SB's decision to sell its DPS pharmacy benefit management business leaves Merck as the only drug company still owning its own PBM. It also creates a powerhouse PBM in the managed care marketplace.

Just over a year ago, the acquisition of managed care specialist ValueHealth by hospital giant Columbia/HCA seemed a match made in heaven--and a new way of thinking about the way to put pharmacy benefit management in context after the failed drug company acquisitions of 1993-4. Now Columbia is spinning ValueRx off. The new deal makes Express Scripts the largest independent PBM in the country and both solidifies and diversifies its customer base. But it also likely spells the end to the PBM alliances of the past several years.