An Analysis Of Medicare Part D Market Share

May 20, 2019 3:18 PM ET | Justin Dopierala

Summary

Medicare Part D is set for continued strong growth over the next decade.

Newly issued CMS guidance is a huge set-back for black box PBM's like CVS Health.

Surprisingly, Rite Aid has achieved the highest organic growth since the end of 2016.

Summary

Due to the current political discussion in America surrounding Medicare, I thought it would be prudent to take a look at which companies may benefit from additional covered lives within Medicare Part D.

According to a recent report Bernie Sanders, Elizabeth Warren, Kamala Harris, Julian Castro, Tulsi Gabbard, John Hickenlooper, Marianne Williamson, and Andrew Yang all support "Medicare for All" while Joe Biden, Cory Booker, Amy Klobuchar, Beto O'Rourke, and Kirsten Gillibrand all support expanding Medicare. While "Medicare for All" will likely never happen in America, it is certainly possible that Medicare could be expanded in one fashion or another.

This article takes a look at the top ten providers of Medicare Part D prescription drug plans. The analysis includes lives covered under stand-alone Part D drug plans as well as those that provide Part D drug coverage in addition to medical coverage.

Since 2017, there has been remarkably very little change to the ordering of the top ten; however, one company clearly stands-out for having significant organic growth: Rite Aid (RAD).

Methodology

An analysis was performed on the recently released CMS report from May 15th, 2019 as well as the reports from January 2019, 2018, and 2017. Each report includes data through the previous month which is why the January reports are being used in place of the December reports.

For each time period analyzed, totals for Express Scripts were added into Cigna's totals. The same was done for Aetna and CVS Health Corporation as well as Caidan Enterprises and WellCare Health. Lastly, Anthem, Anthem Insurance Company, America's 1st Choice Holdings, and HealthSun were also combined.

The January, 2019 CMS report, reflects the required divestiture of over 2 million covered lives from CVS Health Corporation to WellCare Health. In the January, 2019 CMS report WellCare Health has 4,442,557 lives covered compared to 1,611,467 lives covered in the December, 2018 report. Therefore, it appears that over 2.8 million lives were acquired from Aetna.

https://seekingalpha.com/article/4265378-analysis-medicare-part-d-market-share