Aetna is the first health plan to disclose its intent to market a national, standalone prescription drug plan directly to individual Medicare beneficiaries.

The company announced Feb. 23 that it filed a letter of intent with the Centers for Medicare & Medicaid Services to become a national PDP under Medicare Part D.

Aetna could find itself competing against the pharmacy benefit managers Medco and Caremark, assuming all three bids are approved. The two PBMs announced their intent to sponsor national PDPs; they will not, however, market directly to individual beneficiaries but will instead "co-brand" their respective plans with health plan and employer clients (¹ Also see "Medco, Caremark Plan National Medicare Part D Bids; No “Fallback” In 2006" - Pink Sheet, 21 February, 2005., p. 15).

Because Aetna is a national health plan with its own PBM, the firm does not stand to gain from co-branding or customizing a PBM plan for its members; the insurer also would not need to contract with a separate PBM to administer its benefit.

Aetna's PBM, Aetna Pharmacy Management, which has a nationwide network of retail pharmacies and an in-house mail-order facility, will administer the PDP.

Aetna acquired the mail-order facility from Eckerd in 2002. Prior to bringing mail-order services in house, Aetna's mail-order business was handled by Express Scripts (² Also see "Aetna Brings Mail-Order Rx In-House With Acquisition Of Eckerd Facility" - Pink Sheet, 16 December, 2002., p. 13).

Aetna will offer its PDP to beneficiaries who enroll in an Aetna Medicare Advantage plan, those who select a Medicare supplement plan and those who remain in fee-for-service Medicare for their medical coverage. The Aetna plan will also be available to employers who wish to contract with a PDP.

Other large health plans may stand to gain from co-branding or wrapping around Medco or Caremark's national PDP. UnitedHealth Group is Medco's largest client on the health plan side, making it an obvious candidate to serve as a national Part D brand for the PBM's program.

Certain Blue Cross Blue Shield plans may also prefer co-branding a PBM-sponsored national PDP. The BCBS Association said it will not develop a national plan for its members to customize; individual Blues plans will instead be left on their own if they wish to participate in the standalone Part D market.

Smaller regional health plans are less likely to provide national PDPs. For example, PacifiCare has announced that it intends to participate as a standalone plan in up to 21 states (see ³ Also see "PacifiCare’s Medicare Rx Marketing To Rely On Broker Network" - Pink Sheet, 28 February, 2005. ).

Aetna Is First Medicare Part D National Rx Plan Directed To Individuals

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