Helping to lower drug costs
Effective formularies are one of the best ways to ensure you have the lowest total cost of care, and a well-managed formulary starts with proactive, comprehensive pipeline management. Best of all, you have the flexibility to choose a drug mix that best meets your goals thanks to Prime’s highly configurable options for formulary management.
NETRESULTS™
A powerful tool for integrated drug management
Our NetResults formulary gives employees access to the right medications while cutting out drugs that are medically unnecessary or more costly compared to other available therapies. Simply put, we focus on providing access to the drugs people need and not the ones they don’t. What’s more, our clients see an average savings of $19 per member per month with NetResults.¹
REAL-TIME BENEFIT CHECK
Help making better prescribing decisions
Using the electronic medical record (EMR) at the point of prescribing, this product supplies employee-specific benefit information to prescribers in real time so the prescriber and employee can make the right prescription decisions. Benefit information includes drug coverage and pricing as well as information on alternate drugs that are equally effective but may cost less than the originally selected drug.
RX SAVINGS SOLUTIONS CORE SOLUTION
Greater price awareness and engagement
This web-based software fully integrates with your benefit design to analyze claims as they come in. This offering provides the lowest available price to your employees, helping them become better consumers and resulting in savings across the board.
HIGHTOUCHRX®
Integrated data to optimize drug use
Horizon Pharmacy + Prime applies machine learning across integrated end-to-end data from the pharmacy benefit (e.g., oral tablets) and medical benefit (e.g., IV drug infusions) to identify inappropriate use. Then, specialized pharmacists reach out to providers to recommend drug therapy optimization. Following pharmacist intervention, Prime provides reporting showing hard dollar savings.
CASE STUDY
HighTouchRx uncovers $30K in monthly savings
Prime identified an employee who was using a high-cost medication that involved two-tab doses, when the same dosage was available in one tab. By connecting the employee’s doctor and pharmacist, who agreed on the updated dosage, we were able to lower the employee’s drug cost and save the employer tens of thousands each month.3
Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey.
¹ Prime Therapeutics book of business data (2021 vs. 2020). Actual savings vary by group
² Prime internal data
3 Savings specific to health plan, not employer group