For more than 30 years, RxBenefits has helped employers and benefits advisors optimize pharmacy benefits through a model rooted in choice, clinical rigor, and innovation. But time and again, a troubling pattern persists. Pharmacy benefits managers (PBMs), including so-called transparent ones, promise clarity, flexibility, and savings – but fail to deliver. The result? Employers can’t achieve their plan goals and lose trust. Members’ access and experience can suffer.
The need for something fundamentally different is clear. And the time is now.
Introducing Illuminate Rx, the newest addition to RxBenefits’ one-of-its-kind curated marketplace of PBM solutions. What has always made our marketplace unique is that it gives employers and benefits advisors meaningful choice and includes the nation’s leading PBMs. Rather than being stuck with a rigid one-size-fits-all model from one PBM, clients can choose from multiple PBM partners including traditional and transparent ones, for the solution that best fits their needs and objectives.
And, now with the addition of Illuminate Rx, clients have access to a purpose-built, transparent alternative to help them achieve their plan, member care, and clinical priorities. Illuminate Rx is a next-generation PBM, designed by RxBenefits clinicians, and intentionally built to realign the model around the people who matter most: the employers funding the plan and the members depending on it.
Illuminate Rx was built for employers who want more flexibility, clarity, and accountability in pharmacy benefits. As an affiliate of RxBenefits, Illuminate Rx is powered by RxBenefits’ 30-year legacy of excellence in service, scale, and client alignment.
Why now is the time for Illuminate Rx
Repeatedly, we hear the same thing – from clients, benefits advisors, and critics of the PBM industry – there is a need for clarity, control, and a solution that meets each client where they are that remains unmet.
The calls for “more control,” “less confusion,” and “a partner who puts us first” are loud and oft repeated. However, rather than becoming clearer or easier to understand, pharmacy benefits have only grown more convoluted and increasingly opaque.
Furthermore, clients face mounting cost control challenges as emerging therapies push clinical and financial risks to new levels. Consider that:
- Specialty drugs now account for more than 55% of total drug spend
- GLP-1 prescriptions are soaring in both volume and cost
At the same time, employers are stuck with traditional underwriting models that are bound by rules and one-size-fits-all approaches riddled with financial conflicts that don’t serve their needs or help them meet their goals. This leaves them with limited visibility into where their pharmacy dollars are being spent.
Illuminate Rx changes that.
Built to do the right thing
Illuminate Rx is built on a simple but powerful idea – doing the right thing. That means delivering smarter care and complete financial clarity without cutting corners.
Many PBMs, even so-called transparent PBMs claim transparency but hide details like spread pricing, rebate withholds, and drug-level pricing in the shadows.
Illuminate Rx is built on a robust foundation of expertise, offering clients tailored solutions with no hidden fees, no opaque contracts, and a relentless focus on outcomes and affordability.
With Illuminate Rx, there’s none of those games.
Clients get:
- Unprecedented clarity: Rates and rebates don’t stand on their own. A big rebate on a drug with a higher starting price means that drug is still going to cost more than a drug with a smaller rebate but a much lower starting price. Illuminates provides full visibility into drug-level pricing, rebates, and plan performance data so clients make smart, informed decisions
- Lowest net cost strategy: A formulary crafted by clinical pharmacists, which prioritizes biosimilars and generics to ensure the best health outcomes at the lowest cost
- Greater flexibility: The freedom for clients to tailor their formulary to get the best AWP and network to meet their unique needs, with access to innovative solutions like Mark Cuban Cost Plus, Costco Pharmacy, and Amazon Pharmacy
Instead of driving members toward high-cost brand drugs, Illuminate Rx offers formulary options that put clinically appropriate biosimilars and generics first – protecting both member health and the plan’s bottom line. Our outcome-focused clinical management cuts waste, optimizes dosing, and guides members to safe, cost-effective alternatives when it’s the right choice for their care.
Designed by pharmacists. Powered by data. Obsessed with outcomes.
Control without conflict
Illuminate Rx doesn’t prescribe an inflexible plan. It empowers clients to choose options that work for them starting from a transparent evaluation of all available PBM options based on their own pharmacy plan data, plan designs tailored to meet their unique needs, and ongoing monitoring and optimization recommendations to stay ahead of market trends. And, with ongoing and on-demand reporting on plan performance, clients always know where their pharmacy dollars are being spent and why.
Created by RxBenefits. Built for the future.
Illuminate Rx is not meant to replace existing PBM options in the RxBenefits marketplace – it expands what we offer. RxBenefits will continue to recommend the best PBM fit for each client, based on data, goals, and economics. Illuminate Rx simply adds a powerful new option to an already unique and robust marketplace.
For employers who want options beyond what traditional PBMs offer, individual and unique underwriting may be the right choice. With Illuminate Rx, they are armed with the data to make empowered decisions and choose the option that helps them achieve enlightening results. Whether it’s trying to rein in runaway GLP-1 spend, improve plan performance, or just getting their pharmacy plan details out of the dark, Illuminate Rx puts clients back in control. It’s more than a PBM. It’s a new way forward.
