Uncovering High-Impact Savings | The HighTouchRx Approach - Prime Therapeutics
Power your success with combined pharmacy and medical data
Integrated data. Actionable insights. Pharmacist outreach. All in one innovative product.
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 $100M.
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
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.
Outreach
The provider adjusted the prescription, meaning fewer injections for the members and savings for the health plan and member.
$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.
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