Prime saves $100 million in 4 years by keeping specialty pharmacy inside health systems

Through a system that integrates specialty pharmacy with health systems and doctors, Prime Therapeutics has been able to reduce costs for oral drugs for cancer and cystic fibrosis. For the last four years, Prime has been able to save $100 million with the use of its IntegratedRx platform.

Launched in 2022, IntegratedRx is a solution that gives prescribers and pharmacists a shared, real-time view of a patient’s electronic medical record. Within oncology, this integrated approach has resulted in average annual savings of approximately $5,200 per patient and reduced total medical costs by 9%. For patients with cystic fibrosis, there has been a $28,200 average annual savings per patient. IntegratedRx is available to approximately 30 million eligible people across oncology and cystic fibrosis through participating health plan and employer clients.

The IntegratedRx platform is part of a program that aims to keep access to care and dispensing where the provider is already seeing the patient, said Steve Cutts, Pharm.D., chief clinical and specialty officer for Prime.

“The crux of the solution to partner with health systems and pharmacies and providers to ensure that there’s a mechanism whereby they can continue to dispense medications, in this case, oral oncology as well as multiple or cystic fibrosis medications from their existing pharmacies as part of that integrated clinic,” he said in an interview.

The savings, Cutts said, come from the actual dispensing or overall drug cost discounts relative to the rates that are seen at central-fill pharmacies. Prime negotiates with more than 5,000 unique pharmacies across the country that are in their network. “We’re actually able to negotiate a better discount than they [payers] would have otherwise gotten.”

Cutts said the integrated program has improved the overall member experience. The program has provided increased speed for receiving prior authorizations for medications and has improved the timeliness of patients receiving their medications.

Related: Patients more likely to skip specialty medications when sent to pharmacies outside health system

In a study released in February 2026 in JMCP, researchers found patients do get their medications faster through an in-house hospital pharmacy, which improves adherence. In this analysis of prescriptions given at Vanderbilt University Medical Center compared with outside pharmacies, patients who had a prescription sent to an outside pharmacy had 60% higher odds of not picking up a prescription. Turnaround time for patients at a hospital pharmacy was a median of 3 (range of 1 to 6) days and a median of 4 (1 to 10) days for patients filling at an outside pharmacy.

IntegratedRx is a solution that sits on top of the usual pharmacy claims adjudication platform with additional application programming interfaces (APIs) that facilitate the experience with these individual contracted facilities. Since the program began, Prime has had 50,000 prescriptions flow through the program.

Cutts said they are seeing increased momentum in clients interested in the program. The PBM is planning to expand IntegratedRx into other disease areas.