PBM Alliance with Walgreens seeks to lower drug costs, improve outcomes

Published Online: Sep 01,2016
Laurie Toich, Assistant Editor
Drug costs have become a hot button issue throughout the healthcare and pharmaceutical industries, as patient outcomes and value-based care take center stage.
The US Centers for Medicare and Medicaid Services has focused on both aspects of healthcare through proposed rules and payment models, among other cost-controlling actions.
Executives at Prime Therapeutics, a pharmacy benefit manager owned by 14 Blue Cross Blue Shield plans, believe that cost control and improved patient care are both possible through their novel strategic alliance with retail pharmacy chain, Walgreens.
“Prime was one of the earliest to integrate the health plan and the PBM, but until this strategic alliance, nobody has successfully created an opportunity where the retail pharmacy network will be integrated with the PBM, who will also be integrated with the health plan; so that all are sharing information, strategies, and approaches to both the fulfillment of prescriptions and in assisting patients in properly utilizing the prescriptions and finding the lowest cost alternatives,” CEO and President of Prime Therapeutics Jim DuCharme told The American Journal of Pharmacy Benefits.
The strategic alliance will create a new organization that consolidates both companies’ central specialty and mail-order pharmacy businesses. This new company will be run by an independent management team, with an independent board, but will be owned by both Prime and Walgreens.
By aligning Prime’s 22 million customers with Walgreens’ retail pharmacy space, DuCharme predicts that drug costs will decrease.

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