Managing specialty conditions

Specialty drug costs are on a meteoric rise, now exceeding 55% of total drug spend.1 What’s more, 35% of total drug spend is driven by medical drug spend.2 Integrated solutions and strategies – across both medical and pharmacy benefits – help you successfully navigate the complicated and evolving specialty landscape.

Lowering drug costs with biosimilars

Make sure your employees have access to the best treatments. Biologic drugs are changing lives for the people who need them – but often at a very high cost. BCBSAL and Prime promote the use of evidence-based biosimilar drugs that may cost up to 35% less while delivering the same outcomes.3

Greater savings potential, ease and expanded pharmacy options

FlexAccess™ is a copay assistance solution using Prime’s channel-optimized model to give your employees the best available discount when they get their higher-cost medicines. Not only can your employees see copays as low as $0, they may also be able to get their medicines from a broader range of in-network pharmacies, including specialty and retail locations.

FlexAccess is only available for self-funded groups.

Less waste, more savings opportunities

Certain high-cost medications may cause adverse side effects. For these medications, Prime provides a split, or partial, fill prescription with a prorated copay to align with the number of pills dispensed. This gives your employee the opportunity to try a medication to determine the existence and severity of side effects before continuing therapy, potentially saving money and reducing waste.

1IQVIA Institute for Human Data Science. (2022, April). The use of medicines in the U.S. 2022. https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-use-of-medicines-in-the-us-2022/iqvia-institute-the-use-of-medicines-in-the-us-2022.pdf
2Pharmaceutical Strategies Group, LLC. (2022). 2022 Artemetrx® state of specialty spend and trend report.https://www.psgconsults.com/specialtyreport2022
3Roy, Avik and The Apothecary. (2019, March 8). Biologic medicines: The biggest driver of rising drug prices. Forbes.https://www.forbes.com/sites/theapothecary/2019/03/08/biologic-medicines-the-biggest-driver-of-rising-drug-prices/?sh=37c36b0718b0

Exclusions may apply.

BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans that includes Blue Cross and Blue Shield of Alabama.

Prime Therapeutics LLC is an independent company contracted by Blue Cross and Blue Shield of Alabama to provide pharmacy benefit management services. Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.