Posted: 02/19/2021

Drug Adherence Discount Program

Members save money on prescriptions with Drug Adherence Discount Program

Blue Cross Blue Shield of Michigan and Blue Care Network are offering a program to help members save money and stay adherent to their medications. The Drug Adherence Discount Program, powered by Sempre Health, became available to all commercial members with pharmacy benefits starting July 1, 2020. Blue Cross is working with Sempre Health, a digital health technology company that helps members save money by reducing their out-of-pocket costs when they fill prescriptions for select medications as prescribed. As of Dec. 1, 2020, the program has helped save enrolled members more than $1.5 million on their prescription drug costs.

What medications are included in the program?

The medications listed below are currently included in the program. The list may change or expand in the future:

• Eliquis^®
• Ozempic^®
• Pradaxa^®
• Rybelsus^®
• Spiriva^® Respimat^®
• Trijardy^® XR
• Trulicity^®
• Victoza^® 2-Pak and 3-Pak
• Xarelto^®
• Lantus^®
• Toujeo^®

To be eligible for the program, members must first have at least one prescription fill of the medication at their regular cost share amount. The program can help your patients who are already taking these medications to save money, and it’s not intended to change prescribing patterns.

How do members enroll and get the discount?

To enroll in the program, members will receive emails or flyers with program and enrollment information from Sempre Health. Members can enroll by text, phone or website. They will receive a discount ID via text or phone call. When this discount ID is shared with a pharmacist, the member will pay a discounted rate for a prescription refill. Members never pay more than their typical copay. Members will receive reminders to refill prescriptions and discounts if they fill them as prescribed. After they enroll, they’ll receive a program overview and other important information.

Are there any members with pharmacy benefits excluded from the program?

The discount only applies to retail pharmacies. Members currently receiving one of the medications listed above via mail order don’t qualify for the program. Members can’t use both Sempre discounts and a drug manufacturer coupon at the same time. Sempre discounts will always be greater than those provided by coupons as members fill their prescriptions over time. If a member is currently using a coupon and enrolls in Sempre, Sempre will ask the pharmacist to replace the coupon information with Sempre’s secondary ID information.

Who can members contact with questions?

Members can get help in the following ways:

• Text: Text HELP to 1-855-935-1557 anytime to text with a real person. They can text STOP to opt out.
• Phone: Call Customer Service at 1-855-935-1557 from 10 a.m. to 5 p.m. Eastern time. Monday through Friday.
• Website: enroll.semprehealth.com/bcbsm

Provider questions can be directed to the Pharmacy Services Clinical Help Desk at 1-800-437-3803, option 1.

How does this program help my performance on incentive programs?

Incentive opportunities for providers are available through the Proportion of Days Covered - Diabetes All Class and the Comprehensive Diabetes Care and HbA1c Adequate Control (<8) measures. The Drug Adherence Discount Program includes medications indicated for the treatment of diabetes, and member adherence to these medications can help providers close gaps in care for these measures.

Note: All incentive opportunities referenced relate to Blue Cross Blue Shield of Michigan commercial population, except PRP, which is a Blue Care Network program.

Sempre Health is an independent company contract by Blue Cross Blue Shield of Michigan to help members save money by reducing their out-of-pocket costs when they fill prescriptions for select medications as prescribed.