Highmark’s Specialty Pharmacy Innovation Lowers Costs, Improves Experience for Members with Complex Health Conditions

Pittsburgh, Pa. (March 18, 2026)—Through innovative programs and partnerships, Highmark members are receiving their specialty pharmacy prescription medications quicker, adhering to their drug regimen more effectively, and receiving care from pharmacies best equipped to treat complex health conditions.

Highmark’s specialty drug management program, powered by healthcare technology company Free Market Health, has improved specialty medication access rates for first-time users of a specialty drug by more than 50 percent compared to members not managed in the program. First-time users of a specialty medication managed in Highmark’s program also received their first fill of medication quicker, on average two to four days faster than members with no management or a traditional exclusive specialty pharmacy drug management program.

Highmark’s insured business saw on average a two percent improvement in specialty medication discount value through the Free Market Health enabled program, outperforming traditional exclusive specialty pharmacy programs.

“At Highmark, about 30 percent of our overall health care spend is now allocated to pharmacy costs,” said Sarah Marche, SVP of Pharmacy for Highmark Inc. “And, of that pharmacy-related spend, about half of it is on specialty medications that typically treat complex, high-cost health conditions. Our specialty drug management program enabled by the Free Market Health technology platform enhances specialty prescription drug access and adherence and care pathways for members with complex health conditions. With fewer episodes of drug abandonments and lower claims costs for medications, members and group customers both benefit.”

With nearly 500 different medications available, Highmark’s specialty drug management program powered by Free Market Health is being utilized in most of Highmark’s Medicaid, Commercial employer-based and ACA fully-insured business in applicable markets. In addition, nearly half of Highmark’s self-insured employer group clients have chosen this specialty drug management model.

“Highmark believed in Free Market Health from the very beginning,” said Joe Cardosi, founder and CEO of Pittsburgh‑based Free Market Health. “As an early adopter and strategic investor, they recognized that the traditional approach to specialty pharmacy management was no longer working, especially for members. By combining our technology with their focus on personal care, Highmark has created a specialty pharmacy experience where each member gets started on their needed specialty medication faster and easier.”

Free Market Health’s platform connects specialty medication referrals with specialty pharmacies to support each member’s individual needs while balancing the overall cost and quality of care. Leveraging Free Market Health’s flexible platform, Highmark has tailored their program to support several strategic initiatives. For example, participating specialty pharmacies are incentivized to administer social determinants of health (SDOH) assessments to some of the most medically complex members and identify individuals facing additional challenges. Identified members are referred to a Highmark social worker to meet their SDOH concerns.

The platform also enables Highmark’s strategy of expanding access to new, lower-cost generic medications offered through CivicaScript, a non-profit drug company in which Highmark was a founding contributing member, focused on bringing quality and affordable outpatient generic medications to consumers nationwide. Additionally, the platform is also helping support Highmark’s biosimilar-first initiatives increasing access and affordability of medications for individuals with complex conditions requiring specialized medication management.

“Whether it be breakthrough technology, new business and care models, or partnerships with other leading Blues health plans from across the country, Highmark is focused on improving prescription drug access, affordability and experience for our members,” said Marche.

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About Highmark Inc.

An independent licensee of the Blue Cross Blue Shield Association, Highmark Inc., together with its Blue-branded affiliates, collectively comprise the fifth largest overall Blue Cross Blue Shield-affiliated organization in the country with more than 7 million members in Pennsylvania, Delaware, West Virginia and western and northeastern New York. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses. For more information, visit www.highmark.com.

About Free Market Health

Founded in 2019 and headquartered in Pittsburgh, PA, Free Market Health (FMH) is a healthcare technology company streamlining the specialty medication fulfillment journey.

FMH provides payers with a reliable path to the treatment members need while lowering the cost of care and delivering unmatched program control and transparency.

We keep the specialty medication process connected and moving forward so patients don’t have to chase the care they depend on. Learn more at www.freemarkethealth.com.

For more information, contact:

David Golebiewski
Highmark Health
412-216-6305
David.golebiewski@highmarkhealth.org

Abby Tasser
Free Market Health
814-528-6910
Abby@freemarkethealth.com