CerpassRx, an independent pharmacy benefit manager, is teaming up with Waltz Health to launch a new AI-powered tool that aims to better manage specialty drug spending.
Called Intelligent Specialty Engine, the tool leans on Waltz's capabilities to offer clients real-time data analytics and management options that are designed to drive down spending, create greater transparency and improve the experience for both the patient and the plan sponsor.
The PBM said that the platform is a "unique deployment" of Waltz Health's Waltz Connect platform, which connects users to a network of both national and regional pharmacies that compete on price. It uses AI to help steer patients to "the most cost-effective and clinically appropriate pharmacies."
Specialty pharmacy is a central concern for employers, as costs have rapidly increased. These drugs account for about half of all drug spending.
Greg Buscetto, CEO of CerpassRx, told Fierce Healthcare that specialty pharmacy costs are a major concern for plan sponsors, and the traditional models used by PBMs haven't really cracked the secret to bringing these expenses down.
"I think these kind of Intelligence Specialty Engine devices that Waltz has come up with, and other things that are out there in the marketplace that will be innovated over the next several years, are going to be where our industry goes, versus saying, 'Hey, this is the way we did it, and this is the way it was done, and so that's the way we're going to do it,'" Buscetto said.
"We just don't follow that," he continued. "Let's break the model and see what happens."
Beyond the technology making it easier to track and manage costs, the Intelligence Specialty Engine improves the member experience by streamlining the pharmacy process. They are able to secure their needed medications more quickly, skirting the hassles that often come with securing specialty drugs.
Jeff Park, president of Waltz Health, told Fierce Healthcare that the larger PBMs have traditionally served as a single distribution point for specialty drugs, but new players like CerpassRx and Waltz are finding ways outside of that model to reduce costs.
"I believe that if you look at what drives down price, it's competition and transparency," he said. "And the ability to use tools to compete for best price, while keeping service member experience and engagement at the front of the of the experience, can really drive some meaningful cost reductions."