Avera Health Plans Selects Scripius as its PBM

Scripius has been chosen as the PBM for Avera Health Plans’ 88,000 members beginning Jan. 1, 2025. Avera is an integrated health system serving South Dakota, Minnesota, Iowa and Nebraska. Scripius serves almost 2 million members and offers pharmacy benefits for members of Intermountain Health and Select Health.

David Lemperle

“This collaboration allows us to reduce costs for our members and employees, while providing them with in-network benefits at local pharmacies,” David Lemperle, Avera Health Plans president and CEO said in a news release. Avera Health Plans was founded in 1999 and provides coverage for employers and for individuals and families through the Accountable Care Act, as well to seniors looking for a Medicare supplement policy.

Scripius will provide full pharmacy benefit management services for Avera. This will include claims processing, retail network management, rebate aggregation services, utilization management, clinical programs, trend management programs, formulary management, digital services (both member and physician engagement), sales/marketing support, customer service and data analytics.

The agreement includes management of specialty pharmacy. Avera Specialty Pharmacy will be the backbone of the specialty arrangement. Scripius will provide specialty network access for medications not available at Avera, with support from Intermountain Specialty Pharmacy Services.

Related: Scripius Removes Dupixent from Formulary

Work is currently under way related to refining the formulary for 2025, the companies told Formulary Watch. Avera Health Plans has supported membership and providers with a customized formulary for more than 20 years. Scripius will collaborate with Avera to minimize any disruptions while maximizing savings.