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. 

Read the full white paper

When you integrate pharmacy with medical benefits, you’ll see savings. Let us show you why.

Changing the way we do pharmacy

We’re teaming up with the right people to bring the best pharmacy solutions to you. 

See disclaimer below 1

Integration makes things better

Highmark clients with integrated pharmacy can save an average of $230 per member per year.2

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. 

See how our pharmacy benefits work

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

Utilization Management

This helps drive members to quality, affordable medications. Save up to 6.9%.3

Network Management4

Choose pharmacy networks to balance cost and access for all prescription needs. Save up to 2.25%.3

Specialty Drug Management

Our exclusive specialty pharmacy relationships result in better care for members. Save up to 25%.5

Customized Plan Design6

A few extra cost-sharing options like copayment, coinsurance, and mail-order pharmacy that can save you money. Save up to 7%.3

Formulary Management

Choose the best formulary to give access to appropriate, affordable drugs. Save up to 6%.3

Coordinated Care

Support members with a team of on-staff pharmacists, case managers, and health coaches. Save up to 0.6%.3

Let's get you integrated

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

1 By accessing this video, I understand that I am leaving the Highmark website and I will be re-directed to an external website operated by a third-party platform provider. I acknowledge that the platform provider may collect personal information about me, and about the video that I view, on their platform and may use and disclose this information in accordance with its privacy policy. I agree that Highmark is not responsible for the data collection and use practices of this third party.

2Findings 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.

3The savings maximum is an estimate based on adding multiple programs in the Six Strategies bucket; actual savings vary based on current benefit setup.

4Network Management is not available to fully insured groups in Delaware; only available to ASO groups.

5Save up to 25% on medical specialty, site of care drugs.

6In Delaware, member copays cannot vary based on whether the prescription is obtained via retail or mail order.