Prime Therapeutics Launches Pharmacy Solution for Specialty Drugs


Nathan Downhour, Pharm.D., discusses the Pharmacy Match program, which will engage with physicians to make sure a specialty prescription gets to the best-fit pharmacy across a network powered by Free Market Health.

A new solution from Prime Therapeutics and Magellan Rx Management offers a new way to find the pharmacies to provide specialty drugs. Called Pharmacy Match, the solution includes an expanded specialty pharmacy network and allows for real-time comparison of drug costs across the network.

Nathan Downhour, Pharm.D.

Nathan Downhour, Pharm.D.

“What we foresee is an improvement in affordability both for the patient as well as for our client,” Nathan Downhour, Pharm.D., senior vice president, pharmacy and care solutions at Prime/MRx, said in an interview. “Ultimately, we want to impact the affordability for patients and our clients. We want to impact the experience for both our patients and clients. We believe the best way to do that is to embrace other constituents in the delivery of healthcare.”

He said Pharmacy Match is a first step to create a system for specialty care that is intelligently designed, technology-enabled and that improves the experience for members, while eliminating complexities and driving savings.

Pharmacy Match is powered by Free Market Health, which launched in 2019 and partners with payers and specialty pharmacies to help manage specialty drug costs. Prime is not the first to team up with Free Market Health for a specialty drug solution. Earlier this year, Mercer, a business of Marsh McLennan, launched Mercer SelectRx, to access specialty drugs through a curated network of specialty pharmacies.

Related: Mercer Launches Technology Solution for Specialty Drugs

Prime’s Pharmacy Match was developed to work alongside utilization management programs and complement other programs such as IntegratedRx, a Prime solution for more complex conditions.

The new solution is customizable based on state regulations or by client preferences. “We’ve developed the program in a way that considers the entire supply chain value,” Downhour said. “We don't want to overemphasize unit costs, or savings through a drug-specific component at the expense of some other supply chain. We want to look at this holistically to ensure that we're improving the overall costs for our clients.”

Downhour said if clients elect to include Pharmacy Match program for their members, Prime and Free Market Health will engage with physicians to make sure a prescription gets to the best-fit pharmacy. “We will have a team that will help the patient along that journey, making sure they’re informed on who that best-fit pharmacy is and ensuring that they get that medication on time,” he said.

Cost options for Pharmacy Match, as well as potential savings, are still be determined, Downhour said. He said savings are expected because of the competitive environment for pharmacies and is expected also to flow downstream to both the client and the patient.

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