Wal-Mart Stores Inc., having already affected the prescription drug industry with its $4 generic drug pricing, is set to turn everything on its head again with a drug pricing program that works directly with employers.

The Bentonville-based retail giant is already working on a pilot program with Caterpillar Inc. (which soon will have its own manufacturing plant in North Little Rock). According to the Chicago Tribune:

The Wal-Mart contract waives the $5 co-payment for Caterpillar employees on any generic drugs if they purchase them at a Wal-Mart or Sam's Club pharmacy. By giving workers an incentive to fill prescriptions at Wal-Mart rather than another pharmacy, the retailer not only beefs up its pharmacy business, but also attracts more shoppers into the store, where they might make other purchases.

The most radical aspect of the test, however, is the threat of unraveling how the health-care industry buys and sells prescription drugs.

Under the initiative that began in October, Peoria-based Caterpillar has a contract to buy prescription drugs for employees directly from Wal-Mart and has a third-party audit system in place to make sure that prices aren't inflated.

That process contrasts with the way most employers purchase drugs, through a middleman, known as a pharmacy benefit manager, or PBM.

Last week, Wal-Mart said it was in talks with another firm about similar programs. According to a Zack's research note, Wal-Mart's entry into the PBM market is not "insignificant," and could put pricing pressures on PBM players like Medco Health Solutions and others.

It's another way the retail change is a game-changer an industries outside discount retail.

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