Through RxOptimize we provide specialized pharmacy programs that can be customized as a carve-out from your current pharmacy plan; or; 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 and our enhanced and unique specialty drug discount program, we are continually surveying the marketplace for solutions to counteract the rising cost of prescription drugs.

RDS Specialty Drugs

This program accesses additional “class of trade” discounts through our healthcare provider network partners. Employer groups enjoy significant returns on all targeted specialty drugs. This program is the foundation for establishing a custom carve-out plan.

The program highlights a balanced coordination of and includes:

  • Co-Pay assistance
  • PAP discounts
  • 340b coordination
  • No change to plan participant’s drug plan (co-pays remain the same)
  • No change required of the plan participant’s drug or dosage

RDS Clinical Management

An enhanced Prior Authorization program that can reside behind an incumbent PBM or is an integral component of our custom carve-out plan. 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