Managing the rising costs of prescription drugs is prime for Prime Therapeutics. The company, a pharmacy benefits manager (PBM), is owned by and provides services to about a dozen Blue Cross Blue Shield organizations and their members. Prime also services other health care plans used by unions, employers, and third-party administrators, ultimately serving about 20 million members. The company's clients benefit from services that include pharmacy network management, benefit administration, claims processing, marketing support, report building, and formulary design, a process through which drugs are approved for use in a network.
Prime Therapeutics serves nearly 20 million people nationwide. Prime's Blue Plan owner clients include: Alabama, Florida, Illinois, Kansas, Minnesota, Montana, Nebraska, New Mexico, North Dakota, North Carolina, Oklahoma, Texas, and Wyoming.
In addition to serving insurance companies, Prime offers services that are targeted directly to the clients' members. Prime administers Medicare Part D programs through a government program department devoted to the federal government's prescription drug coverage program. Additionally, Prime operates a mail order pharmacy, PrimeMail, which fills prescriptions from facilities in New Mexico and Texas.
The company is seeking to lower medical costs and enhance medication outcomes by improving its information technology systems. Prime licenses software from SXC Health Solutions to manage its retail and mail-order pharmacy transactions.
Prime was founded in 1998 after the merger of Pharmacy Gold, a formulary and clinical services provider, and claims processor ProPar Services. – less