MANAGING SPECIALTY CONDITIONS
Specialty drug costs are on a meteoric rise, now exceeding 55% of total drug spend.1 What’s more, 35% of total drug spend is driven by medical drug spend.2 Integrated solutions and strategies – across both medical and pharmacy benefits – help you successfully navigate the complicated and evolving specialty landscape.
The following products and offerings are for self-funded groups.
Lowering drug costs with biosimilars
Make sure your employees have access to the best treatments. Biologic drugs are changing lives for the people who need them – but often at a very high cost. Blue Cross and Blue Shield of Alabama and Prime promote the use of evidence-based biosimilar drugs that may cost up to 35% less while delivering the same outcomes.3
Greater savings potential, ease and expanded pharmacy options
This copay assistance solution uses Prime’s channel-optimized model to give your employees the best available discount when they get their higher-cost medicines. Not only can your employees see copays as low as $0, they may also be able to get their medicines from a wider network of pharmacies, including specialty and retail locations.
Less waste, more savings opportunities
Certain high-cost medications may cause adverse side effects. For these medications, Prime provides a split, or partial, fill prescription with a prorated copay to align with the number of pills dispensed. This gives your employee the opportunity to try a medication to determine the existence and severity of side effects before continuing therapy, potentially saving money and reducing waste.
1 IQVIA Institute for Human Data Science. (2022, April). The use of medicines in the U.S. 2022. https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-use-of-medicines-in-the-us-2022/iqvia-institute-the-use-of-medicines-in-the-us-2022.pdf
2 Pharmaceutical Strategies Group, LLC. (2022). 2022 Artemetrx® state of specialty spend and trend report. https://www.psgconsults.com/specialtyreport2022
3 Roy, Avik and The Apothecary. (2019, March 8). Biologic medicines: The biggest driver of rising drug prices. Forbes. https://www.forbes.com/sites/theapothecary/2019/03/08/biologic-medicines-the-biggest-driver-of-rising-drug-prices/?sh=37c36b0718b0
Exclusions may apply.
BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans that includes Blue Cross and Blue Shield of Alabama.
Prime Therapeutics LLC is an independent company contracted by Blue Cross and Blue Shield of Alabama to provide pharmacy benefit management services. Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.