Helping to lower drug costs

Effective formularies are one of the best ways to ensure you have the lowest total cost of care, and a well-managed formulary starts with proactive, comprehensive pipeline management. Best of all, you have the flexibility to choose a drug mix that best meets your goals thanks to Prime’s highly configurable options for formulary management.

Integrated data to optimize drug use

With HighTouchRx®, Horizon and Prime apply machine learning across integrated end-to-end data from the pharmacy benefit (e.g., oral tablets) and medical benefit (e.g., IV drug infusions) to identify inappropriate use. Then, specialized pharmacists reach out to providers to recommend drug therapy optimization. Following pharmacist intervention, Prime provides reporting showing hard dollar savings.

HighTouchRx uncovers $30K in monthly savings

Prime identified an employee who was using a high-cost medication that involved two-tab doses, when the same dosage was available in one tab. By connecting the employee’s doctor and pharmacist, who agreed on the updated dosage, we were able to lower the employee’s drug cost and save the employer tens of thousands of dollars each month.3

1 Prime Therapeutics book of business data (2021 vs. 2020). Actual savings vary by group.
2 Prime internal data
3 Savings specific to health plan, not employer group

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey.