Pharmacy Programs

Pharmacy Programs

Highmark Pharmacy Programs help ensure that members have access to the right medications, while managing costs, billing, and reimbursements.

Pharmacy Programs

Rx Processing Under Channel Alignment Program


This program helps ensure that drugs which should be billed through the pharmacy benefit are not billed under the medical benefit.

Free Market Health


Free Market Health is an innovative new specialty pharmacy program that aligns resources, risk, and accountabilities for pharmacy referrals and reimbursement.

Hemophilia and Bleeding Disorder Drug Program


Highmark is taking action to help members manage the high cost of hemophilia and bleeding disorder drugs.

Medical Injectable Drug (MID) Program


Highmark partners with Free Market Health to support the Medical Injectable Drug (MID) Program.

 

Pharmacy Medicare


Review the Medicare Part B Drug Website, which includes the annual Medicare Part B Drug Average Sale Price.

 

 

Pharmaceutical Management (Clinical Management Programs)


This program is designed to safeguard patients from harmful drug interactions and side effects, optimize therapy, and promote appropriate drug utilization and compliance.

Program for Self-Administered Injectable or Oral Biotechnology Drugs


Highmark has taken steps to help manage the rising costs of medications by requiring members to obtain certain specialty drugs through an exclusive specialty provider.

Site of Care Drug Management Program


This program aims to improve the experience for members using certain medically billed infusion drugs that are considered safe and effective for administration outside of a hospital setting.