Getting our annual physical: Prime assesses its commercial products

Helping people to feel better and live well is not a race, but a journey. For decades, Prime has brought innovation and leadership to pharmacy benefit management through industry research and insight. And as we move forward, we routinely work with outside research firms to honestly look at our company, our products, and how we live up to our purpose.

The who, what and how

As we’ve done in previous years, Prime brought in an independent third party to assess our commercial product capabilities against the market. The assessment was done via interviews with consultants who had various levels of interaction with Prime in 2014.

2015: Competing and improving

Our most recent assessment shows that Prime “offers a competitive commercial offering, with some products showing significant improvement in the last year.”[1] Overall, this was expected as we have continued to grow by focusing on products that best match the needs of the marketplace. Our core services — administration, benefit design, formulary and network management — stand up to other pharmacy benefit managers (PBMs), as they should.

Where we lead

  • Specialty — Split fill and reimbursement solutions are considered leading against other PBMs.
  • Core services — Prime continues to successfully compete with most of our offerings.
  • Clinical solutions — Results show commercial medication therapy management and electronic prior authorization (ePA) as market leading.

Where we are growing

  • ePA — Prime’s efforts are recognized as leading in an area where most PBMs are struggling.
  • ePrescribing — Prime is perceived as a market leader.
  • Specialty benefit support — Prime made notable strides in both specialty benefit support and prescription processing.

Where we will learn

  • PrimeMail® — Home delivery is a core function expected by the market. The perception is that Prime lags in dispensing speed and does not handle mandatory mail efficiently. 
  • Value-based design — Consultants believe Prime needs to catch up in marketing and administration of value-based benefit designs, including traditional and consumer-directed plans.
  • 90-day supplies of medicines — Prime is perceived as being behind in the 90-day market. However, 90DayMyWay™ was not offered at the time of the assessment.

It’s not what you know, but what you do.

While Prime was ranked on commercial offerings, and how they compare to the market, we mined many insights from consultant commentary. Their willingness to talk to us gave us good information about the industry’s perception of Prime which showed us areas to focus.

Prime will continue to be thought leaders in the marketplace through competitive products. In partnership with our clients, our integration and commitment to the member will continue to provide unsurpassed value both in overall cost of care and superior clinical outcomes.

Faster prior authorization benefits everyone. Read more.


[1] Bridge Competitive Assessment, March 24, 2015

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