Through RxOptimize we provide specialized pharmacy programs that have one defining characteristic; they do not disrupt existing plan designs and can co-exist under existing PBM arrangements. From our Retiree Drug Subsidy program, where since 2005 we have assisted clients in receiving over 100 million in Medicare subsidies through innovative data analytics software and proprietary processes, to our enhanced prior authorization program ELMCRx and our enhanced and unique specialty drug discount program ECMPRx, we are continually surveying the marketplace for solutions to counteract the rising cost of prescription drugs.


ECMPRx

A program accesses additional “class of trade” discounts through our healthcare provider network partners. Employer groups enjoy a guaranteed 15% return on all targeted specialty drugs. This is in addition to the existing discounts and rebates provided in your current PBM contracts.

The program highlights are:

  • Keep your existing PBM arrangement
  • No change to plan participant’s drug plan (co-pays remain the same)
  • No change required of the plan participant’s drug or dosage
  • Guaranteed 15% additional savings
  • No direct program fees

ELMCRx

An enhanced Prior Authorization program that resides behind an incumbent PBM. Cost savings are achieved through greater oversight of high cost medications.

The program highlights are:

  • Protects the patient clinically
  • No disruption for patient since we work directly with the prescribing doctor and PBM
  • Protects the plan financially (typically reviewing 20% of drugs costing more than $2,500/mo.)
  • Savings estimated at 10% of total drug spend
  • No program fees; fees are contingent on approved savings