Blue Cross programs target lower costs and medication adherence

Every medication says it on the label: Take as directed. Yet many people don’t. Their health suffers as a result. The cost of prescription medication is often a barrier that prevents people from refilling and taking their medication as directed. Blue Cross Blue Shield of Michigan and Blue Care Network’s programs help members take their medications as prescribed and save money.

Drug Adherence Discount Program

It’s fairly common for patients not to take their medications as prescribed. But Blue Cross has been successful in increasing medication adherence among our members.

In 2020, the Drug Adherence Discount Program, powered by Sempre Health, was introduced as a coupon program that encourages timely prescription refills for select maintenance medications. The program uses digital technology, such as text messages, to remind enrollees to fill their medications on time. Those who adhere to their drug therapies, as prescribed by their physician, are rewarded with discounts on their prescriptions for select medications.

Since this program began:

• Members participating in the program have saved over $5.6 million.
• More than 118,000 prescriptions have been filled.

The longer members receive on-time refills, the greater their discounts become for covered medications.

“We really couldn’t be more pleased with the results of our great partnership with the Sempre Health team,” said Kim Foerster, director, Pharmacy Account Management. “They continue to go above and beyond to ensure a great experience for our members that has resulted in significant savings. This collaborative effort allowed us to expand the program in January to now also include home delivery prescriptions. They are also working diligently on expanding the list of drugs covered by the program.”

While this is a significant success, Foerster says Blue Cross is still working to increase the number of members taking advantage of this program.

High-Cost Drug Discount Optimization Program

Blue Cross’ High-Cost Drug Discount Optimization Program, powered by PillarRx, is expanding. The program, started in 2020, uses copay assistance to pay most or all of a member’s prescription copay. In July, almost all the groups with a health savings account or deductible were able to opt in.

“This is really exciting,” Foerster said. “More members will be able to reduce their out-of-pocket costs on more than 300 high-cost drugs. And they don’t have to jump through hoops. PillarRx calls them, explains the program and answers their questions.”

The program includes expensive medications obtained at retail and specialty pharmacies so it’s not limited to exclusive specialty pharmacy arrangements.

Blue Cross and BCN identify eligible members based on their claims history for drugs included in the program. After enrolling, the member can save a significant amount of money. They may even pay nothing for their medication refills. In addition to cost savings, the program improves medication adherence and patient health outcomes.

Blue Cross Blue Shield of Michigan and Blue Care Network have contracted with Sempre Health, an independent company, to provide a drug discount program.

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