Comprehensive Pharmacy Solutions
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Tailoring Pharmaceutical Care for Diverse Stakeholders
PBM Plans for Patients/Employers, TPAs, & Brokers
Patients and employers, Third-Party Administrators (TPAs), and brokers are pivotal entities in the healthcare sector, each with unique needs and contributions toward ensuring accessible pharmaceutical care.
Patients and employers benefit when care is prioritized, especially through strategic assistance from Pharmacy Benefit Managers (PBMs).
TPAs facilitate the delivery of essential medications through adept formulary design and plan customization.
Brokers, on the other hand, navigate the realm of affordable pharmaceutical care, ensuring transparent and sustainable results through strategic plan customization and improved formulary design.
Appro-Rx stands as a supportive pillar for patients and employers, TPas, and brokers by providing tailored solutions, prioritizing care, and enhancing plan and formulary design to ensure optimal healthcare outcomes. See how Appro-Rx supports all three parties below.
Formulary and Plan Design
Appro-Rx offers our clients national Commercial, Medicare Part D, and Medicaid formularies, along with the flexibility to customize formularies to target individual needs. Our programs feature a range of tiers, with a focus on coinsurance or dollar copayments, including generic and brand at the retail, mail, and specialty distribution levels. The Appro-Rx programs allow our clients to experience significant savings on Average Wholesale Pricing (AWP) and dispensing fee costs across all tiers.
State-of-the-Art Software
Appro-Rx clients can easily access information about pharmacy reimbursements, rebates, the Maximum Allowable Cost (MAC) list, and administrative information on industry-leading portals. Live system access allows our clients to see claims data, MAC lists, and formulary updates in real time, giving members and providers the data they need for optimal decision-making and efficiency.
- 100% Transparency - Clients have real-time access to live claims data
- Full formulary access and customization
- Full access to the MAC list
- Full member profile, including acute medical information
- Monitoring of Fraud, Waste and Abuse
- Drug Utilization Review (DUR) implementation
Specialty Pharmacy
This program is designed to improve medication adherence, reduce waste and provide close clinical monitoring to all patients on specialty drugs. By utilizing both an approved specialty pharmacy in partnership with a local pharmacy, patients are provided high-quality clinical care and monitoring.
Our healthcare professionals on our Appro-Rx Clinical Team guide prescribers to the appropriate medications, based on efficacy and cost. Your members will receive friendly, clinically-accurate support that will help them:
- Take or administer medications as prescribed
- Manage any medication side effects
- Monitor symptoms and responses to therapy
- Get counseling on health conditions
- Coordinate new and refill prescriptions
- Work with insurers to verify benefits
