Excellus BCBS Pharmacy Concierge eliminates nearly $20 million in unnecessary spending for more than 2,400 businesses
June 30, 2026
Rochester, N.Y. – When Excellus BlueCross BlueShield launched its Pharmacy Concierge program, its priority was improving member care. Slowing growth in drug spending was an added benefit. Four years in, the health plan’s metrics show the Upstate, N.Y.-based health plan is meeting both objectives.
Continued savings
In 2025, the Excellus BCBS Pharmacy Concierge team continued to record significant progress in offering even more businesses with reduced spending, increasing claims review volume and improved cost avoidance.
- Last year, the team eliminated nearly $20 million in unnecessary or inappropriate pharmacy spending for its midsize and large employers, compared to $17 million in 2024.
- Nearly 2,400 employers participated, and more than 23 million claims were reviewed for potential clinical safety and/or savings opportunities—up from 2,000 employers and 11 million claims the previous year.
- Midway through 2026, the clinical pharmacists have already nearly tripled the identification of unnecessary or inappropriate pharmacy costs from $3 million through April in 2025 to $11 million so far this year.
“With Pharmacy Concierge, our team of clinical pharmacists reviews an employer group’s pharmacy claims for opportunities to improve patient care and/or reduce pharmacy spending,” says Mona Chitre, PharmD, Chief Pharmacy Officer and President of pharmacy solutions at Excellus BCBS. "This includes finding unnecessary or inappropriate medications, incorrect dosing, safety concerns, and savings opportunities with approved generics or biosimilars.”
Groups find success
The health plan cites several examples of both member care improvements and savings for its groups:
- The clinical team identified a member taking a high-cost, brand name oral chemotherapy agent compared to its generic equivalent. The team worked to ensure the generic formulation was available to be dispensed from the pharmacy, then contacted the prescriber recommending the switch. This conversion resulted in over $60,000 in annual savings.
- A member was prescribed a newer, brand name antidepressant medication. The clinical team reviewed the member’s medication history and noted that some generic alternatives have not yet been trialed. The alternatives were discussed with the prescriber, and the switch to a generic alternative resulted in a member savings of over $600 per month, and a total annual savings of $15,000.
- A consortium of upstate New York school districts reduced pharmacy spending by more than $1 million last year using Pharmacy Concierge. Our program delivered similar results for this client the previous year, resulting in significant cumulative savings.
- ur outreach to mental health prescribers resulted in $3.8 million in savings. Excellus BCBS’ pharmacy team targeted treatments that can create an unnecessary cost-burden for members, recommending transition to more affordable alternatives that work just as well.
- Our work with ophthalmologists delivered over $760,000 in savings for our clients. This is accomplished through simplification, recommending streamlined medication regimens that enhance adherence and affordability.
Chitre says all medication decisions are made by the member’s provider in consultation with their patient.
To learn more about Pharmacy Concierge, visit excellusforbusiness.com.
