Prior Authorization...
Reimagined
A clinical, hands-on approach to ensure patients achieve the greatest health outcomes, using the lowest cost medications.
Right
Drug
Right Treatment Plan
Right
Outcome
Too Much Trust...
Too much trust has been placed in prior authorizations and step-therapy. We assume that approval by either of these processes means the patient is on the correct and lowest cost medication.
More often, a more effective and/or lower cost drug could be used to achieve the health outcomes we want.
We've Seen Our Healthcare System Fail, Time and Time Again...
As practicing pharmacists, we’ve seen the gaps in traditional care and the failure to achieve optimal drug management, from provider to PBM to pharmacy. The current system leaves patients navigating a confusing and transactional healthcare process, with very little guidance. As a result, patients are not given the chance to obtain the right medications, in order to achieve the best outcomes.
Providers
Providers have limited time to educate patients and identify the best and most cost-effective medications
Pharmacy
Retail pharmacists are far too overworked and rarely have time for clinical patient care
PBMs
Prior authorizations and step-therapy offered by PBMs are barriers to care and don't assist to identify solutions
Say Hello to Your Most Trusted Benefit
There’s so much focus on reducing drug costs through rebates, patient-assistance-programs and alternative sourcing. However, the ability to reduce these costs through clinical management is completely overlooked.
We integrate with members’ existing healthcare teams to improve the care they currently receive, offering clinical, evidence-based recommendations that reduce costs while never risking members’ health outcomes.
Monthly follow-ups ensure continued success and cost reduction.
Let’s see prior authorizations and step-therapy try to do that!
Managing Prescription Drug Costs is a Top Priority for Most Employer Sponsored Health Plans
High Cost Drugs We Commonly Discontinue, Deescalate or Substitute:
How Does it Work?
Collect
We collect the member’s data from the health plan.
Compare
We compare the member’s data and medical history with their current medications.
Correct
We correct the member’s drug regimen in coordination with their healthcare providers, to ensure they’re taking only the right medications; marrying low costs with the best health outcomes.
Working With Apothicor Wellness is Simple:
No Plan Changes.
No Carrier Changes.
No Formulary Changes.
We know how much bringing results to your clients
matters to you
You’re an innovative health insurance advisor committed to creating transformational change for your clients. You know rising health insurance costs are eating away at employees’ hard-earned take-home pay and your client’s bottom line and you want to help. However, it’s frustrating when you aren’t generating the results you’ve promised your client.
You’ve utilized the best provider network and tools like prior authorization and step-therapy to improve care for plan members. The problem? Healthcare costs, including pharmacy spending, continue to rise. Providers continue to prescribe high cost medications and utilizing a transparent pharmacy benefit managers helps, but you wonder how to further cut costs.
Where can you turn? Enter Apothicor.
We are a drug concierge program that creates lower drug spend and better health outcomes. Here’s how we do it:
1. We collect the member’s health data from the health plan.
2. We compare their health data to their current list of medications.
3. We discontinue, deescalate or substitute expensive and ineffective medications to marry lower costs with better health outcomes.
As a result, members begin receiving the right medications. Employers see a significant reduction in health insurance costs while witnessing improved health outcomes for their workforce and you feel good because you’re delivering on promises knowing you have a partner you can trust.