👨‍💻 Check my work… Does it seem strange that Aetna's MRF does NOT include Remicade rates for Aetna Specialty, CVS Specialty, and Coram Home Infusion? See attached.

🤔CVS/Aetna has programs in place that switch Remicade dispensing to these pharmacies as a lower cost alternative. If they are truly a lower cost alternative, they should prove it by publishing their rates in the Aetna MRFs. Then, this claim can be independently verified.

đź’ˇ All cost containment programs provided by health plans and pharmacies should be validated against the rates in the MRF files. However, this is only possible if Health Plans are publishing these rates as required by TiC.

Background: Remicade is indicated as a preferred specialty drug on Aetna's formulary. It's also in top 5 of dispensed specialty infusions. Link to formulary: https://lnkd.in/eGwC-wAh

Source MRF: 2023-02-09_f542d11b-45c4-4e36-a1ff-76d427179dde_Aetna-Life-Insurance-Company

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Aetna - Remicade Pharmacies.pdf

Link to LinkedIn post: https://www.linkedin.com/posts/briandcotter_aetna-mrf-missing-rates-for-aetna-coram-activity-7061316671151427584-2E7o?utm_source=share&utm_medium=member_desktop