Prime Rolls Out New Medical Benefit Management Offering

As payers continue to look for ways to tackle the rising spending on specialty drugs, Prime Therapeutics LLC is launching a medical drug management program. Known as MedDrive, the offering will be rolled out in phases, with the initial one focused on increasing the use of biosimilars.

Last year, specialty drugs made up more than half of total drug spending for the first time. That trend shows no signs of slowing, as the pharmaceutical pipeline is full of specialty agents, including biosimilars. As of early July 2021, the FDA has approved 29 biosimilars, although not all have launched due to patent litigation. An IQVIA report published in September 2020 estimated that these products could decrease drug costs by $100 billion by 2024.

In April, Prime released a white paper on biosimilars indicating that the company “will actively promote the evidence-based use of biosimilars (and other low-cost drug options),” a position endorsed by the company’s pharmacy and therapeutics (P&T) committee. Prime is collectively owned by 19 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans; the PBM serves nearly 33 million people across 23 Blues plans. The P&T committee is made up of independent, practicing physicians and pharmacists who cover 25 medical and pharmacy specialties, as well as senior leadership from Prime’s Blues plans.

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