- What is Rx Savings Solutions? How does it work?
- Rx Savings Solutions is a free, confidential online tool that shows you and other family members on your health plan ways to save money on medication(s). We look at the medications you take and find lower-cost options to treat the same conditions. The savings opportunities can be generic forms of name-brand drugs, better prices at different pharmacies, but most often are medications that treat the same condition but cost much less than the drug you were originally prescribed. Rx Savings Solutions will automatically notify you whenever you have savings available, via text or email, based on your contact preferences. You may also use the “Search for a Medication” tool to find savings suggestions for any drug your doctor prescribes.
- Is Rx Savings Solutions simply a drug look-up tool?
- No, we give members the ability to search for any medication to find the best prices and any lower-cost but therapeutically equivalent options available. However, what separates our solution from other tools is the ability to proactively notify members via email and text message about savings opportunities they already have.
- Is Rx Savings Solutions a PBM? Will you replace my PBM?
No, we are not a pharmacy benefit manager, nor do we replace yours. We are an additional pharmacy service that layers over and works in conjunction with your existing program to help navigate and optimize your prescription benefit. We are PBM-agnostic and work with many of the largest PBMs.
- Will you alter or replace my existing health plan?
No, we are also health plan-agnostic and work within your existing plan design. In fact, many of our customers are health plans.
- We have maximized our pharmacy program. How can you find savings?
We find additional savings beyond your plan and formulary design by comparing member claims data against available savings opportunities that come from various therapeutic equivalents, dosage optimizations, brand-to-generic and generic-to-generic substitutions, alternate fulfillment channels and other recommendations curated by our in-house pharmacists. Unlike most pharmacy plan designs, our solution is dynamic and continually updated with the newest pricing information, so savings opportunities can be realized immediately rather than the next plan year.
- How can my members trust your recommendations?
Rx Savings Solutions was founded by a pharmacist and is staffed with in-house, licensed pharmacists who provide ongoing oversight. Our “suggestions engine” is maintained and constantly curated by this pharmacy team. We use the Gold Standard clinical database, which is updated daily and includes all pertinent U.S.-approved drug product data and images with professional monographs and corresponding patient education. All recommendations are based on the same peer-reviewed, evidence-based compendia that hospitals, health plans, Medicare, Medicaid, and PBM’s use to establish coverage criteria and evaluate approved/non-approved uses.
- What experience do you have with groups our size and in our industry?
The beauty of our offering is that it has proven to work for groups of all sizes, regardless of industry, PBM, or whether the client works with a consultant. We currently serve groups as small as 5,000 members and as large as 700,000, with demonstrated success in a variety of industries, including health plans, government, healthcare, financial services, retail, manufacturing and communications. We work with a growing number of consultants and welcome their involvement in the discussions around our solution.
- How will you contact my members? What if I want to control the message?
Email is currently the primary medium for member communications and outreach. This includes initial member engagement (registration) campaigns as well as routine follow-up emails alerting members to savings opportunities. Critical to our proactive approach is the ability to contact members, upon their approval, via text messaging. We offer turnkey as well as custom-designed and client-approved marketing plans, depending to what degree the client prefers to control the message.
- How do you handle members who don’t have valid email addresses?
Valid email addresses are necessary for members to take full advantage of the Member Portal and the array of services available. However, to encourage member engagement and registration, we often utilize printed promotional and informational materials, reminders and direct mail to communicate with populations for whom email use is neither common nor practical during the business day. Members may also call our Member Services team for assistance with registering, savings opportunities, prescriber and pharmacy interactions, and any questions they may have.
- What are the most common switches your solution recommends?
The majority of recommendations consist of therapeutic equivalent alternatives and dosage optimization for chronic medications, as well as simple price shopping. Rx Savings Solutions utilizes a patented algorithm that exhausts all clinical and fulfillment alternatives in search of a savings. About 75% of savings are the result of a clinical suggestion and 25% of savings come from fulfillment changes.
- What are your savings opportunities for specialty medications?
By definition, specialty medications typically don’t have as many therapeutic alternatives available as traditional products do. However, we advise and educate members on specialty medications to maximize whatever generics or biosimilar options are available, and to utilize available manufacturer coupons and rebated products that are commonly available in the specialty class. In cases where a mature or saturated therapeutic class exists, members are steered to the lowest-cost medications with the same indications.
- How do you differ from medication therapy management (MTM)?
The biggest difference is purpose and function. MTM programs exist to optimize therapeutic outcomes by actively managing drug therapy and by identifying, preventing and resolving medication-related problems. We exist to provide personalized and proactive pharmacy guidance within the existing benefit, with the goal of saving the member money. Essentially, the respective goals are clinical vs. financial optimization.
- How do I find the savings Rx Savings Solutions has found for me?
After logging into your Rx Savings Solutions account, all the ways you can save on any current prescription(s) will automatically be displayed on your dashboard. To access your dashboard, log in to your account or download the Rx Savings Solutions mobile app. Our confidential and secure portal will walk you through the rest of these steps to help you find and, if necessary, switch to a lower-cost prescription. There is even a “Dear Prescriber” letter you can give to your prescriber, who will be able to see the suggestions that have been made. Based on your contact preferences, we will also notify you via text or email of these savings opportunities.
- What if I'm not interested in the savings suggestions made?
The savings opportunities Rx Savings Solutions finds for you are intended to help you make more informed decisions about your healthcare. The suggestions are for you to consider and discuss with your healthcare provider. If you or your provider do not feel the suggestions are right for your situation, there is no requirement to take action. You may turn off savings alerts on your dashboard if you do not wish to see certain suggestions, and you may turn them back on at any time.
- Is Rx Savings Solutions the same as my current insurance or mail-order pharmacy?
Rx Savings Solutions is not an insurance company or a mail-order pharmacy. It is an additional benefit and transparency tool brought to you by your employer or health plan for you and your eligible health plan dependents. Our goal is to lower your cost at the pharmacy you choose, not by asking you to change to a mail-order pharmacy.
- How does Rx Savings Solutions know which medications I'm taking?
Rx Savings Solutions uses pharmacy claims data provided by your health plan and/or prescription insurance. This confidential data is securely transferred to our software on a regular basis so that we can match the medications you take with any available alternatives that will save you money.
- How is Rx Savings Solutions different than GoodRx or coupons?
Rx Savings Solutions works through your health plan to find you the best options possible covered by your plan. Coupons and copay cards may or may not be the best options. Unlike GoodRx, Rx Savings Solutions shows you exactly what the price will be with your insurance coverage, and how much the prescription will apply to your deductible. Not only do we save you money, but your health plan saves too, which helps keep your healthcare premium costs from rising. We are also staffed with licensed Pharmacy Technicians who are available to answer all of your prescription questions and will even assist you in switching your medication to one that costs you less.
- When I log in to my account, I don't see one of the medications I'm taking. Why isn't it there and how do I add it?
The medications listed on your dashboard are those which you have filled in the last 6 months. In addition, the claims information that Rx Savings Solutions receives from your insurance company comes at a slight delay. If you have started a new medication, you can wait for the information from your insurance company to be delivered to your Rx Savings Solutions portal, or you can use the "Search for a Medication" tool located on your dashboard for current pricing and savings opportunities.
- Can my health plan dependents use Rx Savings Solutions as well? How do I view their prescriptions?
Yes, all dependents on your plan will show up on your Rx Savings Solutions dashboard. You will have access to savings information for any minor dependents. Adult dependents will be required to create their own profile, but you can see on your dashboard when they have a savings alert. If an adult dependent has a savings alert, you can notify them via email directly from the dashboard.
- Can I trust Rx Savings Solutions to secure my personal information?
- Is there an app available for my phone?
Yes, and you can view all of your savings opportunities on there, as well as sign up to receive text and email alerts for new savings suggestions.
- What information of mine do you have?
By using Rx Savings Solutions, members consent to our collection/use/disclosure of their personal information, but only for the purposes of providing our service. This includes claims information, such as the prescriptions you filled, how much you paid, and which pharmacy you utilized. We may automatically gather and keep track of information about a member’s visit to the member portal and their activity. Unlike many websites, we track this only for activity within our own site, never other web browsing.
- Do you sell my information?
No, Rx Savings Solutions will not expose your personal health information to anyone, including your employer. We do not sell or share your information for commercial purposes with any third-party marketing services. We may use and disclose health information with service providers for data analytics purposes, but it is always “deidentified,” i.e. not attached to your identity and contains no protected health information.
- As you add features, how do you ensure my privacy?
Before we utilize a new feature or even put out a new informational piece, like this FAQ, we review it with our legal compliance team to ensure we are fully protecting your data. For example, while Rx Savings Solutions is fully HIPAA-compliant, voice assistant devices are not. Therefore, even though a user can delete data held by a voice assistant device, there is still a risk that health information could be inadvertently disclosed to an unauthorized party if a voice assistant device is used to access our service.
- Why can't everyone use Rx Savings Solutions?
We want to build and deliver only the best, most effective solution possible. We want to make it accessible to the most people possible. That means partnering with employers and health plans. Our technology relies on the secure transfer of data from health plans and pharmacy benefit managers (PBMs) that include plan designs, formularies (lists of covered drugs), deductible status and accumulators, all of which are different for every plan. Without accurate data, our solution would have much lower pricing accuracy, and without the number of eligible members from each health plan, we would reach fewer people.