Prime Therapeutics inks value-based contract for Stelara® with Janssen

Medical and pharmacy claims data will track how long patients stay on Stelara®, informing Prime's clinical programs aimed at better health outcomes

News provided by

Prime Therapeutics LLC

Oct 04, 2018, 10:30 ET

ST. PAUL, Minn., Oct. 4, 2018 /PRNewswire/ -- Prime Therapeutics LLC (Prime), a leading pharmacy benefit manager (PBM) serving more than 27 million members nationally, has signed a value-based contract with the Janssen Pharmaceutical Companies of Johnson & Johnson (Janssen), for Stelara^®(ustekinumab).

Stelara^® is a prescription medicine used to treat adults and adolescents 12 years of age and older with moderate or severe plaque psoriasis who are candidates for phototherapy or systemic therapy. It is also indicated for the treatment of adult patients 18 years and older with active psoriatic arthritis, alone or in combination with methotrexate, and for the treatment of adult patients 18 years or older with moderately to severely active Crohn's disease who have already taken other medicine that did not work well enough or they could not tolerate.

As part of its CareCentered Contracting™ program, Prime will analyze integrated pharmacy and medical claims data for individuals who use Stelara^® to understand how long members stay on the therapy. This measure is important as it's only when patients continue to take their medications for the prescribed amount of time that they obtain the intended benefit from the therapy.

Using both pharmacy and medical claims data gives a comprehensive view of how Stelara^® is used. This is because Stelara^® can be injected by a health care provider or self-administered at home only after proper training, and thus may be processed through the pharmacy or medical benefit.

"Our clients invest in specialty medications and if members don't continue to take them, no one realizes the value of the investment," said Susan Scheid, vice president of pharmaceutical trade relations for Prime. "Prime uses insights from its value-based contracts to build clinical programs to improve member health outcomes."

As a pioneer in value-based contracting since 2010, Prime's manufacturer contracts analyze the value of a selected medicine when taken appropriately, with the goal of improving outcomes and lowering total cost of care. Prime's CareCentered Contracting™ program is an integral part of its value and health outcomes strategy.

About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and offers clinical services for people with complex medical conditions. Prime serves more than 27 million people. It is collectively owned by 18 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. For more information, visit www.primetherapeutics.com or follow @Prime_PBM on Twitter.