Prime Therapeutics cuts member drug costs 26% with focus on biosimilars

 Prime Therapeutics cut per member per month drug costs by 26% in one year through its MedDrive program, which leverages biosimilars to help drive down expenses.

The program uses advanced analytics to flag ways that health plans can cut down drug spend, with a particular focus on the potential of biosimilars. Pharmacy benefit managers are betting on biosimilar products to introduce new competition to popular branded products and drive down costs.

Prime, which serves 33 million members across 23 Blue Cross Blue Shield plans, first launched MedDrive in May 2021 and in its first year the program drove savings by focusing on just three biosimilar categories, the PBM said. Cancer drugs led the way for savings.

“Drug prices continue to rise, which puts pressure both on insurers and the members they serve,” said Kelly McGrail-Pokuta, vice president of trade relations and strategy and chief trade relations officer at Prime, in a statement. “MedDrive leverages the collective strengths of Blue plans and Prime to put the brakes on medical drug spend without compromising patient care.”

In addition to identifying when biosimilars may be useful in lowering costs, MedDrive proactively identifies the factors driving a client health plan's spend to identify other solutions that could decrease drug-related expenses, Prime said. The program will also flag other low-cost alternatives to branded medications beyond biosimilars.

Pokuta wrote in an accompanying blog post that while biosimilars hold significant promise in reducing costs, they aren't a "silver bullet" for solving this challenge. That's why MedDrive is built on analytics that can identify multiple ways to address drug costs.

"Unfortunately, it’s not so simple. Managing both pharmacy and medical drug spend is a challenge for most in the industry due to a lack of integration," she wrote.

https://www.fiercehealthcare.com/payers/prime-therapeutics-cuts-member-drug-costs-26-focus-biosimilars