Optimizing Drug Access
When it comes to accessing drugs and pharmacies, our channel optimization means you can choose the solutions that best meet your needs – and your employees’ preferences. We help ensure your employees have access to their medication where they want it, and at the best available cost.
The following products and offerings are for self-funded groups.
FRAUD, WASTE AND ABUSE PREVENTION
FWA monitoring across pharmacy, prescribers and members
Prime’s fraud, waste and abuse (FWA) solutions sets the standard for detecting and preventing fraud. Many PBMs offer pharmacy fraud products, but only Prime can extend fraud protection to cover member and prescriber fraud. Our FWA offering encompasses all in-network pharmacy types, including retail, mail and specialty.
ADVANCED FRAUD, WASTE AND ABUSE
Smart technology to uncover cost avoidance opportunities
In addition to the visible savings, you can realize significant cost avoidance through our Advanced Fraud, Waste and Abuse (FWA) platform, which integrates pharmacy and medical claims data and applies AI technology and machine learning capabilities to detect FWA across the health system. Recognized by Fast Company for this first-of-its-kind initiative leveraging AI technology to fight FWA, Prime’s platform helped clients save more than $206 million in FWA in 2022 alone.¹
Access, savings and choice
The PreferredOne Network provides great access and substantial savings opportunities, offering access to 30-day supplies at more than 55,000 retail pharmacies and 90-day supplies at over 45,000 pharmacies. This network is ideal for plans looking to push for savings while driving minimal disruption. Employees get convenience, and employers may see savings of up to $2.10 per member per month.2
MEDSYOURWAY® – RETAIL
The best available price at local pharmacies
Your employees no longer need to search for the best discount card prices and then try to remember which card to present at the pharmacy. Through MedsYourWay – Retail, all they need to do is show their insurance card when they fill a prescription to get the lowest available price.
MEDSYOURWAY® – HOME DELIVERY
The lowest available price, integrated home shopping
MedsYourWay – Home Delivery offers an innovative shopping experience through Amazon Pharmacy, including real-time benefits data and integrated discount drug card pricing. Through this offering, your employees get the lowest available prices, and all covered purchases count toward their deductibles.
¹ Prime internal data, 2020
² Internal Prime data, 2021. Savings not guaranteed. Estimates are based on groups who have not already implemented a portion of these strategies. Your actual savings may vary, based on utilization for each segment across the BoB. Represents the opportunity for savings if moving to each of the narrow networks. Savings include the client or group and the employee savings.
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.
Disclaimer: MedsYourWay, provided by InsideRX, an independent company, offers prescription cost savings programs through Amazon, an independent company, to Blue Cross and Blue Shield of Alabama members.