Elevance Health's pharmacy benefit manager CarelonRx is launching a new solution that aims to make it easier for employers to plan for the future around specialty pharmacy costs while connecting members with critical support to manage their conditions.
The SpecialtyRx Savings Navigator operates across the pharmacy and medical benefits to identify savings opportunities for both the member and employer. The tool will identify the members with significant health risks, and once they've been identified, it will initiate a review of clinical diagnoses, medications, other supports and the available sites of care.
A pharmacist will reach out proactively to patients and work to address gaps in care, in coordination with other medical and behavioral care providers.
Employers, meanwhile, will have access to disease-specific estimates that they can use to predict future drug costs and spending, according to the announcement. It will also recommend ways to enhance benefits and build targeting member support to address costs.
“SpecialtyRx Savings Navigator will allow our members to focus solely on their health while we manage the logistics of securing them affordable, convenient, connected care,” said Michele Paige, vice president of product and digital strategy at CarelonRx.
“It will also give employers the peace of mind in knowing their employees who are battling complex and chronic conditions are receiving personalized support, and it will give employers better insights into how best to budget for future specialty spend for their business," Paige said.
The platform is available now to the PBM's administrative services-only clients, according to the announcement.
The program, according to the company, builds on several recent moves to enhance specialty pharmacy management for Carelon members. Elevance has acquired Paragon Healthcare, which specializes in injectable medications, as well as BioPlus, which offers specialty pharmacy services across a broad array of conditions.
It also announced plans earlier this year to bring Kroger Specialty Pharmacy into the fold.
CarelonRx also added that it will "complete its operational scale" by opening three new BioPlus dispensing centers in Chandler, Arizona; Indianapolis, Indiana; and Raleigh/Durham, North Carolina. It will also cut the ribbon on four non-dispensing pharmacies located in Las Vegas, Nevada; Denver, Colorado; St. Louis, Missouri; and Indianapolis, Indiana.