Finding high-cost savings opportunities for members with specialty conditions
Only 1% of members account for 50% of specialty drug spend. Finding members with complex conditions and determining drug therapy intervention opportunities helps lower costs for health plans and members.
HighTouchRx®
We combine integrated data, actionable insights and pharmacist outreach in one innovative product
HighTouchRx uses exclusive clinical predictive modeling applied to medical and pharmacy data, making it easy to quickly locate high-cost members and offer interventions.
Integrated pharmacy and medical data
Identifies more than 1000 medical drug and pharmacy drug savings opportunities.
Specialized pharmacists to perform outreach
Specially-trained pharmacists, in partnership with Blue Plans, conduct high-touch outreach.
Improves member care
Ensures members with specialty conditions are using their medication in a safe, cost-effective way.
Quickly locate high-cost members and offer interventions
WatchCase study
Dispensing optimization
Analytic intel + insights
HighTouchRx identified a member using a high number of expensive, low-strength Cabometyx tabs.
Outreach
The Prime pharmacist and provider agreed to consolidate doses, then contacted the member and pharmacy.
Optimization
The member’s pill burden was reduced, resulting in better care at a lower cost.
Case study
Vial optimization
Analytic intel + insights
HighTouchRx identified 576 non-optimized vial medical claims across 30 drugs for one Blue plan.
Outreach
The Prime team gave information to the plan on the non-optimized claims and medical policy edit process recommendation.
Optimization
Plan implemented proactive medical edits to prevent payment for non-optimized drug vials in accordance with the plan’s provider policy.
Recognition
HighTouchRx pilots awarded for cost containment
The Pharmacy Benefit Management Institute (PBMI) awarded Prime Therapeutics’ HighTouchRx managed care pilots with a 2021 Excellence Award in the category of cost containment.
NEWS
Press releases
January 11, 2022
Prime Therapeutics introduces HighTouchRx® pharmacist outreach program using both medical and pharmacy data to help maximize savings
EAGAN, Minn. – Leading pharmacy benefit manager (PBM) Prime Therapeutics LLC (Prime) announces…
Stories
September 15, 2021
Prime’s High-Value Pharmacist Managed Care pilots win PBMI Excellence Award
The Pharmacy Benefit Management Institute (PBMI) honored Prime Therapeutics’ High-Value Pharmacist Managed Care…
Press releases
April 15, 2020
Managed care pharmacist program sees 9:1 return on investment
EAGAN, Minn. – A program by pharmacy benefit manager (PBM) Prime Therapeutics LLC…