Clinical Care

The Power of Clinically-Driven Pharmacy Care

The Clinically™ platform powers EmpiRx Health’s clinically-driven pharmacy care model. This unique pharmacy care approach has flipped the PBM script by putting the pharmacist at the center of the service model. Our clinically-driven pharmacy care is designed to ensure the most clinically-appropriate, evidence-based medication therapies that keep patients healthy while substantially reducing costs.

How does clinically-driven pharmacy care work? EmpiRx Health’s pharmacists use the Clinically platform’s population health engine and clinical review technologies to identify the patients who could benefit most from a higher level of care. At EmpiRx Health, we are unique in the pharmacy care industry because we attack the drug costs problem “at the pen” – when the physician writes the prescription for those medications.

Based on this in-depth population health analysis, our clinical pharmacists collaborate peer-to-peer with prescribing physicians to recommend clinically appropriate medication therapies that not only optimize patient health but usually involve lower cost drug options as well. Our core mission is to make sure patients receive the right drugs, at the right time, at the right cost.

For example, one of our pharmacists discovered that a patient’s prescribed plaque psoriasis medication could worsen their existing symptoms of inflammatory bowel disease. We recommended a more clinically-appropriate, lower-cost medication that did not worsen the patient’s bowel disease.

This resulted in improved health outcomes for the patient and an annual savings of more than $21,000 for the plan sponsor.

Legacy PBM Industry Has Failed Plan Sponsors and Patients

How do you effectively manage and mitigate constantly rising drug costs to ensure the lifelong health of your members/patients and the continuing viability of your organization’s benefits plans? The pharmacy benefits management (PBM) industry was originally founded with the objective of solving these issues, especially to manage the inexorable rise of prescription drug costs. The problem is that the legacy PBM companies have been pushing a volume-focused, rebate-driven approach to pharmacy benefits care at the expense of plan sponsors and their members. PBM contracts that are structured around per-claim administration fees, or those that maximize rebates, are incentivized to increase the volume of claims.

It’s clear that a volume-driven model does not address the growing concerns around sustainable spending and making sure the most clinically appropriate therapies are provided to members/patients. Increased volume causes members to pay more or take medications they don’t need. Ultimately, plan sponsors are left to pay the bills. That traditional PBM model is so flawed that government regulators and the US Congress are moving aggressively to adopt new measures that will bring more transparency to the industry and rein in the self-dealing practices of the major PBM players. The legacy PBM model is clearly broken, resulting in a vicious cycle of poor plan results and sub-optimal patient health outcomes.

A Better Pharmacy Care Model

There is a better pharmacy care model. It’s founded on a clinically-driven approach to managing the seemingly constant rise in prescription drug costs and ensuring the health and well-being of members/patients.

Simply stated, this revolutionary PBM model prioritizes healthcare value over rebate-driven drug volume. EmpiRx Health pioneered value-based pharmacy benefits management. From day-one our mission has been to fundamentally transform pharmacy care by focusing on true healthcare value for our customers and their members. We’ve done that by replacing the traditional PBM model, which prioritizes volume-driven profits, with a clinically-driven, customer-first approach that is fully aligned with the interests and needs of our customers and their members/patients.

Our new Clinically technology platform is the engine that drives EmpiRx Health’s transformative pharmacy care.

For a Demo of Clinically and to learn more

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