So are we.
Even the ones that call themselves “Transparent.”
Tired of PBMs?
A smarter alternative to the Traditional PBM.
A cost clarity pharmacy benefits platform that can function as your PBM
or give you everything you need to run your own.
Plan Management
Claim Processing
Appro-Rx gives employers access to more than 12 pharmacy networks and contract structures, so the plan is built around what actually works for your population.
With pharmacist led clinical oversight including formulary design, prior authorization, and on demand access to a pharmacist, we manage utilization intentionally and transparently.
The result is the lowest net cost without hidden incentives, inflated pricing models, or rebate driven decision making.
Cost Certainty Guaranteed
Appro-Rx establishes a forward-looking per-member-per-month pharmacy spend target that is guaranteed to improve upon your prior year’s results.
In most cases, that target is up to 20% lower than historical spend on drug spend and stop loss premiums, driven by disciplined clinical management and cost-containment strategies.
If total pharmacy spend exceeds the agreed-upon target, Appro-Rx covers the difference. Simple, predictable, and built for confident budgeting.
Clinical Oversight
Before a plan goes live, we review historical claims and utilization to understand where cost and risk truly sit. This includes high cost therapies, emerging spend drivers, and super claimants that disproportionately impact total pharmacy spend.
Once the plan is active, we continuously monitor claims in real time. Prior authorization decisions, utilization patterns, and member level trends are reviewed with one objective in mind: ensuring access to appropriate therapy at the lowest net cost.
This process is powered by proprietary, pharmacist built technology designed to surface what matters. Not dashboards for show, but tools that identify actionable opportunities and support informed decisions.
Patient-Centered Customer Service
Pharmacy benefits are complex. Members should not have to navigate them alone.
Appro-Rx provides dedicated, high touch support so members can get clear answers from someone who understands their specific drug plan. Each plan is supported by a consistent point of contact who becomes familiar with coverage rules, medications, and common questions.
This is not a ticketing system or outsourced call center. It is informed, accountable support designed to reduce frustration, prevent delays, and improve the member experience.
340B for Health systems and FQHCs
The 340B program can be a source of meaningful savings, but only when it is managed with transparency, compliance, and intent.
Appro-Rx evaluates when and where 340B pricing is appropriate within your plan. We help ensure eligible claims are captured correctly, discounts are applied as intended, and savings are understood, documented, and accountable.
Our goal is to align 340B use with plan goals, member access, and regulatory guardrails. When members receive care through participating FQHC providers, eligible prescriptions may be dispensed at 340B pricing. This can expand access for patients while offering cost relief for employers in appropriate settings.