SPEAKING
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Clinically Speaking Newsletter:
June Issue

Issue 12: May 2025
Rethinking PBMs: Focusing on Measurably Improving Patient Health Outcomes and Lowering Drug Costs
  • Is your PBM a true ALLY? Or does it prioritize their profits over your patients?​​​​​​
  • Our industry-leading biosimilars substitution/utilization rate – 15% vs ~2% with other PBM models.​​​​
  • Based on EmpiRx Health’s book of business trends, our clients’ drug costs increase at approximately 2% per year vs 15% on average for other PBMs.
In Case You Missed It:

Transparency is Rising
EmpiRx Health was proud to sponsor and take part in Transparency is Rising, hosted by Transparency-Rx on June 24–25 in Washington, DC. This first-ever national event brought together healthcare leaders, policymakers, and innovators to tackle the need for more transparency in U.S. healthcare, with a particular focus on PBM reform and transformation. As part of the event, EmpiRx Health hosted a panel discussion called “Clinically-Driven Solutions Empowering Reform and Improving Patient Health,” moderated by our Chief Marketing Officer, Patrick Di Chiro. The panel explored how smart, clinically-focused strategies and PBM reform can lower drug costs, support patients, and improve health outcomes. With keynote speakers Dr. Mehmet Oz, Mark Cuban, Cynthia Fisher, Senators Bill Cassidy and Ron Wyden, and former U.S. Surgeon General Dr. Jerome Adams, Transparency is Rising was a great opportunity to help shape a more effective, patient-focused and transparent healthcare system.
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Empowering Pharmacists to Lower Healthcare Costs
Our CEO Danny Sanchez recently published a new article on Forbes as a member of the Forbes Business Council. Entitled, “More Than Pill Dispensers: Taking A Pharmacist-Led Approach to Curbing Healthcare Costs,” the article highlights the vital role pharmacists have always played in community healthcare.
In the article, Danny emphasizes how pharmacists are uniquely positioned to help patients manage their health by identifying potential risks, spotting drug interactions, and providing personalized medication recommendations. He also mentions the transformative impact clinical pharmacists have on pharmacy benefits care by collaborating with prescribing physicians to make evidence/data-based medication therapy recommendations based on clinical appropriateness for patients, and lowering prescription drug costs. Read the full article by clicking the button below.

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Danny Sanchez, EmpiRx Health CEO featured in PharmaVoice
Danny has also recently been featured in an article published by PharmaVoice. This article notes that states are stepping up, as no progress has been made on PBM reform at the Federal level. Arkansas just became the first state to ban PBMs from owning pharmacies. The new law highlights the urgent need for overall PBM reform, including putting an end to the self-dealing and anticompetitive business practices of the largest PBMs, which now control more than 80% of the US pharmacy care market. In the PharmaVoice article, Danny points out that the lack of federal momentum is influencing state level action on vital PBM reform. He emphasizes how state lawmakers are hearing directly from their constituents and motivating them to act, especially related to protecting community pharmacies, whose very existence has been threatened by the widely discredited business models of the legacy PBMs. Read the full article by clicking the button below.

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Featured Case Study

Patient: 30-year-old female
​​​Diagnosis: Crohn’s Disease
Population Health Management Engine Identified: A new special therapy.

• Our Care Team reviews each patient case for clinical appropriateness eliminating unnecessary drug spend and increasing member access to less costly generic options.

• An EmpiRx Health clinical pharmacist contacted the prescriber to recommend a medication that optimizes treatment for this newly diagnosed condition from evidence-based clinical guidelines

Annual Clinical Savings: $45,913