Leveraging integrated data to help identify high-impact savings opportunities

 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.

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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.

Integrates pharmacy and medical data

HighTouchRx identifies 1,000+ medical drugs and pharmacy savings opportunities.

Offers specialized outreach

Clinical pharmacists partner with health plans to provide high-touch outreach.

Improves care

HighTouchRx promotes member safety and savings opportunities.

Quickly locate high-cost members and offer interventions

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Case study

Optimized vial medical claims

Analytic intel + insights

HighTouchRx identified 576 non-optimized vial medical claims across 30 drugs for one Blue plan.


The Prime team provided the plan with information on the non-optimized claims, along with a medical policy edit process recommendation.


The plan implemented proactive medical edits to prevent payment for non-optimized drug vials in accordance with their provider policy.

Significant savings from capsules

Analytic intel + insights

HighTouchRX identifies potential savings due to a cost difference between Imbruvica® tablets and capsules.


Prime contacted prescriber to recommend a change to capsules and an update to the prior authorization to allow for this coverage.


The health plan realized substantial savings – with zero out-of-pocket impact to the member.

Fewer injections, better experience, lower costs

Analytic intel + insights

HighTouchRx determined that a member was using two strengths of Trulicity® to control their diabetes.


Prime contacted the member’s provided to recommend a prescription adjustment after the release of a new high-strength formula.


The provider adjusted the prescription, meaning fewer injections for the members and savings for the health plan and member.

Plan and member savings from generics

Analytic intel + insights

HighTouchRx identifies a member who was taking a name brand medication, Sabril®, when a cost-saving, clinically effective generic was available.


Prime reached out to the prescriber to recommend a change to the generic based on availability and cost.


Both the member and health plan realized significant savings thanks to a change to the lower-cost generic.

Better care at a lower cost

Analytic intel + insights

HighTouchRx identifies a member using a high number of expensive, low-strength Cabometyx tabs.


The Prime pharmacist and provided agreed to consolidate doses, then contacted the member and pharmacy.


The member’s pill burden was reduced resulting in improved care and reduces costs.


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.



September 15, 2021

Prime’s High-Value Pharmacist Managed Care pilots win PBMI Excellence Award

Pilots achieve proven ROI for high-touch pharmacist services

Press releases

April 15, 2020

Managed care pharmacist program sees 9:1 return on investment

Prime Therapeutics saves health plan clients a net $2.4 million savings in one year