presence in the U.S. employer-sponsored health insurance market - was digesting its $54 billion acquisition of Express Scripts, Inc. (ESI), a pharmacy benefit manager (PBM)... View Details

Keywords: Mergers and Acquisitions; Business Model; Vertical Integration; Insurance Industry

January 1995 (Revised July 1996)
Case

Pharmaceutical Industry in the 1990s, The

Describes the pharmaceutical industry in the 1990s, with particular emphasis on the mergers between American manufacturers and prescription-benefits managers (PBMs). PBMs are distributors with unprecedented access to information on patient and physician... View Details

Keywords: Knowledge Use and Leverage; Distribution; Mergers and Acquisitions; Knowledge Management; Distribution Industry; Pharmaceutical Industry; United States