SSM Health Partners with Costco Wholesale Corporation to Expand Affordable Drug Coverage
ST. LOUIS (March 3, 2020) – SSM Health announced today that Costco has purchased a minority equity interest in its pharmacy benefit management (PBM) company, Navitus Health Solutions, including Lumicera Health Services, its specialty pharmacy subsidiary. The financial terms of the agreement are not being disclosed at this time.
SSM Health and Costco share a commitment to cost transparency, superior customer service, and a focus on providing the highest-quality products and services at the lowest cost. Costco’s investment and expertise will enable the not-for-profit Catholic health system to more rapidly expand its disruptive PBM model to benefit more people.
“Navitus is an industry-leader in transparency with a demonstrated ability to lower overall pharmacy costs for clients,” said Laura S. Kaiser, FACHE, president and CEO of SSM Health. “We are thrilled to strengthen our relationship with Costco, a global organization, and to expand our reach and help millions more individuals and families have access to affordable prescription drug coverage.”
Navitus operates as a 100% pass-through PBM, which means every dollar in rebates, fees and incentives from drug manufacturers is passed through to its clients, along with all network discounts. This approach fully aligns Navitus with its client’s goals, resulting in significantly lower overall pharmacy costs.
“Navitus shares our long-term commitment to transparency and our philosophy of reducing costs and passing savings on to our members. Included in that mission is lowering the health care spend for patients at our pharmacy, optical and hearing aid departments,” said Craig Jelinek, president and CEO of Costco. “We look forward to working together, to expanding our support of the Navitus relationship and to enabling more people to receive the quality care they need at an affordable price.”
Navitus currently serves more than 6 million people across all 50 states, including employers, health plans, and state and local governments.
Goldman Sachs acted as financial advisor and Greensfelder acted as legal advisor to SSM Health for this transaction. Morgan Stanley acted as financial advisor and Perkins Coie acted as legal advisor for Costco.
About SSM Health
SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization’s nearly 40,000 employees and 11,000 providers are committed to providing exceptional health care services and revealing God’s healing presence to everyone they serve.
With care delivery sites in Illinois, Missouri, Oklahoma and Wisconsin, SSM Health includes a pharmacy benefit management company, an accountable care organization, a health insurance company, comprehensive home care and hospice services, 23 hospitals, more than 290 physician offices and other outpatient and virtual care services, as well as 10 post-acute facilities. It is one of the largest employers in every community it serves. For more information, visit ssmhealth.com or find us on Facebook and Twitter.
About Navitus
Navitus Health Solutions, a division of SSM Health, serves as a full pass-through pharmacy benefit manager (PBM) and industry alternative to traditional models. As such, Navitus is committed to taking the unnecessary costs out of pharmacy benefits to make prescriptions more affordable for plan sponsors (i.e. employers, health plans, unions, governments, etc.) and their members. By combining a unique pass-through approach that returns 100% of rebates with a focus on lowest-net-cost medications and comprehensive clinical care programs, Navitus helps reduce costs and improve member health. To learn more about Navitus, call 877.571.7500 or visit www.navitus.com.
About Costco
Costco currently operates 785 warehouses, including 546 in the United States and Puerto Rico, 100 in Canada, 39 in Mexico, 29 in the United Kingdom, 26 in Japan, 16 in Korea, 13 in Taiwan, 11 in Australia, two in Spain, and one each in Iceland, France, and China. Costco also operates ecommerce sites in the U.S., Canada, the United Kingdom, Mexico, Korea, Taiwan and Japan.
Stay Informed and Connected
Receive expert insights, healthcare tips, and important updates on pharmacy benefits, drug recalls, and more—straight to your inbox.
Navigating with a trusted partner
Now Available: 9th Annual Drug Trend Report
Our Drug Trend Report provides a clear view of the trends shaping pharmacy benefits today, along with strategies that are delivering real savings without compromising care.
Related blogs
Navigating Healthcare and Improving Outcomes
Spotlight: Carrie Aiken, Chief Administrative Officer
We recently sat down with Carrie Aiken, Chief Administrative Officer, to discuss her strategic areas of focus — including Human Resources (HR) and Compliance — at Navitus. Tell us more about your position as Chief Administrative Officer, and what you…
2024 Drug Trend Report – Five Key Takeaways
Our 2024 Drug Trend Report reveals how plan sponsors have navigated inflationary pressures, utilization increases and breakthrough therapies, while still controlling costs through transparency and proactive management. All of which are needed more than…
Trend Over Time: Saving Money Isn’t a Race, It’s a Marathon
Partnering with the right pharmacy benefit manager (PBM) is about more than year-one savings. It’s about finding a PBM that truly understands and aligns with a payer’s needs, now and in the future. 10+ Years of Savings One of our clients, Self-Insured…
Rx Disruptors: Navitus Transparent Takedown
The Industry Problem and the Navitus Solution Traditional pharmacy benefit managers (PBMs), who currently control 80% of the pharmacy benefit management marketplace, have received intense media and regulatory scrutiny for their business practices….
Navitus Expands Digital Health Offerings with Hello Heart
At Navitus, we believe smarter pharmacy benefit management isn’t just about lowering drug costs. It’s about improving lives. Our approach goes beyond medication management to address the broader physical and financial well-being of the members we serve. …
The Role of Rebates in Pharmacy Benefits
In this blog, we’ll break down how rebates work, why they’ve come under increased scrutiny and how transparency — especially from your pharmacy benefit manager (PBM) — can help your organization truly lower prescription drug costs. …
PBM 101: Understanding Spread Pricing and Its Impact on Plan Costs
There is no shortage of questions surrounding pharmacy benefit business models, especially when medication costs continue to rise. One major area of concern centers on a practice that often goes unnoticed or not understood: spread pricing. …
Part D Star Ratings Adherence Measures: Enabling Strategic and Focused Support for High-risk Beneficiaries Through the Reporting and Intervention for Stars Excellence (RISE) Program
Authors: Wenxuan Cai, PharmD, PhD; Amanda Lee, PharmD; Caitlin Albrecht, PharmD; Maria Basak, CPhT; Casey Herlache; Capriana Hadel, MBA Executive Summary Adherence to key medication classes is a critical metric for evaluating health plan quality and continuous…
PBM 101: How to Evaluate Your PBM
Choosing a pharmacy benefit manager (PBM) isn’t just about managing prescription drug costs – it’s about ensuring your PBM operates in a way that aligns with your financial, operational and philosophical goals. A truly aligned PBM works toward the same…
