September 24, 2021
Our purpose is to help people get the medicine they need to feel better and live well.
Prime at a Glance
Formed in 1998 by two Blue Cross and Blue Shield plans, Prime has grown steadily. Today, we partner with 19 Blue Plan owner clients. This unique ownership structure makes it possible for us to remain absolutely committed to the health of the members we serve. We manage pharmacy benefits for nearly 33 million members through our relationships with health plans, employers, and government programs, including Medicare and Medicaid.
We believe in a health benefits landscape founded on fairness and focused on outcomes. And in order for more people to benefit from the advances in pharmacy, we are dedicated to defining what’s next in total drug management.
Drug spend managed
2020 $34.2 billion
2021 $36.2 billion (estimated)
Annual claim volume
2020 370 million
2021 393 million (estimated)
When different is good
At Prime, we’re not like other PBMs. We don’t have millions of shareholders. We’re owned by the clients we support — 19 not‑for‑profit Blue Plans that serve state and regional markets — which helps us focus on outcomes, not just income.
Through this unique Blue + Prime partnership, we provide total drug management. By integrating drug management — across both the medical benefit and pharmacy benefit — we can improve health outcomes and reduce costs.
Making health care work better for people
With prescription drugs now accounting for more than 30 percent of total health care costs, our role as a strategic partner is growing. The value we bring lies in innovative collaborations, cost competitiveness, service excellence and quality of care.
- Collaborations with stakeholders like Express Scripts and Walgreens mean our clients and members pay competitive prices for the medicines they need.
- Clinical programs combine data analytics with customized outreach — including high-touch, personalized interventions by pharmacists — to help members and prescribers make better drug management decisions.
- Market-leading analytic tools — including predictive analytics — fuel our award-winning health outcomes research. Our clients are equipped to make informed choices using near real-time data.
- Our decade-long campaign against opioid abuse earned the 2018 Excellence Award from the Pharmacy Benefit Management Institute (PBMI).
- Our fraud, waste and abuse (FWA) program earned us the #2 spot among health care companies on Fast Company’s “Most Innovative Companies List” for 2020.
Leading the way
At Prime, we think differently. We act differently.
Through our superior partnership model and consumer-centric innovation, we’re leading the market in delivering total drug management solutions that put people first. In a complex and often fragmented industry, that’s a difference that makes a difference.
Locations and employees
Headquarters: Eagan, Minnesota
Regional offices: Omaha, NE; Albuquerque, NM
September 23, 2021
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