Health e-Blue guide explains how to access pharmacy data, identify cost-saving

Pharmacy Opportunities Focus: Health e-Blue Pharmacy 2020 is a step-by-step guide to help navigate Health e-Blue. The guide contains details on how to obtain pharmacy claims data as well as how to generate the pharmacy profile report of a primary care physician.

Below are recommendations when looking through pharmacy data to identify potential cost-savings opportunities:

• For moving from brand-name medications to generics: Compare pharmacy claims data with the drug lists.**
• For leveraging the preferred alternatives of a member’s respective drug list:
• Download the free ScriptVision™ Physician App through the App Store^® for your iPhone or iPad. In real time, see the member’s cost share, any plan requirements (for example, prior authorization, step therapy, quantity limit) and lower-cost alternatives.
• Review the spring 2020 opportunities handout for high-cost drugs and lower cost alternatives. It can serve as a quick reference.
• For improving the generic prescribing rates of primary care physicians: Use the physician profile report for details on certain drugs or members.
• For monitoring specialists who prescribe brand-name drugs when a generic is available or nonpreferred drugs when preferred alternatives are available: Identify the specialists and the approach for discussion.

The suggestions above are general guidelines. As always, use clinical judgment to determine the most appropriate option for each patient’s specific circumstances.

The information in this article applies to all members with Blue Cross Blue Shield of Michigan and Blue Care Network commercial pharmacy plans.

**The drug lists are updated on a monthly basis (for example, new drug approvals, new safety or efficacy data, clinical guideline updates). Please refer to the online documents for the most up-to-date versions.