New data supports the value of pharmacy integration

When purchasing health insurance, decision makers are faced with the question of whether to include pharmacy benefits as part of the total health package, or a carve-out model as a separate benefit administered by an external pharmacy benefit manager (PBM).

A recent two-year analysis conducted by Blue Cross® and Blue Shield® of Minnesota and Prime Therapeutics brings new evidence to light for employers considering these options.

The analysis compared the per-member, per-year (PMPY) allowed medical costs, hospitalizations and emergency room visits of commercially insured members with chronic conditions to those with carve-out benefits.

Results

Integrating pharmacy and medical with Blue Cross and Blue Shield of Minnesota demonstrated significant savings over the carve-out model:

• $422 average savings on medical costs PMPY* compared to $148 from a leading competitor
• 17% lower hospitalization rates*
• 13% fewer emergency room visits*

Blue Cross and Blue Shield of Minnesota members using specialty drugs and integrated benefits, compared to those with a carve-out PBM, were found to have:

• 22% overall lower hospitalization rates*
• 21% overall lower medical costs*

Contact your Blue Cross representative to discuss how integration could benefit your business.