Sandra Clark on Transforming Healthcare Through Key Partnerships | California Blue Shield

Sandra Clark

At Blue Shield of California, we continue to create value for our members with our ambitious plan to transform a dysfunctional healthcare system into one that is worthy of our family and friends. As a COO, I know that we cannot drive significant systemic change and innovation alone. That’s why we invest in key, strategic partnerships that focus on reducing costs and supporting our members’ experiences, as well as driving system-wide change.

Our pharmacy team and Pharmacy Care Reimagined work in it every day focus on how to reimagine the prescription drug experience. We believe that every patient should have safe, affordable and appropriate access to medicines. This means constantly evaluating and challenging the status quo to ensure that all parts of the system deliver real value.

Investing in partnerships to drive innovation

Blue Shield of California is working on several market partnerships. We invest in companies that aim to make prescription drugs more affordable by increasing price transparency and measuring their effectiveness.

Whenever we evaluate an investment or partnership, it is important to consider the benefit to members and the best use of Blue Shield of California’s resources. We always expect a fair financial return for these ventures in addition to a tangible impact on the cost and quality of health care. Three of Blue Shield’s key investments include:

CivicaScript. Blue Shield of California led the charge to launch CivicaScript, a nonprofit drug company dedicated to lowering outpatient drug prices. Blue Shield joined more than a dozen other Blue plans in 2020 to invest a total of $55 million in CivicaScript. The goal is to join with manufacturing partners to bring more affordable generic drugs to non-competitive markets.

Our investment in CivicaScript is important because it helps address the high rates of abandonment that occur when patients stop using their prescribed medications because they are too expensive or because they are tired of asking their pharmacist to call their doctor for cheaper alternative medicines.

In August, CivicaScript launched its first drug, abiraterone acetate, a generic drug used to treat prostate cancer that has spread to other parts of the body. The recommended maximum price for pharmacies of $171 per bottle is about $3,000 less per month than the drug’s current price.

Blue Shield also joined Civica to announce funding to develop and distribute insulins at a significantly lower cost than current drugs. Civica plans to set a recommended transparent price for the consumer of no more than $30 per vial. This is another example of how Blue Shield is working to disrupt the drug market for the benefit of our members and the entire healthcare system.

Evio Pharmacy Solutions. Blue Shield of California invested last year in Evio Pharmacy Solutions, a startup that takes a data-driven approach aimed at controlling drug costs. The company aims to help its investor health plans by improving drug affordability, patient experience and clinical outcomes. Evio uses evidence and data from real patient experiences to show how individual medicines work for patients in their own context, across drug indications, different patient types and combinations of other co-morbidities. Four other Blue Cross, Blue Shield health plans also fund Evio.

Our investment in Evio has a real opportunity to change the trajectory of pharmacy spending, improve clinical outcomes and make it easier for patients to access the medicines and treatments they need.

Hello Gemini. In 2019, Blue Shield of California funded Gemini Health, a San Francisco Bay Area company that provides real-time patient-specific benefits, formularies and prescription drug cost information to prescribers at multiple points of care, including patient-physician visits. The goal is to give prescribers useful information about drugs and potential lower-cost options so that they can discuss clinically appropriate alternatives with their patients. The investment yielded more than $20 million in drug cost savings in the first two years of the initiative.

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