Prime Insights

    Total cost of care

July 20, 2016 | Cathy Starner, PharmD, BCPS

America’s opioid epidemic: Part 5 — the future of safer opioid use

The opioid crisis is staggering, but steps are being taken in the right direction. What will tomorrow hold for safer opioid use?

Important work being done on the opioid front


July 12, 2016 | Cathy Starner

America’s opioid epidemic: Part 4 — fighting overuse through legislation, advocacy and political action

Solving the opioid crisis goes beyond the private sector. To drive meaningful change, health care, government and industry groups all have to work together.  

Evidence-based policies that could help combat the crisis


July 8, 2016 | Cathy Starner

America’s opioid epidemic: Part 3 — strategies for curbing abuse

Combating the opioid crisis requires a full set of tools — and proof that they work. See how the research stacks up. 

Strategies to keep members safe and control the total cost of care


July 5, 2016 | Cathy Starner

America’s opioid epidemic: Part 2 — adding it up

To address the problem, we first have to gauge it. Prime’s researchers have worked to pinpoint who’s at highest risk for harm from controlled substances, such as opioids, and how this use potentially impacts the total cost of care. 

How can plan sponsors find high-risk users, and how does use impact the cost of care?


June 28, 2016 | Cathy Starner

America’s opioid epidemic: Part 1 — diagnosing the problem

Opioid drugs are killing more Americans than ever. Every health care stakeholder must take action. Prime explores the ins and outs of opioid overuse and management in our latest five-part series.

Who's using opioids, and who can help curb this deadly trend?


April 28, 2015 | Kevin Bowen

What can drug therapy tell us about severe hypoglycemic events?

Hypoglycemia can trigger serious symptoms, such as impaired vision, seizures and unconsciousness.
To better understand if and how emergency department visits for hypoglycemia are related to diabetes types and drug regimens, our team studied data from nearly 4 million members. 

What we learned | Study poster


April 22, 2015 | Cathy Starner

Taken together, triple threat drugs prove dangerous — and costly

As administrators of prescription drug programs, pharmacy benefit managers can play an important role in helping prevent opioid overdose deaths. Prime reviewed data from 15 million members to study the impact of “Triple Threat” drug use.

What we learned | Study poster


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.

Event 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. 11, 2015 | Kevin Bowen

Beyond PSCK9 prices: How valuable is coronary heart disease event prevention? 

With prices topping $14,000 per patient, per year, PSCK9 inhibitors have been dominating the headlines. But proactively managing care is just as important to controlling costs. When members who could benefit from cholesterol-lowering drug therapy aren’t being treated optimally, or at all, they’re at greater risk for costly coronary heart disease events.

Study analysis


July 21, 2015 | Prime Therapeutics

As high-cost cholesterol drugs loom, study finds statins underused

To determine appropriate coverage of the new PCSK9 inhibitors (Proprotein Convertase Subtilisin/Kexin type 9) drugs, Prime analyzed its claims data and confirmed current statin treatments were not being used or adhered to as guidelines recommend. Adherence to statins is a long-standing national problem which is well studied and documented. Not surprisingly, Prime’s analysis validates there is a significant opportunity to optimize statin use even for members who may be eligible for PCSK9s.

Study analysis


Feb. 3, 2014 | Prime Therapeutics

Study finds lower cost of care and improved adherence with Prime Specialty Pharmacy

Generally, members who stick to their specialty drug regimens are likely to have lower cost of care due to fewer complications and doctor visits. Prime strives to keep members adherent through an effective and efficient care management program, offering services beyond what they would receive in a standard pharmacy. In a separate study, specialty drug adherence was found to be higher among members using Prime Specialty Pharmacy compared to a standard retail pharmacy.

Study analysis


Sept. 29, 2014 | Prime Therapeutics

Award-winning research to be presented

This October, Prime’s clinical research team will present findings from four studies at the fall meeting of the Academy of Managed Care Pharmacy (AMCP) in Boston. Two of Prime’s submissions are Platinum-level award winners. Instead of the traditional poster presentation, these two studies will be shared during a special educational session.

Poster session summary


Aug. 6, 2014 | Prime Therapeutics

REPORT: Enabling better outcomes and lower costs through integration

The report draws on a study sponsored by the Blue Cross and Blue Shield Association (BCBSA) that found positive outcomes and medical cost savings when pharmacy benefits are carved in with the medical. The BCBSA study findings are presented alongside data demonstrating Prime’s notable success in achieving the industry’s lowest net ingredient costs.

Report summary | Full report


June 17, 2014 | Prime Therapeutics

INFOGRAPHIC: Spotlight on specialty

Spending on specialty medicines is growing quickly. Prime projects that 10 years from today, these high-cost medicines could represent one quarter of all health care costs. How much do you know about these drugs? Our new infographic can quickly get you up to speed. 

Infographic


March 27, 2014 | David Lassen

A potential $1.5 million pharmacy bill prompts collaborative investigation

The call came from one of Prime’s clients. A pharmacy director noticed something strange on a report. One of their members had specialty pharmacy claims adding up to approximately $129,000 within just one month. Something wasn’t right. Both Prime and the Blue Plan looked into the situation. 

Case study


Jan. 20, 2014 | Kevin Bowen

Integrated analysis of current HER2 chemotherapy helps in estimating future costs

Our health outcomes team studied claims data for members from 11 health plans to determine recent use of Herceptin. We estimated the number of members who will be started on chemotherapy for early stage breast cancer each year along with the percentage of these members who will be treated with anti-HER2 drugs.

Study analysis