We focus on a bigger picture: better health outcomes and lowering cost of care for employers.
Not your usual PBM
The number at the bottom of a spreadsheet is fine, but there’s more to consider. That’s why we work differently than other pharmacy benefit managers (PBMs).
Our unique access to pharmacy and medical data means we can see and solve for costs that other PBMs can’t. We make integrated decisions to help clients achieve lowest net costs, not to increase our profits.
We offer an industry-leading toolkit of PBM products and services to help manage costs. For example, our NetResults™ managed formulary is one of our most powerful tools. It removes high-cost drugs while making sure equally safe and efficient alternatives are available to employees.
Collaborating for success
Our approach starts with analyzing both clinical and medical data. We turn that data into insights and recommendations that make a big impact on an employers’ bottom line.
An integrated approach like ours has been proven to be the best way to lower total health care costs. Plus, we understand the needs of each market, which means we offer greater support to our clients.
We put people first
We’re dedicated to making every member interaction as smooth as possible. Our programs and services help employees get the care and support they need to make the best decisions about their health.
A great example would be how our GuidedHealth® tool uses data and analytics to improve health outcomes, increase safety and lower total cost of care.
Managing rising specialty drug costs
New specialty drugs for rare diseases can cost millions of dollars. These conditions may not be as common as others, but it only takes one employee taking specialty drugs to impact cost of care.
Our Blue + Prime partnership model lets us work with employers to determine the most appropriate area for specialty fills — the pharmacy benefit or medical benefit. Many of our competitors recommend moving costs to the pharmacy benefit, whether it makes sense or not. With our model, Prime helps Blue Plans find the most ideal balance.