How Would Integrating Pharmacy and Medical Benefits Lead to Better Analyses of a Drug's Value?

Video

Jon Gavras, MD, chief medical officer at Prime Therapeutics, explores how combining medical and pharmacy benefits could result in a better understanding of a certain drug's value.

Gavras: Many specialty medications are administered from both the medical benefit and the pharmacy benefit. For instance, an autoimmune disorder is almost split 50/50. Since these patients are so complex, that are on a specialty medication, you really want to understand all the complex conditions that those members have and look at them much more holistically. Therefore, you really need to look at both the medical and pharmacy benefit and how that benefit is applied. At Prime Therapeutics, we are in a very unique situation in that with our clients we have a very integrative model where we have not just their pharmacy data but all their medical claims data; so we can take a much more holistic view of that member. And we’ve demonstrated over time that as we help manage that medical benefit for that patient that we actually, last year alone, saved over $45 million for our health plans.

Related Videos
Semaglutide Ozempic injection control blood sugar levels | Image Credit: myskin - stock.adobe.com
Image credit: motortion | stock.adobe.com - Young depressed woman talking to lady psychologist during session, mental health
Image credit: Sergey | stock.adobe.com - Unhappy woman with insomnia lying on bed next to alarm clock at night
Image credit:  Chanintorn.v | stock.adobe.com - PTSD Mental health concept, Psychologist sitting and touch hand young depressed asian man for encouragement near window with low light environment.Selective focus.
Image credit:  JPC-PROD | stock.adobe.com - Choosing method of contraception : Birth control pills, an injection syringe, condom, IUD-method, on grey
Image credit: сергей костюченко | stock.adobe.com - human head with brain
Image credit: photoopus | stock.adobe.com Borderline personality disorder (BPD) Mental Illness. Banner and Concept Image.
Schizophrenia - Image credit: freshidea | stock.adobe.com
© 2024 MJH Life Sciences

All rights reserved.