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Problem Tech Solves

Tech Brief

Consumers never know exactly how much they will pay for their prescription meds until they checkout at the pharmacy counter. Also, what they pay at the pharmacy today can be very different if they pay at a different pharmacy tomorrow. When people fill a prescription, they’re spinning a roulette wheel, and the invisible players in the drug supply chain decide if they’re a winner (lower price) or a loser (higher price). Between a drug manufacturer and at the pharmacy counter sits pharmacy benefit managers (PBMs). The big three PBMs account for more than 75% of prescription claims processing and utilize antiquated technology. They thrive in opaque systems that isolate the drug makers, insurers, and pharmacies from communicating with each other. These legacy juggernauts prevent meaningful progress on reducing drug spending and driving up consumer costs. This is the problem Capital Rx is addressing: The lack of transparency in the drug supply chain. Historically, there’s been no need for the major PBMs to provide transparent, affordable prescription drug benefits to their customers - employers and their employees. This model is in stark contrast to the acute conditions employers are grappling with today. Managing skyrocketing healthcare benefits costs impacted by inflation has become the number one priority for most employers. They have begun to have a laser focus on cost-effective benefits, including pharmacy benefits, to attract and keep top talent. Capital Rx Illuminates the black box of pharmacy benefits by creating transparent pricing at each stage of the patient and client experience.

Tech Differentiators

Unlike traditional PBMs, Capital Rx leverages modern technology and a transparent, government-authorized pricing framework called NADAC to help employers save an average of 27% on their prescription drug spend. Capital Rx’s JUDI’s serverless architecture allows for unlimited scalability, instant right-sizing, and the unique capability to handle clients of any size. In addition, pharmacy claims are processed at remarkably faster speeds than the industry standard time. JUDI™ ensures that even the most complex prescription drug plans are flawlessly implemented in a fraction of the time compared to legacy systems. Thanks to JUDI™, changes made at the plan level are processed within 3-5 minutes vs the industry average of 30-35 days. It takes 8-12 hrs for new plan setups with Capital Rx while it takes 250-600 hours with the other PBMs. JUDI™ allows infrastructure deployments to happen in 1 day, meanwhile, it takes 3-12 months with other PBMs. The JUDI™ platform open-API architecture also breaks industry standards by enabling real-time communication among physicians, pharmacies, patients, and plans and allowing better medication access at the lowest cost possible.


JUDI™ powered all aspects of Capital Rx’s business incclduing its drug pricing model called the Clearinghouse Model™ which is the first ethical framework for drug pricing. Capital Rx clients receive lower medication costs and benefit from integrated clinical strategies that improve patient care, streamline workflows and result in cost savings on specialty drugs. Because of JUDI and the Clearinghouse Model™ clients save an average of 27% on their drug spend, including a 15% savings on specialty drug spend.

Why Us