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

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.


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Recent articles


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

AVXS-101 is new to the watch list for spinal muscular atrophy.

AVXS-101 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


Watch now: Dr. Gavras on total drug management

September 20, 2018

Video: Watch our recent discussion with Jonathan Gavras, M.D., FCCP, Prime’s senior vice president and chief medical officer. From technology breakthroughs to the importance of total drug management, Dr. Gavras explains how we’ve evolved to meet future needs.

Watch now


Drug pipeline: October

September 13, 2018

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

October pipeline


Three ways to make data make sense

September 10, 2018

Without data, it’s hard to choose the best pharmacy benefits for your members. But trying to make sense of a report crammed with metrics can make anyone’s eyes glaze over.

We get it.


Data is constantly being generated. What do you do with it?

September 7, 2018

The health care industry generates a lot of data. That’s important, because the decisions being made based on that data can have a big impact on a person’s health.

Pushing past the data


Drug watch list: Asthma

August 30, 2018

Dupixent has a new indication for those with moderate-to-severe asthma.

Dupixent and asthma overview


Don’t hope for the best experience. Design it.

August 28, 2018

We support those who support members. This is the foundation of our customer experience design — looking beyond the member to understand the big picture and improving health outcomes.   

Customer experience design


Three insights about insights

August 14, 2018

The basics of developing true customer-centric programs

Foundation first


We know because we listen. We’re successful because we act.

August 13, 2018

We have a deep understanding of the customer journey, and all of the players along the way. But we don’t stop at understanding. We put those insights to work.  

Who’s on the journey?


Drug pipeline: September

August 7, 2018

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

September pipeline


Stopping fraud, waste and abuse requires finding it, first

August 2, 2018

With an array of programs that spot bad behavior, Prime is saving money and by investigating across the entire prescribing process – from prescriber to pharmacy to member.

Fraud, waste and abuse


Not your father’s workplace

July 26, 2018

In today’s workplace, diversity rules. And for good reason. Studies show that companies with a diverse workforce perform better than non-diverse companies. But different workers can have different needs.

Here’s how we’re helping.


Predictive modeling is only as good as the data that drives it

July 23, 2018

That definition of “predictive modeling” is a mouthful. But it’s not as complicated as it sounds. Simply put: It’s a process that uses data to predict future events.

The buzz that is happening around data-driven predictive modeling


Forget about your members for a minute

July 23, 2018

It’s important to talk about providing members with a superior experience. But that’s just one point. For complete specialty management, it’s everything your members don’t see.

Get a better view


When employees are sick, companies feel the pain

July 19, 2018

Employees get sick. It happens all the time. But too many sick days can create major productivity losses for an entire organization.

So companies can feel the pain, too.


Blue + Prime in action

July 17, 2018

Take a closer look at three examples where we worked with Blue clients to achieve great success.

In action


Blue + Prime = 3

July 17, 2018

Blue + Prime is more than a business model – it is a philosophy that delivers value to our client’s year-after-year. Blue + Prime is built on three critical points. Information, collaboration and trust.

What does this mean for you?


Drug pipeline: August

July 11, 2018

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

August pipeline


Patent cliff strategy: When brand name drugs lose patent protection

July 3, 2018

When a brand name drug loses its protection, it opens the door for less costly generic versions. A patent cliff strategy allows your employees to temporarily continue with their brand name drugs while only paying generic prices.

Patent cliff strategy

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