Union - Prime Therapeutics
Designed for unions, delivered with care
At Prime Therapeutics (Prime), we built our model around transparency, flexibility and aligned incentives from the start. We don’t just help unions respond to change — we help you lead through it.
Integrated data reveals savings opportunities
Finding and supporting members with complex conditions helps lower costs for health plans, employers and members. HighTouchRx® applies exclusive clinical predictive modeling to your medical and pharmacy data, making it easy to quickly determine high-cost members and offer interventions. Since April 2022, HighTouchRx has saved commercial and Medicare plans over $150M.
Pharmacy + medical data
Identify 1,000+ medical drugs and pharmacy savings opportunities.
Specialized outreach
Partner with clinical pharmacists to provide high-touch outreach.
Improved care
Promote member safety and savings opportunities.
$11,500 employer group savings
Analytic intel + insights
HighTouchRx rules engine identified a member who recently initiated Mounjaro treatment and has continued their previously prescribed Ozempic. Member has continued to have both medications filled for the past two months.Outreach
The HighTouchRx pharmacist reached out directly to the member’s provider and encouraged consolidation to a single GLP-1 therapy to reduce costs and prevent adverse events.Optimization
The member discontinued Ozempic treatment and continued Mounjaro monotherapy for their diabetes treatment.
$129,000 annual health plan savings
Analytic intel + insights
HighTouchRx identified potential savings due to a cost difference between Imbruvica tablets and capsules.
Outreach
Prime contacted the prescriber to recommend a change to capsules and an update to the prior authorization to allow for this coverage.
Outcome
The health plan realized substantial savings — with zero out-of-pocket impact to the member.
$10,000 in health plan savings with $700 out-of-pocket member savings, annually
Outcome The provider adjusted the prescription, meaning fewer injections for the members and savings for the health plan and member.
Analytic intel + insights
HighTouchRx determined that a member was using two strengths of Trulicity to control their diabetes.
Outreach
Prime contacted the member’s provider to recommend a prescription adjustment after the release of a new high-strength formula.
Outcome
$200,000 health plan savings with $360 out-of-pocket member savings, annually
Analytic intel + insights
HighTouchRx identified a member who was taking a brand-name medication, Sabril, when a cost-saving, clinically effective generic was available.
Outreach
Prime reached out to the prescriber to recommend a change to the generic based on availability and cost.
Outcome
Both the member and health plan realized significant savings thanks to a change to the lower-cost generic.
Recognized for cost containment
The Academy of Managed Care Pharmacy (AMCP) awarded our HighTouchRx platinum for its significant impact in identifying and managing duplicate incretin therapies, demonstrating $3.5 million in validated savings and achieving a 66% success rate in transitioning patients to single-drug therapy.
Footnotes
*All brand names are property of their respective owners.
A tailored approach that puts your people first
Prime has always operated with a transparent, conflict-free model. We support collective bargaining principles and give union trustees the pricing visibility and fiduciary alignment they expect, not just because it’s required but because it’s right. Grounded in principles like ERISA and the Fair Wage Act, Prime’s approach reflects a deep respect for the protections and priorities that matter to union members. Our approach is rooted in trust, flexibility and a deep understanding of the relationships that drive union benefit plans.
We combine this foundation with the strength of a national pharmacy benefit manager (PBM), delivering:
We combine this foundation with the strength of a national pharmacy benefit manager (PBM), delivering:
Best-in-class pharmacy solutions
Our high-quality pharmacy benefit products are backed by the scale and strength of our national footprint — without compromising on flexibility or service.
Clinical and specialty expertise
Prime’s specialty drug management and clinical programs are designed to improve outcomes and reduce costs, tailored to the unique needs of union populations.
Proven onboarding protocols
With an established playbook for launching new union business, we ensure smooth transitions, clear communication and rapid implementation.
Member-centered engagement
Prime prioritizes the member experience with a patient-first approach, helping unions deliver care that’s personal, accessible and effective.
Grounded in shared values
We’re proud to work alongside organizations like LaborPress, Helmets to Hardhats and the Association of Benefit Administrators. Together, we're supporting workers, veterans and the legal protections that uphold union strength. These affiliations reflect our ongoing efforts to listen, learn and build meaningful relationships with the labor community.
Save, Simplify, Support™
Through our Save, Simplify, Support approach, Prime builds and curates solutions that are focused on three things that will always matter to unions and your members: saving on drug costs, simplifying the experience and supporting the best health outcomes.
Commitment in action
At Prime, we don’t just serve unions — we stand with them. Here are four real-world examples of how we deliver for labor funds:
A union client who had been with Prime for over a decade conducted a price check and issued an RFP. Despite exploring other options, they chose to stay with Prime, a testament to our responsiveness, value and long-term commitment.
In 2019, a labor client asked Prime to explore a new copay assistance model. We became the first PBM to work with Payer Matrix, giving the program a chance when others wouldn’t. Today, it’s a national hybrid solution born from union-driven innovation.
Unions don’t want cookie-cutter answers. Prime’s trade team works creatively and collaboratively to meet them where they are. When a challenge arises, we solve it together.
Prime isn’t just a vendor; we’re an extension of your fund. From trustee meetings to benefit fairs and community events, we show up. We help unions stand up projects quickly, offering the engine behind their plans: claims, clinical and formulary management.
Insights that matter to unions
Be in the know with ‘Pharmacy Friends’
Stay informed on the pharmacy trends that matter most. From benefit design to clinical innovation, this podcast series features Prime experts breaking down complex topics in a way that’s relevant to union leaders and benefit managers.
Fight fraud, waste & abuse (FWA)
Our Special Investigations Unit (SIU) uses advanced analytics and clinical oversight to uncover FWA and ensure safe, cost-effective care — aligning with union values of transparency and accountability. Recently, the SIU’s Jessica Johnson shared how Prime identifies cases of fraud with counterfeit GLP-1s.
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