Priority Health Outperforms Industry Benchmarks for Pharmacy Costs, Extends Partnership With Express Scripts

GRAND RAPIDS, Mich.--(BUSINESS WIRE)--Priority Health, a nationally recognized nonprofit health plan, announced today that it outperformed regional, national and coalition benchmarks for pharmacy costs by up to 30% in 2020*. The company is also extending its partnership with Express Scripts, one of the largest pharmacy benefit managers (PBM) in the nation through 2025.

Year-over-year, Priority Health continues to show the lowest cost trends when compared to coalitions, regional and national health plans. The organization also posted a decrease in their pharmacy costs from 2019 to 2020 of 2.9%*, delivering savings for Michigan employers and individuals looking to control rising pharmacy costs.

“Together, Priority Health and Express Scripts deliver cost-effective pharmacy benefits that our members need, giving them peace of mind about their coverage,” said Christina Barrington, Vice President of Pharmacy Programs at Priority Health. “Our partnership with Express Scripts is unique because due to their size and scale they can negotiate competitive pricing, a nationwide retail pharmacy network and specialty drug benefits, but then we take it a step further by using a customized formulary and utilization management approach to deliver additional savings and better medical outcomes for employers and our members.”

With health care quality and cost on everyone’s mind, an integrated medical and pharmacy benefit offers employers and members the opportunity to stay healthier, receive better care and get more value from their spend. That is why Priority Health recently conducted a market check to see if the Express Scripts relationship was still the best PBM partnership to achieve its goal of combating the rising medical prescription cost trend. Through this process, it was determined that the relationship is still very successful and competitive, allowing Priority Health to continue their focus on delivering sustainable savings for Michigan residents and employers. The organization will continue to evaluate the success of this relationship annually to ensure it’s delivering for Michigan.

Priority Health leads the industry with a passion for price transparency for both members and prescribers. That is why it offers its members the Cost Estimator tool, which allows them to search the name of their prescription to see the price as well as other cost-effective alternatives such as generic and biosimilars. Priority Health offers a similar tool for prescribers to help educate on the cost implications of certain therapies and works to shift prescribing trends.

*Source: 2020 ESI Drug Trend Benchmark Report, based off Priority Health ASO 2020 PMPM performance.

For more information, visit priorityhealth.com.

About Priority Health:

With over 30 years in business, Priority Health is the second largest health plan in Michigan, offering a broad portfolio of health benefits options for employer groups and individuals, including Medicare and Medicaid plans. Serving more than a million members each year and offering a broad network of primary care physicians in Michigan, Priority Health continues to be recognized as a leader for quality, customer service, transparency and product innovation. Learn more about affordable, quality health coverage options from Priority Health.