Smarter Pharmacy Benefits: A Complete Approach that Saves You More

The Challenge Employers Face

Did you know that pharmacy benefits are one of the most frequently used parts of an employee health plan? That’s why they’re a critical factor in both employee wellbeing and cost control.

Rising drug prices and complex benefit structures create challenges for businesses striving to balance affordability and access.  Managing these challenges shouldn’t mean sacrificing employee health or increasing administrative burdens. Excellus BlueCross BlueShield(BCBS) takes a more complete approach to care that focuses on the needs of members. That’s our approach every day—putting people first, making service simple and leveraging the strength of an unmatched network. Our pharmacy approach builds on those overarching pillars – bringing together powerful, holistic benefits with personalized service and clinical expertise from a health plan you know and trust. Here’s how we make it happen:

A Pharmacy Model Built for Your Benefit

Here at Excellus BCBS, better pharmacy care happens by design. Our model leverages national scale with local expertise to deliver maximum value while ensuring personalized support.

What This Means:

• Employers will be part of a vast national, regional and local pharmacy network with 66,000+ locations, ensuring employees can easily access prescriptions¹
• A plan with flexible formularies that adapt to business needs with keeping costs in check
• No financial ties to specialty or mail-order pharmacies, ensuring unbiased drug policies
• Advanced fraud, waste and abuse investigations, generating an estimated $2 million in additional savings¹

Bringing More Value Through a More Complete Approach

Making sure our members get the prescription medications they need is a top priority—but we don’t stop there. We offer a variety of programs designed to lower costs, encourage proper use and ultimately support better health, all while keeping overall expenses as low as possible. Excellus BCBS enhances this value by offering the following programs:

• Pharmacy Concierge: with a total annual Rx savings of $19 million+¹
• High-Cost Claimant Team: $4 million+ in annual medication cost savings and cost avoidance1
• Site of Care Program: Recently, a member accepted our suggestion to transition to home infusion to treat psoriasis. This saved the business $43,000+ annually¹
• SaveOnSP: $543 per participant per month (PPPM) savings¹
• HelpScript Medical Specialty Drug Copay Assistance Benefit: Recently, an employer group experienced savings of up to $10,000 with one fill³
• Specialty Drug Benefit Optimization: $2.8 million total annual savings³

Partnerships That Drive Savings and Innovation

Providing the best care requires continuous innovation and strategic partnerships. We collaborate with providers, vendors and pharmaceutical companies to drive affordability and better outcomes:

• 50.6 million in pharmacy savings over a five-year period (2019-2023) through provider cost and quality agreements (ACQAs)⁴
• Strategic partnerships like OncoHealth ensure evidence-based, cost-effective cancer care
• Site of Care optimization helps employers save $43,000+ annually by transitioning high-cost treatments to lower-cost savings¹

Making Pharmacy Benefits Easier

Managing pharmacy benefits should be simple and effective. That’s why we help prioritize seamless service to reduce administrative burdens, including:

• 99% first-call resolution rate, ensuring employer and member issues are handled quickly.²
• A dedicated implementation team provides hands-on guidance, making benefit transitions smooth.
• Compliance support helps businesses navigate regulatory changes with ease.

Take the Next Step

A smarter approach to pharmacy benefits means lower costs, better care and a stronger workforce. Excellus BCBS delivers the expertise, innovation and support employers need to optimize their pharmacy benefits.

Contact your account representative today to learn how our complete approach can bring more value to your organization. Learn more in our brochure.

1 2023 Health Plan Data.

2 Based on 2022-2023 Health Plan Data.

3 Based on 2024 Health Plan Data.

4 Based on 2019-2023 Health Plan Data.

Copyright © 2025, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. All rights reserved. SaveOnSP is an independent company that offers specialty coinsurance assistance services for certain specialty prescription drugs to Excellus BlueCross BlueShield members. Excellus BlueCross BlueShield has contracted with Expion Health Company, an independent company, to provide HelpScript program benefits to our members. Excellus BlueCross BlueShield is partnering with OncoHealth, an independent company, to provide clinical expertise regarding hematology and oncology medical specialty drug and pharmacy drug prior authorization reviews for members