Synergie Medication Collective Announcement
January 11, 2023
On Jan. 5, 2023, Synergie Medication Collective (Synergie) will be publicly announcing its inception with the following press release. This document provides an overview of Synergie and what it means for health plan clients of Prime Therapeutics in 2023 and 2024.
Note: Prime will serve as your conduit to Synergie. You will continue to work with your existing Prime contact to receive any plan-specific information related to Synergie or make any needed decisions such as product opt in.
What is Synergie?
- Synergie is a health plan medication collective aimed at improving affordability and access to effective medications covered on the medical benefit, which are typically high-cost specialty drugs.
- The company will transform the medical benefit drug value chain by unifying the effort of Blue Cross and Blue Shield and independent health plans to secure enhanced medical drug rebates, create administrative efficiencies and accelerate new value contracting models to help curb the extraordinary cost of these medications — ultimately allowing health plan members to access effective medications at affordable rates.
Who is the Synergie team?
- Synergie is an independent entity in which Prime holds the largest ownership stake. It has its own operations and management team.
- Investors in Synergie include Blue Cross Blue Shield Association (BCBSA), Prime Therapeutics (including Magellan Rx Management as part of Prime), Elevance Health, Evio Pharmacy Solutions (founded by Blue Cross Blue Shield of Massachusetts, Blue Cross Blue Shield of Michigan, Blue Shield of California, Highmark Inc., and Independence Blue Cross), Blue Cross and Blue Shield of Arizona, Arkansas Blue Cross and Blue Shield, Blue Cross of Idaho, CareFirst BlueCross BlueShield, Blue Cross and Blue Shield of Kansas City, Premera Blue Cross, Blue Cross and Blue Shield of Vermont, Wellmark Blue Cross and Blue Shield, and Blue Shield of South Carolina.
- Synergie is governed by a board, with two representatives from each of Prime (Mostafa Kamal, CEO of Magellan Rx and Martha Wofford, CEO BCBS Rhode Island), Evio and Elevance, and one representative from BCBSA and one representative elected by the unaffiliated independent Blue health plans.
- Jarrod Henshaw is serving as CEO of Synergie. Most recently, Jarrod served as chief supply chain officer and chief innovation officer for Prime Therapeutics. In addition to Jarrod, Synergie’s executive team is made up of exceptional and diverse industry talent. Additional information about Synergie’s executive team can be found on Synergie’s website, which will be launched the first week of January 2023.
What offerings will Synergie have and when will health plans receive them?
- Synergie’s first focus is on achieving medical rebates for the benefit of its client organizations. As that competency is achieved, Synergie will pursue additional innovation in the form of value-based contracts and adjacent opportunities, all under the direction of the board.
- In mid-April to early May 2023, Synergie will present Prime with enhanced medical rebate savings, effective January 1, 2024. Prime will work with you to share savings analyses and Utilization Management (UM) language that corresponds to the various rebate options and UM designs. Prime and Magellan Rx will work with you through the selection process.
- As you select Synergie rates, we will continue to perform billing, collection and data aggregation on your behalf.
How will the business model work?
- All savings opportunities created through Synergie will be passed on to the payers with the goal of improving affordability to costly specialty medications. Synergie’s goal is not to create profits for itself, but rather to create and fully pass-through meaningful savings opportunities to payers for the purpose of lowering costs.
- Synergie will work directly with pharmaceutical companies and other stakeholders in the medical drug supply chain to create collaborative partnerships that drive affordability and access to costly medications.
What does this mean for medical rebates in 2023?
- For 2023, rates will remain the same. Prime and Magellan Rx will continue to work with you to achieve the most savings possible throughout the year.
What does this mean for medical rebates in 2024?
- In mid-April to early May 2023, Synergie will provide Prime with a rate sheet for 2024. Prime will then analyze, share details and consult with Plans on the various options and value secured by Synergie.
- Plans will finalize and select categories/options and rates for 2024.
- Minimum participation requires 80% of total rebate eligible WAC spend to go through Synergie.
Who can I contact with questions?
Please direct any questions you may have to your client engagement AVP contact.