Prime Insights

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Delivering specialty solutions with a patient-centered approach

Prime combines in-depth category knowledge, integrated research and ongoing dialogue with clients. The result: patient-centered specialty solutions -- for hereditary angioedema, for hemophilia, for autoimmune conditions.

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    Recent insights

September 7, 2018

Using an extra tier to add a new adherence tool 

by Shannon Kampa, PharmD, MBA, Senior Director, Medicare Clinical Program Management 

When Prime lowered member cost share for generics in targeted categories, member adherence went up for our Medicare clients. Read more.


September 7, 2018

Prime's missed refill program is a hit with Medicare plans

By Stephanie Dauer, PharmD, MS, MBA, RPh, Director, Medicare Clinical Program Development 

A two-touch rapid response program helps nudge members to refill their prescription.  Read more.


June 30, 2018

Small populations, big dollars

By Pat Gleason, PharmD, FCCP, FAMCP, BCPS

Hemophilia.  Myasthenia gravis.  Heriditary Angioedema.  These conditions are rare, challenging to treat and difficult to live with. And the annual drug therapy price tag for members for these conditions can top $1 million. With stakes this high, specialty drug management becomes even more important. Read the series:

Part 1: Hemophilia  |  Part 2: Myasthenia gravis  |  Part 3: Heriditary Angioedema


April 30, 2018

Pharmacist integration delivers big results

Blue Cross & Blue Shield of Rhode Island (BCBSRI) started funding pharmacists in physician practices in 2014. Within three years, the program helped avoid $23 million in health care costs (commercial and Medicare). See how that worked in this four-part series.

Part 1 | Part 2 | Part 3 | Part 4


June 15, 2018 | Cathy A. Starner, PharmD, BCPS

Reducing opioid use among outliers; are we doing enough?  

Prime’s opioid research demonstrates our ability to identify and impact members whose opioid use puts them outside the norm. Do you know who they are and what impact they could be having on your business? Read more


Dec. 27, 2017 | Kevin Bowen, MD, MBA, Principal Health Outcomes Researcher 

Rheumatoid Arthritis: We dig deeper for insights that make a difference

Prime’s analysis of integrated medical and pharmacy data gives us insights into whether members are getting the most effective treatment for rheumatoid arthritis (RA), according to clinical guidelines. Following clinical guidelines improves the standard of care. 

RA infographic 

Part 1: What is RA and why is it important? 
Part 2: The role of csDMARDS and b/tsDMARDS in treating rheumatoid arthritis (RA)  
Part 3: What can a PBM and plan sponsor do to help?


March 29, 2018 | By Patrick Gleason, PharmD, FCCP, FAMCP, BCPS 

Assigning the right value to value-based insurance design

Does value-based insurance design (VBID) work? 

Pat Gleason has studied pharmacy benefit health insurance for many years. He’s linked medical and pharmacy claims data to look for outcomes; he’ll provide some insights on VBID strategy. Read more.


Feb. 20, 2018 | Prime Therapeutics 

Prime’s 2018 drug trend represents the second consecutive year of outstanding results 

In 2017, clients across all lines of business — commercial, Medicaid, and Medicare Part D — saw lower overall spending on prescription drugs (per member per month) when compared to 2016. These negative trend numbers prove Prime’s value. See individual reports by business line: Commercial | Medicare Part D | Medicaid | News release summary


Dec. 12-27, 2017 | Patrick Gleason, PharmD, FCCP, BCPS, FAMCP

Gene therapy opens new worlds in health care  

This four-part series explores some of the near and long-term implications of gene therapy treatment. 

  1. Kymriah™ launches great expectations
  2. Rewrite the textbooks; treating disease has been turned inside out
  3. Today’s drugs: What’s the investment in time and money from idea to market?
  4. Gene therapy will redefine health care

Nov. 14, 2017 | Prime Therapeutics

Specialty drug spend forecast: The stakes are high  

Five years ago, Prime predicted specialty drugs would hit 50% of total drug spend by 2018. Looks like we were right. Now, we predict it will hit 60% by 2021.

Check out our latest specialty infographic

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care


Oct. 31, 2017 | Cathy Starner, PharmD, BCPS

America’s opioid epidemic: A public health emergency 

A look at the opioid epidemic from a managed care perspective. Prime’s programs have lowered opioid use 15 percent over the last five years. How do we keep moving forward?

Part 1 |  Part 2  |  Part 3  |  Part 4Part 5  

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care


Sept. 27, 2017 | Prime Therapeutics

The Drug Pipeline Impact Series 

Over the last five years, the increase in drug costs has been unprecedented. This four-part series will help you understand some of these changes, and how Prime continues to deliver consistent value.

Part 1 | Part 2 | Part 3 | Part 4

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care


May 10, 2017 | Prime Therapeutics

Insights with Impact: managing diabetes costs with data 

Prime looks beyond diabetes drugs to address the total cost of diabetes care.

Read about study.


May 3, 2017 | Prime Therapeutics

Insights with Impact: more data isn’t better data

Why Prime’s adherence predictors top bulk consumer data.

Read about the study


April 26, 2017 | Prime Therapeutics

Insights with Impact: Different, but not just to be different

Being different is only better when it makes a difference.

Read about the two studies


April 27, 2017 | Prime Therapeutics

Insights with Impact: Pharmacist interventions

Research proves people do make a difference. Learn about the effects of pharmacist interventions on specific high-risk populations.

Read about two studies


April 6, 2017 | Prime Therapeutics

Prime releases 2017 Drug Trend Reports

Prime is creating partnerships and programs that will reshape the PBM industry. These reports illustrate the powerful results that this work can generate.

Get the highlights


Nov. 11, 2016 | Prime Therapeutics

Managing accelerating autoimmune drugs costs across benefits is critical

Just 5 in every 1,000 members use autoimmune drugs. Yet it’s the most expensive drug class under both the medical and pharmacy benefit — and one of the fastest growing.

Prime's latest autoimmune drug research


Nov. 11, 2016 | Prime Therapeutics

Infographic: Drug pipeline profile: Duchenne muscular dystrophy

New  therapies for this rare disease are in pipeline, and they could have a big impact on drug costs — up to $4.57 per member per year.

DMD and what’s on the horizon


Aug. 31, 2016 | Patrick Gleason, PharmD, FCCP, BCPS

Prime research decodes top Stars-related adherence predictors by category

Prime explores the top predictors of future adherence for three key Star ratings drug categories — high blood pressure, high cholesterol and diabetes — based on a recent study of more than 1.1 million Medicare members.

Top adherence predictors by category


Aug. 24, 2016 | Patrick Gleason, PharmD, FCCP, BCPS

Can big data help boost medicine-related Star ratings?

Prime performs adherence predictive modeling, using big data, to provide evidence-based recommendations to drive higher ratings for Star-related drug categories. 

Top predictors of adherence


Aug. 2 2016 | Jonathan Gavras, MD, FCCP

The CREATES Act: A viable solution for more affordable prescription drug choices

Lawmakers are fighting for more affordable prescription drug choices for families. The CREATES Act can pave the way, and Prime Therapeutics is on board.

How the CREATES Act can help

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