Connect | Prime Therapeutics

Feeling OK doesn’t mean you’re OK

High cholesterol is stealthy. It doesn’t cause any symptoms. There’s no way of knowing that something is wrong until you have a heart attack or a stroke.


Recent articles

Drug pipeline: June

May 20, 2019

Your monthly snapshot of new drugs expected to hit the market.

June pipeline

Drug pipeline: May

May 13, 2019

Your monthly snapshot of new drugs expected to hit the market.

May pipeline

Pharmacy networks: design makes the difference

April 16, 2019

Pharmacy networks were created to help bring pharmacy costs down. Find out how these networks are designed and managed to help clients save money.

Network design

Reimbursement Solutions: Seeking out savings opportunities

March 25, 2019

Physician fee schedules can seem like a complicated maze of data, but Prime has the tools to simplify them for health plans. Prime reviews these fee schedules in detail for savings opportunities through our Reimbursement Solutions program, to provide recommendations to help guide health plans to a lower cost of care.

Reimbursement Solutions

What’s behind PBM industry changes?

March 18, 2019

Q&A with Jonathan Gavras, M.D., FCCP: In health care and the PBM industry – change is constant. To understand the changing PBM landscape, we spoke with Jonathan Gavras, M.D., FCCP, Prime Therapeutics’ senior vice president and chief medical officer.

What’s behind PBM industry changes?

Drug pipeline: April

March 15, 2019

Your monthly snapshot of new drugs expected to hit the market.

April pipeline

Three ways to keep members on their medicines

February 12, 2019

Members with high cholesterol don’t have symptoms, so they don’t always stay on their medicines. GuidedHealth gets them back on track.

Once, twice, three times adherent

Feeling OK doesn’t mean you’re OK

February 11, 2019

High cholesterol is stealthy. It doesn’t cause any symptoms. There’s no way of knowing that something is wrong until you have a heart attack or a stroke.

Bring it down, then keep it down

Drug pipeline: March

February 7, 2019

Your monthly snapshot of new drugs expected to hit the market.

March pipeline

Drug watch list: Treatment Resistant Depression (TRD)

February 4, 2019

Esketamine is new to the watch list for treatment resistant depression.

Esketamine and treatment resistant depression overview

Drug pipeline: February

January 24, 2019

Your monthly snapshot of new drugs expected to hit the market.

February pipeline

Pharmacy networks: the fundamentals

January 14, 2019

As pharmacy benefits continue to grow, pharmacy networks also continue to evolve. Take a moment to learn some of the basics of networks.  

Basics of networks

The Opioid Epidemic: Understanding the danger (Part 2)

January 3, 2019

The opioid epidemic continues to leave a wave of destruction across America. The health care industry has the power to do something about it. Find out what Prime Therapeutics (Prime) is doing to help combat this crisis.

Part 2

The Opioid Epidemic: Understanding the danger

January 2, 2019

“The opioid epidemic” is more than fodder for news reports and a talking point for politicians. But how wide spread is it, what is it and what can be done to stop its spread? Better understanding opioids and their use and abuse is the first step.  

Part 1

Proud of our accomplishments; confident in our future

December 20, 2018

As I prepare to retire from Prime Therapeutics (Prime), I'm taking stock of our successes and gaining a perspective on the extraordinary challenge and opportunity facing Blue + Prime.

Hear from Jim DuCharme

So, what, exactly, ARE accumulators?

December 19, 2018

Health care isn’t simple. Especially accumulators. At Prime Therapeutics, we’re here to help make them simple for both our clients and your employees. Because once you know what they really are, you’ll understand how we (simply) make them work harder for you.

What are accumulators?

We need to talk

December 18, 2018

Members who take multiple drugs for multiple chronic health conditions need extra help. For one thing, they have a greater chance of having a negative drug interaction. Their nonadherence rates can also be higher. Talking with a pharmacist can help.

Listen up

Drug pipeline: January

December 12, 2018

Your monthly snapshot of new drugs expected to hit the market.

January pipeline

Making good choices doesn’t always happen

November 28, 2018

What happens when employees have a chronic health condition but don’t take their medication as prescribed? Or don’t refill their prescription? They usually get sicker. And the added doctor, urgent care or ER visits mean higher health care costs — for them and for you.

Follow the PBM’s orders

Drug watch list: Spinal muscular atrophy (SMA)

November 26, 2018

Zolgensma® is new to the watch list for spinal muscular atrophy.

Zolgensma and spinal muscular atrophy overview

Improving quality of care with drug utilization reviews

November 21, 2018

Making sure members take their medicine correctly is important for two reasons. It’s a way to help improve health outcomes and lower overall health care costs. That’s why drug utilization reviews (DURs) are a major part of Prime Therapeutics’ program offerings.

Drug utilization reviews

Site of Care: “where” matters.

November 20, 2018

What is “site of care?” “Site of care” is exactly what it sounds like: the physical site, or location, where members receive their infusion treatment. It’s important for health plans and necessary for infusion patients. It may be a small part of the bigger picture, but it’s no less important.

Site of care

Drug pipeline: December

November 16, 2018

Your monthly snapshot of new drugs expected to hit the market.

December pipeline

The Specialty Drug Strategy Committee: Nothing brings Blue Plans together like this

November 14, 2018

With ultra-expensive specialty medication continuing to drive drug spend, you need a place to discuss strategies and options. And no other PBM brings Blue Plans together like this. With Prime Therapeutics’ Specialty Drug Strategy Committee, you get that opportunity to discuss those strategies and learn about solutions that could benefit you and your members.  This is one way we connect you to the full picture like no one else.

Watch video about the unique value of this collaboration

Three reasons to make it a team effort

November 13, 2018

We talk a lot about how data analyses can help clients with their specialty drug management strategies. Now we’re getting specific. Here are three insights from the Specialty Drug Strategy Committee.

Specialty Drug Strategy Committee

Putting members first isn’t a cliché — it’s our culture

November 12, 2018

When members have urgent questions about their medicine or their pharmacy benefits — or both — they need fast, clear answers. Here’s our question: How can we help?

We’re listening

What is a PBM and what does Prime mean for your employees?

November 5, 2018

Explaining to your employees what Prime does might seem hard at first glance. Breaking it down and keeping it simple are key to helping people understand what we do, and how it helps them.

Breaking it down

It’s OK to be wary. We’ll help.

October 29, 2018

Implementation. Sometimes it’s because a health plan must choose a new pharmacy benefit manager. Sometimes it’s because you want to. But at Prime Therapeutics (Prime), both situations have one thing in common.  

We’ll help.

Premiums. Out-of-pocket maximums. Drug tiers. Are your eyes glazing over yet?

October 25, 2018

Do you know what “co-insurance” is? How about “out-of-pocket maximums”? Well, you’re not alone. We’ll break it down for you.

Let’s break it down.

Keeping it simple: The ABCs of EGWP

October 23, 2018

EGWP stands for employer group waiver plan. It’s simple. Similar to RDS which was adversely affected by the PPACA, EGWP is a CMS program as a part of the OPEB and is normally administered by a PBM or insurer that contracts directly with CMS.

OK, maybe it’s not that simple, so let’s simplify it.

Unclogging the drug pipeline

October 16, 2018

New drugs are always in development. They’re hitting the market faster than ever — at costs that are driving up drug trend. If you don’t know what’s coming, you can’t make the best decisions about your benefit costs.

Dive in

Drug pipeline: November

October 10, 2018

Your monthly snapshot of new drugs expected to hit the market.

November pipeline

Drug watch list: Chronic coronary and/or peripheral artery disease (CAD/PAD)

October 5, 2018

Xarelto has a new indication for reducing the risk of major cardiovascular events.

Xarelto and CAD/PAD overview

Medical utilization management 101: Taking down rising medical drug costs

October 2, 2018

Traditionally, pharmacy benefit managers (PBMs) are set up to manage drugs on the pharmacy benefit. But when it comes to specialty drugs, ignoring opportunities to also manage drugs on the medical benefit could be a costly mistake. Prime Therapeutics’ medical utilization management is the solution.

Medical utilization management

Play it safe with your formulary strategy, and you may be sorry

October 1, 2018

In the health care industry, taking risks isn’t always a good thing. But when you’re managing pharmacy benefit costs, playing it safe may not always get the results you want.

Go for it