Elevance Health PBM introduces new specialty pharmacy cost-saving tool

CarelonRx, Elevance Health’s pharmacy benefits manager, is rolling out a new analytics tool called SpecialtyRx Savings Navigator, designed to help employers plan for future specialty pharmacy costs and provide advocacy for employees using specialty medications.

The tool utilizes advanced analytics to identify members at the highest health risk, prompting a review of their clinical diagnoses, medications, and whole-health integrated support. Members will then receive pharmacist-led outreach to address barriers to care and coordinate integrated care with their health team.

Specialty medications are projected to make up 43% of global medicine spending by 2027, making tools like SpecialtyRx Savings Navigator crucial for employers to manage future drug spend projections and budgeting.

Michele Paige, vice president of product and digital strategy at CarelonRx, emphasized that the tool will provide employers with disease-specific forecasts, optimized plan design recommendations, and customized member support to reduce costs and optimize spend.

Elevance Health has been expanding its footprint in specialty pharmacy, recently acquiring Paragon Healthcare and intending to acquire Kroger Specialty Pharmacy. Last year, the company acquired BioPlus, a specialty pharmacy services provider for patients with complex conditions.

In 2024, CarelonRx plans to open additional BioPlus Specialty Pharmacy dispensing centers and non-dispensing pharmacies in various locations across the country.

The launch of the SpecialtyRx Savings Navigator and other initiatives by CarelonRx highlight the company’s commitment to supporting members with complex illnesses and enhancing its specialty pharmacy services.