CarelonRx Launches SpecialtyRx Savings Navigator

CarelonRx announced the launch of SpecialtyRx Savings Navigator, a comprehensive approach to specialty medication savings across pharmacy and medical benefits. This solution aims to help employers plan for the specialty spend of tomorrow, while providing advocacy and care to their employees who utilize specialty medications today.

Using advanced analytics, CarelonRx’s SpecialtyRx Savings Navigator will identify members whose health is at the greatest risk. Once identified, this sparks a thorough review of a member’s clinical diagnoses, medications, whole-health integrated support, and a review of their site of care options.

Members will then experience proactive pharmacist-led outreach to address any barriers to care, and to further coordinate integrated care with their whole health team, including medical and behavioral health professionals. The SpecialtyRx Savings Navigator product is now available to integrated Administrative Services Only (ASO) clients.

Elevance Health’s CarelonRx segment markets and offers pharmacy services, including pharmacy benefit management services, to its affiliated health plan customers, as well as to external customers outside of the health plans the company owns.

CarelonRx offers a comprehensive pharmacy services portfolio, which includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services.

CarelonRx delegates certain core pharmacy services to CVS Caremark, pursuant to an agreement that is set to terminate on December 31, 2025.

While just 3% of CarelonRx plan members take specialty medications, specialty drugs/medications account for over 60% of total drug spend (medical + pharmacy).

Elevance Health continues to execute its strategy to accelerate capabilities and services, invest in high-growth opportunities, and optimize its health benefits business. In implementing the company’s strategy, SpecialtyRx Savings Navigator is one of several ways the company is supporting members who are living with complex illnesses and expanding its footprint in specialty pharmacy:

• Elevance Health recently acquired Paragon Healthcare, a company specializing in infusible and injectable therapies.
• The company also intends to acquire Kroger Specialty Pharmacy in 2024.
• Elevance Health acquired BioPlus, a company that provides a complete range of specialty pharmacy services for patients living with complex and chronic conditions, such as cancer, multiple sclerosis, hepatitis C, autoimmune diseases, and rheumatology.
• In 2024, CarelonRx will complete its operational scale by opening three additional BioPlus Specialty Pharmacy dispensing centers in Chandler, Arizona; Indianapolis, Indiana; and Raleigh/Durham, North Carolina; as well as four non-dispensing pharmacies in Las Vegas, Nevada; Denver, Colorado; St. Louis, Missouri; and Indianapolis, Indiana. These additional pharmacy sites reflect CarelonRx’s expansion to support specialty pharmacy delivery and medication management for its customers.

Elevance Health’s companies serve more than 115 million people through a diverse portfolio of industry-leading medical, digital, pharmacy, behavioral, clinical, and complex care solutions.