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The $22,383 Prescription Your Clients Don’t Have to Pay For
How our pharmacist-led clinical team is cutting specialty and GLP-1 spend, without disrupting members
Specialty drugs and GLP-1 medications drive the toughest pharmacy cost conversations you have with clients. At Serve You Rx, a licensed pharmacist is part of those conversations. As we celebrated National Pharmacy Week this October, we took a closer look at the clinicians behind the results.
Specialty: stopping the product hop
Biosimilars for Humira and Stelara deliver the same clinical response at an 80–90% discount. Manufacturers know it, so they steer patients toward newer patent-protected brands like Skyrizi and Rinvoq. Skyrizi runs $22,383 per fill. The biosimilar costs $1,245.
Our Biosimilar Advantage Formulary closes that gap. It steers first to a proven biosimilar, excludes legacy brands, and blocks the reflexive switch to high-cost newcomers. For one employer with about 700 members, the result was a $34 PMPM reduction in drug spend. Because we’re independent, with no ownership stake in any biosimilar, we recommend the lowest-cost, most clinically appropriate product every time.
GLP-1s: savings without waiting for renewal
Another self-funded client watched weight-loss GLP-1 costs climb. Our clinical team analyzed their utilization and worked with them on a targeted strategy:
- Prior authorization for weight-loss medications
- Grandfathering for members already on therapy
- Outcomes and utilization reviews at 6 and 12 months
The client made these changes mid-year, outside the standard renewal cycle. Monthly spend on weight-management drugs dropped nearly 10%, putting the plan on track to save nearly $350,000 a year. Current members kept their therapy without interruption.
A pharmacist assigned to your client
Results like these start with our Clinical Account Executives (CAEs). Every client can work with a dedicated CAE, a licensed pharmacist who monitors utilization and trend data, spots savings opportunities early, and brings clear recommendations to the table.
Several of our CAEs bring close to, or more than, 20 years of clinical and managed care experience, along with backgrounds in retail, hospital, and clinic practice. Beyond the PharmD, some are Certified Specialty Pharmacists and others hold an MBA. When a PBM decision reaches your client’s CEO and CFO, your CAE’s recommendations hold up clinically and financially.
Keeping members on therapy, without the friction
Behind every CAE is a clinical review team that keeps members moving:
- Clinical Pharmacists review prior authorization and step therapy requests, keep clinical criteria current, and flag formulary changes, recalls, and withdrawals early.
- Prior Authorization Technicians handle each request from start to finish, follow up with prescriber offices, and research alternate funding options when a drug isn’t covered.
- A dedicated Specialty Prior Authorization Technician works directly with our specialty pharmacy partner to resolve access issues fast.
For your clients, that means fewer surprises, fewer frustrated members, and fewer escalations landing on your desk.
Let’s connect
To see what our clinical team could find in your clients’ plans, email Sales@ServeYouRx.com or call 888-243-6890.
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About Serve You Rx®
Serve You Rx is a full-service pharmacy benefit manager (PBM) with unquestionable flexibility and an unwavering commitment to doing what’s best for its clients. With a fervent focus on those it serves, including insurance brokers, consultants, third-party administrators, and their clients, Serve You Rx delivers exceptional service and tailored, cost-effective benefit solutions. Independent and privately held for nearly 40 years, Serve You Rx can implement new groups in 30 days or less and say “yes” to a wide variety of viable solutions. Known for its adaptability, quality, and client-centricity, Serve You Rx aims to be a benchmark for better client service.
