HEALTH PLAN/PHARMACY BENEFIT MANAGER COLLABORATIVE RESEARCH

摘要

Prime Therapeutics is a pharmacy benefit manager (PBM) co-owned by 12 Blue Cross and Blue Shield plans. As a health plan-owned PBM, not only does Prime Therapeutics have real-time access to prescription claims data, it also has access to medical claim information that can be integrated to perform collaborative comparative-effectiveness research. For example, integrated medical and pharmacy data broadens our ability to conduct comprehensive research into pharmaceutical utilization and cost by diagnosis. Understanding the condition prevalence, pharmaceutical treatment rates, and the total cost of care is essential to ensuring insured individuals are receiving optimal cost-effective medication therapy management.