A new Premera program
gives customers and their doctors information to avoid high prescription
drug prices. The program saved customers more than $5 million in its first
Here's how it works:
- Premera's pharmacy team scans customer claims
for unusual price spikes for prescription drugs.
- When a drug price hits a specific cap, we
start a rapid-response team. They determine if lower-cost options are
available that could provide the same results.
- The team initiates communications with doctors
and customers to notify them about their options. Those options could include
generic drugs or lower-priced brands.
- Doctors have the choice to discuss similar
treatment options with their patients when it's appropriate.
“When we find a drug
with a large price change, we now can take immediate action to assist our
customers and their doctors to find a clinically appropriate, more affordable
alternative,” said Premera Pharmacy Manager Dan Danielson.
Sometimes Premera puts
pre-approval requirements in place for the more expensive drug. That causes
doctors to explain why the costlier drug is necessary. This may seem
inconvenient, but it also may save customers money if they haven't already
tried an alternative drug.
“This gives us time to
contact prescribing doctors and let them know of the change,” Danielson said.
“When we learn of an eye-popping price increase, we can encourage doctors to
move their patients to alternative therapies as soon as possible.”
You may pay less when
you pick up your prescription at the pharmacy. That's especially true if you
have a high-deductible health plan.
But even if you pay
the same amount, the change could mean you pay less for your healthcare. When
more customers choose lower-cost alternatives, it helps keep premium prices
lower for everyone.
Premera’s pharmacy benefits
Check out our pharmacy benefit guide, learn about mail-order prescriptions, discover how to save money with generic drugs, and more at our pharmacy page!Explore pharmacy services
A $500,000 increase in
drug spending is enough to trigger a premium rate increase. This program aims
to inform customers and their doctors about their options before that happens
by addressing increases of at least $50,000. That could be a very common drug
with a small price increase or a more rare treatment that's quadrupled in
For more information on
what Premera is doing to help customers with rising prescription drug prices: