Specialty Medication Management

Flexible Specialty Solutions. Calibrate Rx.

We offer an array of specialty and high-cost medication management options that balance member experience, outcomes, and bottom lines.

Through our consultative approach, we gain an understanding of your clients’ goals and personalize a program to achieve their desired results. Our flexibility and experience empower you to serve your clients best – whether they want maximum access and choice, comprehensive claim oversight, or a solution in between.

The table suggests a tiered approach to specialty medications management, starting from broad access with minimal oversight ("Core Elements") to more controlled and cost-effective strategies ("Comprehensive Oversight"). Each strategy is designed to meet different client needs and priorities, balancing member experience, outcomes, and financial considerations. It had three columns - core elements, enhances strategy, and comprehensive oversight. It has six rows - Network, formulary, clinical management, voluntary international drug sourcing, j-code oversight/site of care optimization, and funding options.
The table suggests a tiered approach to specialty medications management, starting from broad access with minimal oversight ("Core Elements") to more controlled and cost-effective strategies ("Comprehensive Oversight"). Each strategy is designed to meet different client needs and priorities, balancing member experience, outcomes, and financial considerations. It had three columns - core elements, enhances strategy, and comprehensive oversight. It has six rows - Network, formulary, clinical management, voluntary international drug sourcing, j-code oversight/site of care optimization, and funding options.
The table suggests a tiered approach to specialty medications management, starting from broad access with minimal oversight ("Core Elements") to more controlled and cost-effective strategies ("Comprehensive Oversight"). Each strategy is designed to meet different client needs and priorities, balancing member experience, outcomes, and financial considerations. It had three columns - core elements, enhances strategy, and comprehensive oversight. It has six rows - Network, formulary, clinical management, voluntary international drug sourcing, j-code oversight/site of care optimization, and funding options.

Customized Solutions to Manage Specialty Medications

If you want to learn more about Calibrate Rx and our flexible approach to cost containment, we're here to help.

Flexible Solutions for high-cost and specialty medications Include:

Our recommended network of pharmacies with our Preferred Specialty Network

Extensive oversight with our in-house clinical management

Biosimilar Advantage Formulary to promote the adoption of biosimilars and improve cost-effectiveness for plan members

Select Formulary - our preferred formulary option

Copay accumulator savings with CAAP Rx

340B pricing provides access to deeper discounts when patient assistance isn't an option

J-Code oversight and site of care optimization

A voluntary international sourcing option for select high-cost medications

Featured Clinical Programs

Specialty Drug Management

Contain costs to ensure your client achieves their desired outcomes for dollars spent on specialty medications. We provide flexible options so you can balance clinical management and patient choice.

With our comprehensive specialty drug management solution, you'll be able to provide strategies for containing drug costs and managing trend.

Diabetes care plus

The leading non-specialty drug cost driver, diabetes, affects ten percent of Americans.

Our Diabetes Care Plus Program uses a comprehensive approach to improve your client's member health education and outcomes by providing tailored interventions, increasing care access, and improving medication adherence. 

Opioid Risk Management

Through monitoring, education, and intervention, our innovative solution minimizes the epidemic's grave health, safety, and financial risks. By reducing the likelihood of misuse, our program aims to be the beginning of opioid addiction's end. Our free Opioid Risk Management Program highlights the importance we place on responsibility and accountability.