Pharmacy Benefit Management Institute (PBMI) honors IntegratedRx program with Excellence Award

Prime Therapeutics/Magellan Rx Management (Prime/Magellan Rx) has reimagined the cancer and cystic fibrosis care journey through IntegratedRx^®, an integrated care solution that helps patients receive medicines through their provider or care system’s integrated specialty pharmacy where the provider and pharmacist are a coordinated team. The IntegratedRx solution provides a better experience, promoting faster treatment start times, lower drug costs and coordinated care between providers and pharmacists. The Pharmacy Benefit Management Institute (PBMI) recently honored the IntegratedRx solution with a 2024 Excellence Award in the category of cost containment.

“We created IntegratedRx because, unlike other PBMs, we don’t have to think about having medications filled from our own pharmacy,” said Marci Conlin, vice president of pharmacy network management. “We’re able to ask, what’s the best pharmacy for you?”

IntegratedRx’s whole-person treatment approach helps Prime/Magellan Rx provide human-focused care that helps simplify a complex health system. Using a medically integrated dispensing model, IntegratedRx can reduce pharmacy costs, improve patient satisfaction and decrease total cost of care. IntegratedRx has a 95% member satisfaction rate and a Net Promoter Score^® of 80 compared to 81% overall satisfaction with central fill, according to Prime/Magellan Rx internal data from 2023.

Using integrated care models also curbs waste due to medication overfills, translating to potential savings of over $1 million. IntegratedRx – Oncology has achieved $5,000 annual savings per utilizing member and a $1,000 total savings per claim, and IntegratedRx – Cystic Fibrosis has proven its potential to save clients $20,000 annually per utilizing member, according to internal data. Research shows that integrated care also leads to up to a 15% increased adherence compared to central fill pharmacy.

Prime previously won a 2021 PBMI Excellence Award in the cost containment category for its High-Value Pharmacist Managed Care pilots, which leveraged the carve-in pharmacy benefit manager alignment within the health plan and integrated medical and pharmacy claims from Prime’s industry-leading data and analytics tool, as well as in 2018 for its Controlled Substance Management Program, which was recognized in the Opioid Management Strategies category. The program uses a comprehensive approach to identify individuals who are at risk of controlled substance misuse and encourages them to pursue programs to help reduce their risk.

Prime/Magellan Rx accepted the Excellence Award on Sept. 4 at the PBMI Annual National Conference in Orlando, Florida. During the conference, Managed Healthcare Executive celebrated its Emerging Leaders in Healthcare honorees, including one of Prime/Magellan Rx’s specialty clinicians.