I think this is a good, bold move. Prime Therapeutics has launched four new programs. The most aggressive is called Reliance and guarantees your net spend per Rx at $47. The easy way to do this would be to exclude specialty drugs and basically offer a generics-only formulary. My quick read from their drug trend report and press release is that it includes specialty drugs. It also includes a lot of utilization management programs, suggestions on plan design, encouragement for mail order, and other features. I’ll be interested to see the adoption of the program or whether it’s just a great program to encourage clients to consider new, more aggressive plan designs.
“Our Reliance plan keeps costs predictable for plan sponsors,” said Michael Showalter, Prime Chief Marketing Officer. “The goal is to make pharmacy benefits easy, understandable and affordable. Through Reliance, there will be no surprises, allowing organizations to better plan for and manage their pharmacy costs and reduce overall health care costs, while providing excellent benefits. We provide a single number demonstrating the true cost of care – $47. We are the only PBM to back that up with a price guarantee and complete price transparency.”
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