SPEAKING
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Clinically Speaking Issue 18: January 2026

Best-in-Class Member Care Advocacy Program
  • 3%-5% of any given member population have markedly higher healthcare complexity and need much greater care and attention than the rest of the population. This sometimes results in these patients/members getting lost in the mix.
  • Our Member Care Advocates proactively reach out to members before common issues arise. They coordinate with doctors’ offices and pharmacies as needed, ensuring members feel supported and taken care of.
In Case You Missed It:

EmpiRx Health is excited to introduce “MO,” our newly expanded Medication Optimization operating model.
​​​​MO is reinventing the pharmacy care industry by deploying our team of in-house pharmacists, who leverage proprietary, AI-powered technologies to optimize the patients’ drug mix. With MO, EmpiRx Health delivers improved patient health outcomes while guaranteeing substantial clinically-driven savings for our clients. Clients can expect an average 15% decrease in drug spend in the first year with continued optimization that compounds their “MO Savings” over time. EmpiRx Health has achieved a 50%+ reduction in annual drug spending growth compared to the overall pharmacy care market. As a result, MO’s net savings outweigh what clients would have gained from a traditional, rebate-driven PBM model. Learn more in our press release here and watch our video below.

​​​2026 Leaf Health Roundtable
EmpiRx Health was proud to sponsor the 2026 Leaf Health Roundtable in Austin, TX. During this important industry event, Leaf Health brought together healthcare leaders to discuss new ways to improve pharmacy care and lower costs. Led by our team members Jeff Somar, Robert Finch, and Christie Murray, EmpiRx Health presented “AI-Enabled Population Health,” which explored insights on:

  • Clinical considerations and applications to improve patient health outcomes
  • AI’s role in augmenting the capabilities of physicians and pharmacists
  • Leveraging AI to evaluate financial risk and impact

EmpiRx Health’s Mathew Garcia also joined the team during the event to share how our strong collaboration with Leaf Health has led to even stronger results for clients. Thank you to Leaf Health for hosting this roundtable, which enabled valuable discussions and information sharing!

Resourceful Finance Pro: California PBM Law May Rest Pharmacy Oversight for Finance
​​California’s new PBM law sets a new standard for accountability and transparency in pharmacy benefits. Our CEO, Danny Sanchez, is quoted in the Resourceful Finance Pro article discussing how EmpiRx Health is already aligned with new PBM reform requirements to help employers ensure that pharmacy benefit savings are real, measurable, and patient-centered. Read the full article in the link below.

2026 MercerRx Vendor Expo
Our EmpiRx Health team had the pleasure of participating in the 2026 MercerRx Vendor Expo hosted by Mercer in Nashville, TN. EmpiRx Health team members Jeff Somar, Mathew Garcia, and Kevin Newton were on site connecting with Mercer colleagues and sharing details about the recent launch of our newly expanded Medication Optimization (MO) operating model. Thank you to our great Mercer colleagues for hosting this impactful event and encouraging meaningful collaboration and conversation.

2026 Gallagher National Pharmacy and Health Plan Services Educational Forum

We had a fantastic opportunity to spend time with our Gallagher colleagues at the 2026 Gallagher National Pharmacy and Health Plan Services Educational Forum held in Palm Beach Gardens, FL. We want to thank our great Gallagher partner, Gregory Redlinger, Area Vice President, Pharmacy Consulting, for collaborating with us during this annual event. Greg and his team are truly leading the way in pharmacy benefits care, and we are proud to partner with them and all of our Gallagher colleagues.

Clinical Case Study

Patient: 63-year-old male
Diagnosis: Lung Adenocarcinoma
Population Health Management Engine Identified: High-risk situation, clinical criteria must align with Rx.

Our Care Team reviewed the patient’s prescribed twice per day dosage of the Tagrisso therapy, which could exacerbate the patient’s comorbid condition cardiomyopathy and could be life-threatening.

  • To prevent any adverse side effects of the high dosage, our in-house pharmacists recommended a clinically appropriate lower dosage of Tagrisso to once per day based on the patient’s clinical criteria.
  • The prescriber agreed with the pharmacist’s recommendation and the patient is stable and responding well to the lower dosage. This has resulted in improved clinical outcomes and measurable cost savings.
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Annual Clinical Savings for the Plan Sponsor: $15,695