Elevance Health Will Acquire Specialty Pharmacy To Treat Chronic Diseases

Elevance Health has announced plans to acquire a comprehensive specialty pharmacy for patients with complex and chronic diseases.

“As a trusted, lifetime health partner, the acquisition of BioPlus helps us deliver on our whole-health strategy that gives our consumers improved access and reliability to their prescriptions when they need it most,” Pete Haytaian, executive vice president at Elevance Health and president of Carelon, said in the press release.

“In making BioPlus part of the Elevance Health family, we are committed to leveraging our resources to scale and broaden the reach of BioPlus’ best-in-class specialty pharmacy capabilities, delivering greater affordability and access to critical medications.”

BioPlus serves patients with conditions like cancer, hepatitis C, autoimmune diseases, and other complex conditions. As a result, Elevance Health indicated that the acquisition would assist the payer in facilitating end-to-end pharmacy services.

While the payer emphasized BioPlus’s capacity to complement Elevance Health’s existing services, Elevance Health has already mentioned plans to improve the pharmacy’s output by increasing the company’s speed. Additionally, the payer indicated that it might expand BioPlus’s service models to serve more treatments areas.

Elevance Health may also seek to expand the specialty pharmacy’s centers of excellence. BioPlus currently offers centers of excellence for conditions including oncology and multiple sclerosis, but the payer sees an opportunity to extend these capabilities into other conditions.

“After BioPlus is integrated into Elevance Health, consumers who receive both medical and pharmacy benefits from Elevance Health’s subsidiaries will benefit from the company’s ability to leverage medical and pharmacy data to deliver proactive, whole-health insights,” the press release stated.

Elevance Health would acquire BioPlus from CarepathRx, which is a portfolio company of Nautic Partners. Upon acquisition, BioPlus would become a part of IngenioRx, Elevance Health’s pharmacy benefit manager. Carelon, the part of the company that oversees Elevance Health’s healthcare services, will empower BioPlus pharmacy team members to connect patients who require behavioral healthcare or home healthcare with needed resources through a digital platform.

The partners anticipate that the acquisition will close in the first half of 2023 and, if this occurs, the transaction is not anticipated to affect 2023 adjusted earnings per share.

Elevance Health’s approach to expanding its whole person care services aligns with the general trajectory of the payer industry.

For example, payers and employers have been exploring how to use centers of excellence in order to improve quality of care. Some payers have created distinctions for high-performing centers of excellence.

However, not all payers are moving into the pharmacy space. Earlier in 2022, Centene announced that it planned to sell its pharmacy benefit manager and pharmacy, MagellanRx and PANTHERx Rare, respectively. The payer would make $2.7 billion on the deal. This transaction represented a significant move away from pharmacy benefit management for the major insurer.

While some payers have gravitated toward specialty pharmacies to improve personalization, experts have identified that these pharmacies can have mixed results on pricing and access to medications for individuals with complex conditions like cancer.

Some specialty pharmacies do improve personalization, but others deliver their services almost entirely by mail and some consumers report life-threatening shipping errors. Insurer-run specialty pharmacies paired with insurer-run pharmacy benefits managers can disincentivize payers from cutting costs.