Uncovering the true cost of your pharmacy benefit
Consistently delivering low PMPM
*Than national benchmarks
Employing multiple drug management methods
The most effective PBMs help deliver the best patient outcomes at a lower cost. Prime takes a holistic approach to help ensure our formularies include the best options, promote evidence-based biosimilars and offer industry-leading utilization programs.
Some PBMs prioritize high-priced drugs over lower-cost options due to manufacturer rebates. But Prime focuses on the lowest-cost, most clinically effective options to keep costs low and improve health outcomes.
Specialty drug management
Prime is focused on improving access to low-cost specialty drugs by developing innovative products and driving the use of evidence-based biosimilars.
Utilization management (UM)
We help our clients choose UM programs that not only provide their members safe, cost-effective medicines, but also address industry-wide problems like inappropriate use and fraud, waste and abuse.
1 Milliman survey, 2020; commercial business including fully insured and self-insured
2 Prime Therapeutics internal data, 2022
3 U.S. Food and Drug Administration, and Federal Trade Commission. (2020, February 3). FDA and FTC announce new efforts to further deter anti-competitive business practices, support competitive market for biological products to help Americans [Press release]. https://www.fda.gov/news-events/press-announcements/fda-and-ftc-announce-new-efforts-further-deter-anti-competitive-business-practices-support
4 Watanabe, J. H., McInnis, T., & Hirsch, J. D. (2018, March 26). Cost of prescription drug-related morbidity and mortality. Annals of Pharmacotherapy, 52(9). https://journals.sagepub.com/doi/10.1177/1060028018765159