Pharmacy Solutions

Our pharmacy benefit team is reducing costs, improving quality, and helping people to better manage their care — and we've got the studies to prove it.
Drawing of a pharmacy and a compound drug mortar and pestle to illustrate Highmark pharmacy options

Changing the way we do pharmacy.

We're teaming up with the right people to bring the best pharmacy solutions to you. See how:

Integration makes things better.

Highmark clients with integrated pharmacy can save an average of $230 per member per year.*

Read the full white paper to find out more.

Integration also leads to shorter hospital stays, better chronic condition management, and better overall health for members in general. Now that’s a win-win scenario.

How our pharmacy benefits work.

We use six key strategies to help keep your costs down while keeping members healthy.

Drawing of prescription bottle to illustrate Highmark pharmacy benefits
Utilization Management

This helps drive members to quality, affordable medications. Save up to 6.9%.**

Network Management ****

Choose pharmacy networks to balance cost and access for all prescription needs. Save up to 2.25%.**

Specialty Drug Management

Our exclusive specialty pharmacy relationships can give you better care. Save up to 25%.***

Customized Plan Design *****

A few extra cost-sharing options like copayment, coinsurance, and mail-order pharmacy that can save you money. Save up to 7%.**

blood pressure
Illustration of inhaler, capsule and pills to show Highmark pharmacy benefits coverage.
Formulary Management

Choose the best formulary to give access to appropriate, affordable drugs. Save up to 6%.**

Coordinated Care

Support members with a team of on-staff pharmacists, case managers, and health coaches. Save up to 0.6%.**

Let's get you integrated

Our pharmacy solutions can improve lives and save your company money.

* Findings based on 2020 HealthScape Advisors study. HealthScape Advisors, an independent company, was engaged by Highmark to conduct an analysis of medical claims costs for ASO groups from 2017-2019.

** The savings maximum is an estimate based on adding multiple programs in the Six Strategies bucket; actual savings very based on current benefit setup.

*** Save up to 25% on medical specialty, site of care drugs.

**** Network Management is not available to fully insured groups in Delaware; only available to ASO groups.

***** In Delaware, member copays cannot vary based on whether the prescription is obtained via retail or mail order.