Capital Rx Receives Validation for Savings from Validation Institute - New Groups Experience Significant PMPM Cost Trend Improvement

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Dec 08, 2022, 06:00 ET

Validation Institute certifies Capital Rx cost savings for customers in a new report
In addition to the savings validation, Capital Rx's model contract meets Validation Institute standards for transparency, including definitions of terms, client access to data, and guarantees by Capital Rx

NEW YORK, Dec. 8, 2022 /PRNewswire/ -- Capital Rx, a healthcare technology company changing the way prescription drugs are priced and patients are serviced, today announced that its full-service pharmacy benefit management (PBM) solution meets Validation Institute standards for savings. Validation Institute determined that groups using Capital Rx for their PBM solution do, on average, experience lower costs per member per month (PMPM) than they had with their prior PBM in the first one to two years with Capital Rx. Earlier this year, Capital Rx was awarded Validation for Contractual Integrity by Validation Institute, which certified the transparency of Capital Rx's model contract.

Capital Rx, one of North America's fastest-growing companies, attributes the savings clients experience to an aligned financial model that promotes clinically appropriate decisions over those that maximize profitability for a PBM and drive prices up for payors. Unlike traditional PBMs, Capital Rx leverages modern technology - JUDI®, its enterprise pharmacy platform - to improve operating efficiency and a transparent, government-authorized pricing framework called NADAC to help employers save on their prescription drug spending. Capital Rx is the only PBM that utilizes NADAC in the commercial market.

"Capital Rx is on a mission to change how prescriptions are priced and patients are cared for to create enduring social change," said Kristin Begley, PharmD, Chief Growth Officer at Capital Rx. "Validation Institute's acknowledgment of the -14.1% weighted average savings that 10 clients experienced compared to their prior PBMs is tremendous, especially when paired with the Validation Institute's validation of our model contract for transparency. These validations reflect Capital Rx's commitment to delivering a better, more predictable PBM experience to Plan sponsors and their members and proof that an aligned single-ledger model outperforms the status quo PBM model."

Validation Institute reviewed 10 of Capital Rx's employer groups that have been with Capital Rx for one to three years and have served between 400 and 21,000 enrolled members, including the financial data of the employer groups' prior PBM and the employer groups' first 1 to 2 years with Capital Rx. Validation Institute assessed the invoiced costs from the previous PBMs and compared them with the current costs from Capital Rx, including the PMPM, which was calculated net of rebates and administrative fees.

"At a time when pharmacy benefit costs are rising, and scrutiny of PBMs is high, we're thrilled to see Capital Rx's PBM model satisfy the components to achieve a validation for savings to complement its validation for contractual integrity," said Benny DiCecca, President & CEO of Validation Institute. "Capital Rx excels in providing their employer group customers with transparency and cost savings, and we stand behind them with our Financial Credibility Guarantee."

You can find the full validation report here.

About Capital Rx

Capital Rx is built around the mission of changing the way prescription drugs are priced, and patients are serviced. A health technology company daring to reimagine the pharmacy benefits industry, Capital Rx is executing that mission through its Clearinghouse Model® - the first ethical framework for drug pricing. Capital Rx's enterprise pharmacy platform, JUDI®, connects every aspect of the pharmacy ecosystem in one platform, enabling patient engagement and increasing efficiency to achieve the highest standards of clinical care. For more information, visit www.cap-rx.com.

About Validation Institute

Validation Institute is an independent, objective, third party organization on a mission to improve the quality and cost of healthcare. Based in Woburn, MA, the organization is made up of a network of health benefits purchasers, health benefits advisors, and healthcare solution providers focused on delivering better health value and stronger outcomes than conventional healthcare. www.validationinstitute.com

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SOURCE Capital Rx