Making Prescriptions More Affordable

Inflation is driving up costs all around us—at the grocery store, the gas station, on our utility bills and more. But this trend is nothing new for health care – we’ve seen the effects of rising medical costs for decades. In North Carolina, individuals and businesses have faced some of the highest health care costs in the country.

Prescription drug prices, in particular, are an acute source of financial pain. Patients in the United States pay 2.5 times the price for medications compared to those in other countries. For that reason, it may not be surprising to learn that nearly a third of U.S. adults are not taking their medications as prescribed because they simply can’t afford to.

We’re giving members the tools to find more affordable medications

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to making health care more affordable. We’ve lowered premium costs by an estimated billion¹ dollars in the Affordable Care Act (ACA) market from 2018 through 2024. Part of our work is fighting rising out-of-pocket drug costs, while improving the quality and access of care our members receive. We have worked to negotiate lower costs with drug manufacturers and ensure Blue Cross NC plans cover the most effective drugs at a lower cost. While pharmaceutical costs in the U.S. grew 9.4% in 2022², Blue Cross NC was able to keep numbers in the ACA market to under 1% in 2022 and under 3% in 2023³. Our work is helping North Carolinians in all 100 counties to find easy, affordable ways to improve their health.

Making Specialty Medications More Affordable

Specialty drugs are expensive prescription medications used to treat complex, chronic conditions like cancer, diabetes, and multiple sclerosis. Blue Cross NC has launched new programs to lower the cost of specialty medications. We’ve debuted a new copay assistance, or coupon, program for specialty medications. FlexAccess™ is available to members whose employers have enrolled. FlexAccess will use the specialty pharmacy the group elects making access easier for members. Savings are expected to average more than $120⁴ per year, per member.

We’ve also introduced an innovative program that makes specialty medications more affordable. Free Market Health helps members “shop” for their specialty drugs at the lowest cost possible by using a market-based system through Blue Cross NC contracted specialty pharmacies.

Increasing Access and Affordability By Giving Back

Blue Cross NC is working with RemediChain to reclaim unused drugs from patients, hospitals and providers and redistribute via their mail order pharmacy to patients in need. RemediChain works with doctors to set members up for the program, which is free for patients. Since its inception, this program has provided more than $1.1 million⁵ in medication provided at no cost to patients. RemediChain is primarily for chemotherapy drugs.

Increasing Access and Affordability for All

Ways to find instant pharmacy savings
Blue Cross NC members have access to MedsYourWay – Retail, which automatically finds the lowest medication discount card available. MedsYourWay applies to covered prescriptions according to a member’s benefit plan and over the counter medications. MedsYourWay – Retail works at any participating pharmacy.

Bringing Savings Closer to Home
Blue Cross NC members get clear pricing on their medication, plus additional savings through the MedsYourWay discount card, administered by Inside Rx and Amazon home delivery.

Our work to lower the cost of prescription medicines is just one way Blue Cross NC is making health care easier—connecting North Carolinians to the information they need, when they need it, and making better health care more affordable for all.

Improving Adherence and Affordability

As prescription drug prices have risen, patients’ adherence to medication has declined⁶. Blue Cross NC has teamed up with Sempre Health to reverse both trends with a program that allows eligible members to save more money on prescriptions when they refill their medications on time. This incentivizes patients managing complex, chronic diabetic, respiratory and cardiovascular conditions to stay on track with treatment and helps drive costs down across the health system. Since the launch of this text-message-based program in 2022, Sempre Health has enabled Blue Cross NC patients to save over $3.7 million on their prescription co-pays and reinstated more than 1,550 patients in their treatment programs with more than 15,500 members enrolled⁷.