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

Watch

Case 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…