Cost Savings
Should two separate patients be paying different prices at the register for the same prescription? We don’t think so. With our Single-Ledger Model™, plan sponsors and members alike can be confident they are getting true cost transparency. No more confusion at the register. No more obfuscated drug prices. Just financial alignment. Pure and simple, as it should be.
Seamless Implementation
Let us do the heavy lifting. Have peace of mind knowing our dedicated team is here to support you every step of the way – from plan inception to your go-live date. Seamless onboarding is supplemented with proactive go-live monitoring, rapid issue resolution, and rigorous testing. All these factors are why Capital Rx has a 100% implementation satisfaction rate.
Award-Winning Service
We are always here to assist you. With expert guidance and support from our pharmacist-led account team and 24/7 award-winning customer service, you will have the support you need through implementation and beyond, reducing your call volume and ensuring swift issue resolution. Our dedication to our members has earned us a Gold Stevie® award in 2024 for Achievement in Customer Experience.
Clinical Support
Your members have unique needs, and we are prepared to meet them. Our formulary was designed for safe, effective, and cost-efficient medications. Plus, our award winning platform and clinical management is handled through our enterprise pharmacy platform, Judi®, helping save you and your members money. You can also leverage programs for utilization management, cost containment, patient safety, population health, and high-touch personalized care.
Are you interested in unbundling your pharmacy benefits to gain flexibility?
Learn about our Never Move Again™ solution
.png)
.png)
PBM FAQs
What is a Pharmacy Benefit Manager?
A Pharmacy Benefit Manager (PBM) is an administrator that processes prescription drug claims on behalf of payers, such as employers and health plans. PBMs also handle numerous other behind-the-scenes processes, from plan design to eligibility, card printing, formulary, and much more.
Is Capital Rx a Transparent PBM?
Yes! Capital Rx is a transparent PBM in all aspects of pharmacy benefits management. We never earn revenue on drug spend, pass through 100% of manufacturer rebates to employers, and leverage a public pricing benchmark – National Average Drug Acquisition Cost (NADAC) - to offer trustworthy and reliable visibility into drug pricing.
What Is NADAC and Why Does Capital Rx Use It?
NADAC is a public benchmark calculated by the Centers for Medicare and Medicaid Services (CMS) that reflects the average amount pharmacies pay wholesalers for medications. As opposed to Average Wholesale Price (AWP), which is based on wholesale pricing data that private companies collect from drug manufacturers, and which doesn’t include rebates or discounts, NADAC offers a fair and transparent view into real drug costs. Capital Rx uses NADAC to provide fair and transparent pricing for clients, and NADAC’s publicly available nature allows clients to hold us to being a transparent PBM.
How Does Implementation Work with Capital Rx?
Capital Rx delivers a seamless and efficient implementation experience. Our dedicated team guides clients through every step, facilitating smooth data migration and integration with existing systems, minimizing member disruption by addressing concerns promptly, enabling continuity of care, and helping maintain existing pharmacy relationships where possible.
How Does Capital Rx Handle Rebates from Drug Manufacturers?
Capital Rx passes 100% of drug manufacturer rebates through to clients, eliminating hidden fees and redirecting all financial benefits to them.
