Collaborative approach between Prime Therapeutics and Blue Cross and Blue Shield of Minnesota helped them succeed during COVID-19 response

With or without a worldwide pandemic, Prime Therapeutics (Prime) collaborates with its health plan clients to help ensure their members get the right medicines, at the right cost, at the right time. When COVID-19 hit the U.S. in March, the relationships between pharmacy benefit manager and health plan grew even stronger.

At a recent Medical Industry Leadership Institute (MILI) webinar, through the University of Minnesota’s Carlson School of Management, Prime’s Chief Clinical Officer David Lassen (pictured right) and Blue Cross and Blue Shield of Minnesota’s (BCBSMN) Vice President of Pharmacy Randall Hanna discussed the challenges and opportunities that COVID-19 presented to their organizations.

Long-standing relationship

Prime was born out of BCBSMN in 1998, so the two organizations have a long history of working together. They are aligned on goals and work closely to evaluate medicines that help ensure a holistic view of members to treat conditions and yield optimal outcomes. During the pandemic, the two organizations leveraged their strong relationship to strategize on how to best manage and safeguard prescription drug benefits for members.

Changing regulations

Throughout the pandemic, both federal and state regulations rapidly changed to adapt to what was known about the virus and possible treatments. More than 200 legislative mandates required compliance and quick adaptation for both Prime and BCBSMN. The single greatest impact according to both Lassen and Hanna were mandates that required coverage of medicines that were not approved by the Food and Drug Administration or evidence-based.

Other changes such as allowing early refills, expanding pharmacy networks and removing formulary or utilization management requirements impacted member benefits and medication supplies. At the root of it all was the foundational goal of helping members get the medicines they needed safely during lockdown or quarantines, while protecting the supply of critical medicines – some of which people used to treat other chronic illnesses.

Looking forward

While the companies successfully weathered the first six months of the pandemic response, the focus now is on the distribution of vaccines and therapeutic treatments for COVID-19. The Prime and BCBSMN teams continue to work on distribution plans through its pharmacy networks, drug list coverage, storage and billing. Both organizations agree they are well positioned to address the needs going forward.

Keeping the good

While 2020 has offered many challenges, the pandemic has also created many positive outcomes for the Prime/BCBSMN relationship. Both organizations learned they can transition entire workforces to work from home status with minimal member disruption and with increased productivity. Both organizations have also increased their flexibility to respond quickly to new information and changing intel.

Throughout navigating the pandemic, Prime and BCBSMN “collaborated extremely well,” Lassen said. Hear more from Lassen and Hanna, and watch the full webinar here.