SOURCE: Pharmacy Benefit Management Institute

Pharmacy Benefit Management Institute

March 03, 2015 11:00 ET

PBMI Announces Prime Therapeutics as the 2015 Rx Benefit Innovation Award Winner

PLANO, TX--(Marketwired - Mar 3, 2015) -  The Pharmacy Benefit Management Institute presented Prime Therapeutics LLC (Prime) with the 2015 Rx Benefit Innovation Award earlier today at its 20th Annual Drug Benefit Conference held in San Antonio, Texas. This award is given to organizations that demonstrate innovative management approaches to address drug benefit challenges.

Prime is being recognized for its creation of a Specialty Drug Watch List. Prime first used this "early warning tool" with the introduction of two new drugs released in late 2013 to treat the hepatitis C virus (HCV). Prime predicted the impact of these medications to increase costs to health plans by 800% in 2014. This Specialty Drug Watch List provides clients with clinical intelligence for actionable decision making around popular drug launches. 

To help proactively manage this drug class, Prime improved its operational readiness by implementing the following:

  • Fast Path Process - enables utilization management and approvals by plans prior to drug launch
  • Off-Cycle Pharmacy and Therapeutics (P&T) Committee meetings - reviews safety and efficacy of drugs in an expedited manner
  • Revised trend impact estimator - ability to anticipate a drug's per member per month (PMPM) impact on medical and pharmacy benefit based on analysis of claims data and additional diagnosis and testing analysis
  • Evaluation of new products while working with manufacturers to leverage discounts

In addition to the aforementioned practices, Prime also implemented comprehensive communication strategies and programs to help eligible members afford these medications. 

As a result of these Specialty Drug Watch List efforts to specifically manage hepatitis C, Prime's clients were able to take proactive comprehensive management steps that trimmed their HCV drug costs by 38% in 2014.

Click here to learn more about this case study.

About PBMI

The mission of the Pharmacy Benefit Management Institute (PBMI) is to create the industry's premier forum for health care purchasers to exchange ideas, advance best practices, and drive appropriate changes in the pharmacy benefit management marketplace.

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