Express Scripts ( ESRX) and Medco Health Solutions ( MHS) are two great examples.
Express Scripts (ESRX) is a good candidate to short sell on any big bounce.
FORBES: Super Committee Sets Up A Great Opportunity To Short Health Care
The company divorced from pharmacy benefit manager Express Scripts ( ESRX) only to get back together.
Express Scripts is advising the health plans it works for to reject Pfizer's deals for Lipitor.
Express Scripts shares dropped more than 12% amid lackluster figures and a grim outlook.
That left millions of Americans with Express Scripts drug plans looking for a new pharmacy.
But what if insurers like Wellpoint or pharmacy-benefit managers such as Express Scripts don't want to listen?
The acquisitions boost Express Scripts to 36 million customers and make it the third-largest in this business.
Express Scripts, a publicly traded outfit 45%owned by New York Life, is the one doing the squeezing.
But even the Express Scripts imbroglio cannot stop the boost from customers coming in for flu shots.
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It erased some doubts about whether a bump from new Express Scripts would be short lived.
More than half of mail order is controlled by three PBMs: Express Scripts, Medco Health Solutions and Caremark.
Express Scripts quickly gave up most of its premium as the dot-com crowd moved on to other flavors-of-the-week.
For a few days in March, Barrett Toan, the scholarly ex-Missouri welfare official who runs Express Scripts, Inc.
The few health care properties that sell at premiums are mid-teens growers like Celgene, Gilead, Express Scripts and Medco.
But Express Scripts knows all the drugs a patient is taking, so its on-line advice will be more complete.
Express Scripts even removed Lipitor from its formulary entirely, playing hardball on cost.
Toan believes PBMs like Express Scripts provide a much-needed check on drug prices.
The primary reason for the decline in the number of prescriptions filled was the loss of Express Scripts user-base.
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Louis, Missouri, Express Scripts serves as a middleman between health plans covering about 36 million people and the drug suppliers.
The number of prescriptions filled by the company have dipped steadily since January when the deal with Express Scripts expired.
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This assumes that Walgreen manages to retain 25% of the Express Scripts business, which seems to be rather optimistic.
Express Scripts (nasdaq: EXPR - news - people ), a pharmacy-benefits manager, recently removed Lipitor from its formulary.
When investors, for example, wanted to know how Congress would weigh in on the proposed merger between Express Scripts Inc.
Express Scripts quickly gave up most of its premium as the dot-com crowd moved on to other flavors of the week.
The dispute between Walgreen and pharmacy-benefits manager Express Scripts, which ended only last month, weighed heavily on Walgreen in 2012.
Emily Cox, one of the Express Scripts researchers, says this means scarce health care dollars may be going to the wrong place.
Prescription managers like Express Scripts and insurance firms like Wellpoint will continue to push for cheaper prices on Lipitor and other medicines.
Express Scripts negotiates with the drugmaker, a company like Merck or Pfizer (nyse: PFE - news - people ).
But during the spat, boatloads of Express Scripts customers shifted over to CVS Caremark ( CVS) and are unlikely to change back.
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