A message from Atheer Kaddis, vice president, Pharmacy Services
We’re continuing our efforts to lower prescription drug costs and enhance pharmacy benefits

When we announced recently that our partner, Civica Rx, plans to produce three insulin medications and make them available to consumers next year at a significant discount, it marked the latest salvo in the war to combat rising drug costs.

As I’ve written in this newsletter over the past few years, Blue Cross Blue Shield of Michigan and Blue Care Network have been working to lower drug costs on many different fronts. Here’s an update on a few recent efforts:

High-Cost Drug Discount Optimization Program, powered by PillarRx  
Over the past three years, this initiative has helped members take advantage of manufacturer copayment assistance programs that significantly lower their out-of-pocket costs for more than 300 high-cost medications.

As of April 1, 2023, the PillarRx program was expanded to include nearly 50 high-volume diabetes and migraine drugs. This helps members afford their medications and adhere to their therapies as prescribed by their health care providers.

Drug Adherence Discount Program, powered by Sempre Health
We’re working with Sempre Health, a digital health technology company that helps members save money by reducing their out-of-pocket costs when they fill prescriptions for select brand-name medications as prescribed. Enrolled members who are adherent to their drug therapies are rewarded with discounts on their prescriptions. Each time they refill a prescription, they may receive a bigger discount.

Generics Advantage Program
GAP, our newest free adherence program, launched on March 1, 2023. The program helps BCN commercial members with pharmacy benefits to save money by reducing their out-of-pocket costs when they fill prescriptions for select generic medications as prescribed. As with the Drug Adherence Discount Program, but for generic medications, members who adhere to their drug therapies are rewarded with discounts on their prescriptions for select medications. Each time they refill a prescription they may receive a bigger discount.

Evio Pharmacy Solutions
In June 2021, Blue Cross partnered with four other Blue plans to launch Evio Pharmacy Solutions to lower the rising cost of prescription and specialty drugs affecting our customer groups and members. Evio uses real-world evidence to support a value-based model for pharmacy management, design best practice strategies for therapeutic management, build and acquire capabilities and work with innovators in the value chain for pharmacy and specialty pharmacy.

Blue Cross worked with its Evio partners recently to help launch Synergie Medication Collective, a group purchasing organization that’s focused on improving affordability and access to costly medical benefit drugs — ones that are injected or infused by a health care professional in a clinical setting. This effort is expected to benefit nearly 100 million people covered by Blue Cross Blue Shield plans across the United States.

Part of a larger effort
It’s gratifying to know that Blue Cross isn’t alone in its efforts to stem rising drug costs. Blue Cross President and CEO Daniel J. Loepp hosted a conversation with Gov. Gretchen Whitmer in February as she discussed her budget proposal with the business community at a Detroit Regional Chamber event — a conversation that included health care access and costs.

Gov. Whitmer has expressed an interest in establishing a Michigan-based insulin manufacturing facility to produce low-cost insulin for distribution in Michigan. “The cost of insulin is remarkably high compared with the rest of the world,” she said. “I think that states can lead, and we should. I am always mindful about how we can increase access, and this is one area.”

I’m pleased that Blue Cross, through its partnership with Civica Rx, is doing its part. Civica plans to set a recommended price to the consumer of no more than $30 per vial and no more than $55 for a box of five pen cartridges, a significant discount to prices charged to uninsured individuals today.

We’ll continue to keep our eye on ways to further reduce the cost of prescription drugs and enhance our pharmacy benefits. At Blue Cross, we believe medication should be both accessible and affordable.

Civica Rx is an independent company that will provide select generic drugs to Blue Cross Blue Shield of Michigan and Blue Care Network members.

PillarRx is an independent company providing Blue Cross Blue Shield of Michigan and Blue Care Network with a high-cost drug discount program.

Sempre Health is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to provide a drug discount program.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.