- Gives plan sponsors much greater pricing visibility and transparency by shifting infusion therapies covered under the medical benefits to the pharmacy benefit
- New program delivers up to 10%+ in savings to benefits plans sponsors
- Leverages EmpiRx Health’s Medication Optimization (“MO”) operating model to deliver expanded clinical oversight over costly infusions
MONTVALE, N.J., April 15, 2026 /PRNewswire/ — EmpiRx Health, the leading pharmacist-led pharmacy benefits management (PBM) company, today announced the launch of a breakthrough Infusion Therapy Management solution that delivers increased pricing visibility and significant cost savings by shifting infusion therapies from being covered under the medical benefit to a pharmacy benefit. The new program ensures the clinical appropriateness of high-cost infusion therapy treatments by providing significantly enhanced clinical oversight through EmpiRx Health’s exclusive Medication Optimization (“MO”) operating model.
With over 50% of specialty medications – including infusion therapies – covered under the medical benefit, cost optimization is essential for employers who sponsor health benefits plans. Additionally, over half of infusion therapies and injectables are delivered in higher-cost hospital outpatient settings, leading to price inflation of up to 300%.
EmpiRx Health’s Infusion Therapy Management solution shifts coverage from the medical benefit to the pharmacy benefit. This shift is critically important as only 35% of employers received rebates under their medical benefit versus 92% under the pharmacy benefit.[1] By streamlining specialty medication coverage, addressing inefficiencies, and enabling eligible patients to access copay assistance, EmpiRx Health’s new solution can deliver savings of 10%+ for benefit plan sponsors.
“As we regularly meet with employers and their benefits consultants and advisors, probably the number one concern we hear is how to better manage the constantly rising costs of prescription drugs, especially specialty medications,” said Danny Sanchez, Chief Executive Officer of EmpiRx Health. “Our new Infusion Therapy Management solution strongly addresses these concerns by giving plan sponsors much greater visibility into pricing than is possible under the traditional medical benefit coverage.”
Sanchez continued: “The fact is that medical billing often obscures costs and limits the ability of employers to address unexpected cost drivers. Our innovative new Infusion Therapy program not only enhances cost transparency but also enables strategic management of these lifesaving therapies. This results in improved patient health outcomes as well as measurable cost savings for plan sponsors.”
The new solution also features 24/7 hands-on care management support that provides guidance tailored for individual members and their specific therapies and locations. In addition, the solution’s enhanced clinical oversight includes increased engagement with prescribing physicians to ensure the right drug, at the right dose, and the right cost for every member.
Beyond cost savings, the new Infusion Therapy Management program provides enhanced clinical oversight through EmpiRx Health’s Medication Optimization (“MO”) operating model. The integrated MO pharmacy care model ensures members receive clinically appropriate, cost-effective, and timely care.
With MO, EmpiRx Health’s team of in-house pharmacists leverage proprietary, AI-powered technologies to optimize the patients’ drug mix with clinically appropriate care. The result is improved patient health outcomes and sustainable reductions in prescription drug spending and costs. EmpiRx Health clients can expect an average 15% decrease in drug spend in the first year alone because of MO. In addition, the clients’ drug spending is continually optimized through MO, keeping costs down in succeeding years and compounding the “MO Savings” over time.
About EmpiRx Health
EmpiRx Health is the leading clinically-driven pharmacy benefits management (PBM) company that puts the pharmacist at the center of its unique Medication Optimization operating model, called “MO.” With MO, EmpiRx Health’s in-house team of clinical pharmacists leverage the company’s Clinically™ technology platform to optimize the patients’ drug mix with clinically appropriate care. This results in improved member health outcomes and substantially reduced prescription drug costs for benefits plan sponsors. With major offices in Montvale, NJ and Orlando, FL, EmpiRx Health celebrated its 10-year anniversary in 2024. To learn more, visit www.empirxhealth.com. More information on Clinically can be found at www.clinically.co.
Contact:
Stephanie Cox
Phone: (201) 775-6971
Email: [email protected]
SOURCE EmpiRx Health
