Pharmacy Benefit Companies Continue To Build on Commitment To Health Equity

JC Scott
3 min readJan 19, 2024

The COVID-19 pandemic’s spotlight on health care and the resources available across the country put into stark realization that certain groups and communities lack the same opportunities and access to high-quality care that others take for granted. The health care system is grossly inequitable for communities of color, economically disadvantaged, and geographically isolated from health care providers, whether urban or rural.

Pharmaceutical Care Management Association (PCMA) members have long advocated for and implemented new programs to achieve a more equitable health care system, but in 2021, the severity of the health disparities revealed during the pandemic spurred the formal declaration of our industry’s commitment to health equity. We are happy to share our first Health Equity Progress Report, which showcases what pharmacy benefit companies are doing to advance a more affordable, accessible, and equitable health care future.

When we made our formal commitment to health equity in 2021, we pinpointed four key areas of focus.

· Address disparities in access, disease burden, and outcomes;

· Promote equitable, affordable pharmacy benefit design;

· Create a culture of equity and person-centered care; and

· Invest in meaningful data, evidence, and measurement.

From our report, we found that pharmacy benefit companies are actively addressing each key area of focus. Our vision for a more equitable health care system is built on these four patient-centered goals, prompting our companies to lead, innovate, and implement programs to meet them.

Let’s take a look at some examples of the incredible work we’ve done as an industry to improve health equity:

The Cigna Group implemented its IndependentRx Initiative, which increases patients’ access to care by contracting and leveraging community pharmacies in rural areas through direct-to-patient prescribing, testing services, disease management, and medication administration.

Through its Project Health program, CVS Health has provided no-cost health screenings and health care resources to historically marginalized communities for nearly 20 years. In 2022, the program provided $5.5 million in free medical services in underserved communities nationwide.

Elevance Health established a program that provides in-home risk assessments for health-related social needs and resource connectivity to help remove barriers and improve care coordination and delivery.

Humana recognizes that social factors affect health equity and has partnered with community-based organizations to eliminate social and structural barriers to health. Through its Flexible Care Assistance program, Humana has been able to assist members with housing needs (e.g., pest control, minor repairs, etc.).

Optum Rx’s Genoa Healthcare program runs more than 700 pharmacies within community health clinics nationwide, which help individuals living with behavioral health and other health issues.

PerformRx is sponsoring multiple associate resource groups for all associates across several states, including training and programs focused on promoting community volunteerism and allyship in the workplace.

Prime Therapeutics has teams that conduct outreach to the community in two key areas: clinical and concierge. Both teams directly reach out to patients to educate them on their drug therapies and other areas using zip codes to target specific groups.

Given the scope of the challenge, this initial progress is merely a start, but it’s an important step. Pharmacy benefit companies remain steadfast in executing on the commitment to health care equity made in 2021. The industry will continue to innovate and implement change for the better, and we hope others in the health care system will work with us.

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JC Scott

JC Scott is the President & CEO of the Pharmaceutical Care Management Association (PCMA), the association representing America’s pharmacy benefit managers