Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is launching IntegratedRx^™ for ASO groups with pharmacy benefit coverage through Blue Cross NC starting May 2, 2022.  

This new clinically integrated program streamlines the treatment pathway for members who are diagnosed with cancer so they can now receive their oral oncolytic and companion medications in the clinical setting directly from their oncologist’s clinic or affiliated hospital pharmacy.  

To incorporate IntegratedRx^™ into your patient’s care, you will need to self-identify (by applying and entering in agreement with Prime Therapeutics) that your health system is in the network and then the patient’s pharmacy would need to run a test claim (after prior authorization is approved) to determine if this Blue Cross NC member has this benefit. If the member does not have the IntegratedRx^™ benefit, they would receive their medication from their normal specialty pharmacy. 

MORE INFORMATION ON INTEGRATEDRX 

Prime Therapeutic’s IntegratedRx^™ network invites provider-based pharmacies to participate, allowing members to receive their medicine through their clinic’s integrated pharmacy. In this model where their provider and pharmacist are part of the same team, several advantages are unlocked: 

• Allows for direct lines of communication   
• Helps improve adherence   
• Shortens time to dispense   
• Creates a better member and provider experience from the first fill to the last fill 

Prime’s IntegratedRx^™ model is unique in that it does not restrict members to a central fill specialty pharmacy. This allows Prime to deliver a solution that works best for members by opening access to a drug channel that provides member centric care at competitive network costs. 

IntegratedRx^™ is currently focused on oral oncology drugs and oncology companion products only (pharmacy benefit). Prime plans to expand beyond oral oncology in the future and into other specialty disease states. The drug list is reviewed biannually and/or as new products come to market. 

In addition to potential for reduced waste, the cost for the medicines will be equal to or lower cost than the member’s current specialty network option.