Prime Therapeutics, Blue Cross and Blue Shield of North Carolina partner on drug cost comparison tool, improving transparency and helping members reduce prescription costs

Consumers are frustrated by a complex health care system and lack of drug pricing transparency. At the same time, a record-breaking number of new, more expensive drugs are coming to market each year, and drug therapy continues to be used more often in a patient’s overall care plan. As a result, it’s extremely important that people leave their doctor’s office with the best possible prescription at the lowest possible price. Since Prime Therapeutics (Prime) and Blue Cross and Blue Shield of North Carolina (Blue Cross NC) are closely aligned on simplifying health care and providing a variety of solutions that put information at members’ fingertips, it made sense to work together to help members lower their out-of-pocket prescription drug costs.

Earlier this year, Blue Cross NC launched Rx Savings Solutions, a software tool that alerts members to possible drug cost savings opportunities via email or text message. The tool creates customized recommendations based on members’ formularies and plan designs. Prime’s claims engine works in the background to power the Rx Savings Solutions software with member benefit information and drug claim history, and current pricing at various in-network pharmacies near that member. This real-time information helps pinpoint drug savings opportunities customized for that particular member in an effort to help them save on their drug costs.

“In an era where consumers are demanding more information on drug prices at their fingertips, Prime offers an array of tools that provide transparency across the health care continuum – from provider to member to pharmacy,” said Laura Terry, vice president, marketing and communications at Prime. “Through our superior partnership model with Blue Plans, Prime is actively testing a number of transparency solutions – Rx Savings Solutions being one of them – so we can quickly innovate and scale our product offerings. These consumer-centric tools simplify health care and empower the family CEO to make more informed health care decisions.”

Members who have opted into Blue Cross NC’s BlueConnectSM platform can use Rx Savings Solutions to see drug savings opportunities online. Using a mobile app or by accessing the member portal, members can see:

• Alternative drugs that are equally safe and effective – but cost less.
• Alternative pharmacies with a cost comparison between locations.
• Different drug formulations available that may provide savings, e.g., cream vs. ointment.

When members choose to switch to a lower cost drug, Rx Savings Solutions provides an easy, preformatted letter to send to their doctor requesting a new prescription. Rx Savings Solutions has seen on average members saving $153 per fill.

“Blue Cross NC is committed to transforming the health care system for better, simpler, more affordable health care and addressing the cost of prescription drugs is critical to that work,” said Estay Greene, Blue Cross NC vice president of pharmacy services. “Rx Savings Solutions is a powerful tool to help members make well-informed health care decisions when it comes to their prescriptions. “Transformation of health care starts with total drug management and involving all parts of the system, including the patient. Rx Savings Solutions is just one example of how Prime Therapeutics and its Blue Plans can manage both medical and pharmacy drug therapies to help achieve the lowest total cost of care.

Prime’s suite of cost transparency tools.