Prime Insights

    Benefit design

April 29, 2016 | Kevin Bowen

4.5-year study finds diabetes and related drug costs surging

By 2050, as many as 1 in 3 adults in the United States will have diabetes. Coupled with drug price inflation, rising diabetic drug use has led to mounting costs for plan sponsors. To help measure the impact of rising use and costs, our team dove deep into Prime’s data to study diabetes prevalence, incidence and drug therapy.

What we learned | Study poster


March 7, 2016 | Patrick Gleason

Coupons prove costly across the health system

Higher costs are probably the last thing that comes to mind when most people think of coupons. For insurers and pharmacy benefit managers (PBMs), however, coupons used on non-preferred drugs are contributing to escalating health care costs. That’s why I focused on this topic for my presentation at the annual the specialty-focused conference of the Pharmaceutical Management Association’s (sPCMA) conference on Feb. 8, 2016.

Presentation recap


March 14, 2016 | Steven Johnson

“No” isn't the answer to managing specialty drug costs

Saying “no” to expensive specialty drug claims isn’t the best way to control costs. Instead, saying “yes” — to the right drug, the right person and the right channel by using the right drug management tools — is the most effective strategy. That’s the message I delivered to industry leaders at the Pharmacy Benefit Management Institute’s (PBMI’s) recent Drug Benefit Conference.

Presentation recap


Dec. 3, 2015 | Prime Therapeutics

An evidence-based approach to solving the opioid epidemic

Prescription drugs are an essential part of effective health care. But misuse, abuse, addiction and overdose can transform some medicines, notably opioids, into a dangerous public health concern. Prime’s director of health outcomes, Pat Gleason, PharmD, FCCP, BCPS, collaborated with a diverse group of experts to author a report outlining an evidence-based response to the nation’s opioid epidemic.

Report summary


Nov. 25, 2015 | Prime Therapeutics

Pilot study proves value of high-risk medicine interventions for Medicare beneficiaries

Health care spend among U.S. seniors is wildly disproportionate. At 13 percent, those ages 65 and older make up a small segment of the population. Yet they account for more than one-third of all health care costs — spending at a rate three times that of the average working-age person.

Study analysis


July 15, 2015 | Cathy Starner

Sharing Prime’s insights on controlled substances

Controlled substance abuse is no laughing matter. During the past decade, increases in controlled substance prescribing have coincided with higher rates of misuse, abuse, hospitalizations and deaths. Right now, opioids cause more overdose deaths than heroin and cocaine combined. We have developed new ways to identify potential abuse using integrated medical and pharmacy data and measured the effect of interventions aimed at potential overuse. 

Study analysis


Oct. 10, 2014 | Prime Therapeutics

Prime research featured in Health Affairs

The October 2014 edition of Health Affairs is dedicated to Specialty Pharmaceutical Spending and Policy. Prime's article in this issue is titled "Specialty Drug Coupons Lower Out-Of-Pocket Costs and May Improve Adherence At The Risk Of Increasing Premiums.” It examines insurers’ role in maintaining the affordability and accessibility of specialty drugs while maximizing their value.

Research coverage


April 4, 2014 | Patrick Gleason

What does $250 buy? More appropriate drug use

Nearly one third of all initial drug prescriptions were not filled within nine months. Nonadherence was highest for expensive drugs and chronic preventive therapies. Prime’s clinical outcomes team studied this problem in two specialty drug categories: multiple sclerosis (MS) and biologic anti-inflammatory (BAI) drugs used to treat conditions like rheumatoid arthritis, psoriasis and Crohn’s disease. We found that members who paid less than $250 out-of-pocket were much more likely to start MS or BAI therapy. 

Study analysis



Feb. 4, 2014 | Patrick Gleason

A year-long look at copay offset efforts and results

Early in 2013, the health outcomes research team at Prime began measuring the effect of “copay offsets” – the use of manufacturer coupons and patient assistance programs to reduce members’ specialty drug costs. My colleague, Shelley Sánchez, and I have prepared an update on our efforts to help make specialty drugs more affordable — and why we think this is so important for people who take specialty medicines.

Study analysis