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Clinically Speaking Issue 19: February 2026

A Clinically Driven PBM with Guaranteed Results

EmpiRx Health takes a clinically driven approach led by pharmacists, with a strong emphasis on accountability and measurable savings. Focused on improving health outcomes and putting clients first, we offer a different model in a market where pharmacy costs continue to rise.

Is your PBM clinically-driven, with pharmacists driving the service model?

Do those other PBMs guarantee the savings they offer?

  • Clinical savings guaranteed at 3:1 ROI.
  • If we don’t meet our Clinical Savings Guarantee, we pay the client dollar-for-dollar. No other PBM in the market will do this.

Does your PBM focus on healthcare outcomes—or on financial arbitrage that prioritizes its own profits over your needs?

  • With an estimated $863 BILLION in pharmacy spend by 2028 in the United States, you need a PBM that puts you and your members first.
In Case You Missed It:

New Webinar: How Pharmacists are Transforming Pharmacy Care by Using AI-Powered Medication Optimization (MO)
​​​Plan Sponsors are looking for an alternative PBM model that provides greater accountability, affordability, and improved patient health outcomes. Medication Optimization (“MO”), a breakthrough pharmacy care model, is that alternative.

MO is making pharmacy care more affordable, sustainable, and transparent by pairing advanced AI technology with hands-on, pharmacist-led care. As transparency continues to drive the discussion around PBM reform, MO is proving to plan sponsors and their members that there is another type of PBM model delivering better care and lower costs.

Ready to transform your pharmacy benefits plan? Join us for our upcoming webinar, “How Pharmacists are Transforming Pharmacy Care by Using AI-Powered Medication Optimization (MO).”

NEW Date: Thursday, March 26th, 2026
Time: 11:00 AM EST
Featured Speakers: Glenn Di Biasi, Fund Administrator for the United Food and Commercial Workers (UFCW) National Health and Welfare Fund, and Kimberly Howland, EmpiRx Health Executive Vice President and Chief Product Development Officer.
Moderator: Jeff Somar, Chief Commercial Officer, EmpiRx Health Space is limited so be sure to reserve your spot.

​​​HRMorning
As prescription drug costs continue to rise, plan sponsors are re-evaluating traditional rebate-driven PBM models and questioning how effectively these models manage drug spending and improve health outcomes.

A recent HRMorning article by Carol Warner highlights that legacy PBM models often lack ongoing accountability and provide limited visibility for employers once coverage begins. This makes it challenging for HR teams to track cost shifts and changes throughout the plan year.

The article spotlights EmpiRx Health’s newly expanded Medication Optimization (“MO”) operating model as an alternative approach to pharmacy benefits. The MO operating model is clinically focused and pharmacist-led, enabling consistent oversight, clearer accountability, and better control of drug costs and member health outcomes. Read the full article below.

“Reimagining Member Experience: White-Glove Service to Streamlined Prior Authorization” Webinar with Ushur and Fierce Healthcare
Thank you to everyone who joined the recent webinar, “Reimagining Member Experience: From White-Glove Service to Streamlined Prior Authorization,” presented in partnership with Ushur and Fierce Healthcare.

If you missed the webinar, you could watch the recording in the link below. During the event, EmpiRx Health’s Kim Howland and Ushur’s Yvonne Daugherty discussed how PBMs can improve the member experience by streamlining prior authorizations, increasing transparency, and aligning clinical integrity with cost management. In addition, Kim outlined EmpiRx Health’s breakthrough pharmacy care model, called Medication Optimization, or “MO” for short. With the MO operating model, EmpiRx Health’s frontline pharmacists use AI-powered population health technology to optimize the patients’ drug mix, leading to substantial annual savings on plan sponsors’ drug costs. Watch the recording below.

PBM Reform Bill
​​EmpiRx Health supports the inclusion of key PBM reform measures in the recently enacted government spending package. These measures represent an important, bipartisan step toward meaningful pharmacy care reform that spans both the commercial market and Medicare. As we have consistently noted, the legacy PBM system fails to serve patients effectively and contributes to higher healthcare costs for employers and working families.

As a pioneer in value-based, clinically driven pharmacy care, EmpiRx Health remains committed to collaborating with policymakers on both sides of the aisle, along with pharmacy leaders and healthcare stakeholders, to ensure the PBM industry meaningfully addresses the needs of more than 180 million Americans who rely on employer-sponsored health benefit plans.

National Labor and Management Conference

EmpiRx Health was thrilled to exhibit at the 49th National Labor and Management Conference in Hollywood, FL. NLMC brings together labor and management leaders from across the country to discuss key issues shaping today’s workforce. EmpiRx Health team members Chris Mabie and Kevin Newton connected with industry leaders and continued the conversation around innovative pharmacy care solutions that improve member health outcomes and produce substantial savings for plan sponsors.

WTW Pharmacy Training and Partnership Summit

We were excited to be back in Nashville, TN, participating in the WTW Pharmacy Training and Partnership Summit. EmpiRx Health team members Jeff Somar, Shannon Strickland, and Tracey Monahan were on site connecting with our WTW colleagues, sharing insights, and discussing high-impact strategies to improve pharmacy care outcomes for plan sponsors and their members. We truly value our partnership with WTW and the opportunity to engage with industry professionals and the WTW pharmacy team.

Clinical Case Study

Patient: 13-year-old female
Diagnosis: Juvenile Idiopathic Arthritis (JIA)
Population Health Management Engine Identified: High-cost specialty medication

•    Our Care Management Team reviewed the prescribed Ruxience therapy and contacted the prescriber, as the medication was being prescribed off-label for a pediatric patient.
•    The Clinical Pharmacist discussed the patient’s treatment history, including previously tried and failed therapies, and recommended switching to an FDA-approved medication for the patient’s diagnosis of Juvenile Idiopathic Arthritis (JIA): Xeljanz.
•    The prescriber agreed to change the therapy. The patient was counseled on the alternative treatment, resulting in improved clinical appropriateness, a better health outcome, and plan savings.
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Annual Clinical Savings for the Plan Sponsor: $9,168