Quarterly Round-Up: Capital Rx in the News - Q1 2024

April 2, 2024

Keith LaFountaine

Q1 of 2024 has proven to be a busy, exciting time here at Capital Rx! Below, we’ve put together a quick round-up of all the newsworthy accomplishments the team has achieved since January.

Capital Rx Announces Strategic Alliance with Prime Therapeutics

Our announcement of a strategic alliance with Prime Therapeutics was one of the most significant pieces of news that came out in the first quarter of 2024. Prime is licensing Capital Rx’s leading technology platform, JUDI®, to achieve a higher standard of care, increase operational efficiency, and provide the foundation for the next generation of integrated pharmacy care for the more than 50 million Americans they serve. Once implemented, JUDI will process roughly 20% of the country’s pharmacy claims.

Capital Rx CEO AJ Loiacono and Prime CEO Mostafa Kamal spoke with MedCity News about the alliance. Explaining the current state of technological solutions in the pharmacy benefit industry, Kamal said, “The majority of the industry is using 30 to 40-year-old technology to do all of this work.”

He continued, “When we looked at everything that’s out there in the market, JUDI stood head and shoulders above anything that’s out there, anything that’s in development from our viewpoint.”

Want to learn more about this strategic alliance, how it came together, and what the future holds? Keep an eye out for our new episode of The Astonishing Healthcare Podcast on April 5, where SVP of Marketing and Communications, Michael Passanante, sat down with AJ Loiacono and Mostafa Kamal to discuss this very subject.

Capital Rx Unveils a New Medicare Prescription Payment Plan (M3P) Solution

In March, Capital Rx announced the introduction of a standalone, turnkey, end-to-end Medicare Prescription Payment Plan (M3P) solution. This solution is designed to facilitate supporting plan members’ ability to pay for their medications as required by the Centers for Medicare & Medicaid Services (CMS) guidance.

What’s exciting about this development is that JUDI is uniquely positioned to handle these needs. As CEO & Co-Founder AJ Loiacono put it, “This is the kind of new program that JUDI is tailor-made to meet the requirements of. Our modern technology’s unparalleled flexibility, efficiency, transparency, and accuracy shine in these situations, and we’re looking forward to helping health plans smoothly implement this program so that seniors can afford the medication they need on more flexible payment terms.”

“This is the biggest thing to happen to Medicare Part D since Medicare Part D,” said Jason Barretto, Vice President of Government Program Operations on episode 11 of the Astonishing Healthcare Podcast. The best part? Capital Rx’s M3P solution is an end-to-end, turnkey solution within JUDI.

New York City FC and Capital Rx Announce Sleeve Partnership

In February, Capital Rx and the New York City FC announced an official sleeve partnership. However, this is far from just an addition to their jersey. This partnership expands Capital Rx’s platform as we work to bring transparency to the pharmaceutical supply chain and lower costs to employers, health plans, municipalities, and other payers offering pharmacy benefit programs to plan members and their beneficiaries.  

Throughout this partnership, NYCFC and Capital Rx will host community programs and events to champion healthier lives for New Yorkers, which has already started with an employee volunteer community pitch cleanup day. Additionally, Capital Rx will also partner with the Club on its existing marquee events and initiatives, including the continuation of New York City Soccer Initiative to build 26 new mini-soccer pitches throughout the five boroughs ahead of the FIFA World Cup 26™ and the Club’s Golf Classic.

Capital Rx’s Co-Founder & CEO, AJ Loiacono, said, “Having grown up in the tri-state area and with soccer a major influence on my life, this partnership with NYCFC and the opportunity to amplify the work our team is and has been doing while positively impacting the local community carries special meaning.”

Kristin Begley & Mike Miele Discuss Pharmacy Benefit Procurement in IFEBP

The PBM procurement process was top of mind throughout the first quarter of 2024. Not only did Bridget Mulvenna pen an article for BenefitsPro back in January 2024, but she also hosted a webinar on the same subject in March.

Kristin Begley, PharmD (Chief Commercial Officer) and Mike Miele (SVP, Insured Services) wrote an article for International Foundation of Employee Benefit Plan’s (IFEBP) March/April benefits magazine. In this article, they broke down the PBM procurement process, pharmacy cost drivers, and how plan sponsors can achieve more predictable total costs (net of all discounts and rebates).

Kristin and Mike also addressed one of the primary cost drivers for most plans, drug mix, writing, "Most large rebates come from the most expensive brand and specialty drugs, incentivizing the PBM to dispense those drugs, yielding a more expensive drug mix, to meet the guarantees instead of trying lower cost alternatives. Plan sponsors must understand that larger rebates don’t necessarily help the plan’s economics in the long run."

5 Years of the NY Digital Health 100

The New York Digital Health 100 has been running since 2017, and Capital Rx is proud to have been included on the list for five straight years, including 2024. This is a huge accomplishment on its own, but it’s even more remarkable as the competition has grown with each year.

Capital Rx Placed on the Inc 5000 Regionals for 3rd Straight Year

For the third year in a row, Capital Rx placed on the Inc 5000 Regional – Northeast list. Not only that, but we ranked #32 – exceeding last year’s ranking and further proving the demand for and success of JUDI®, our cloud-native enterprise health platform.

5 Stevie® Customer Service and Sales Award Finalists

Another exciting award development was the news that Capital Rx has earned 5 finalist submissions as part of the 2024® Stevie Customer Service and Sales Awards. These finalists cover both departmental achievements for the Customer Service department and individual recognition for superior service and achievement.

The official status for each finalist – either a Gold, Silver, or Bronze award – will be revealed at the award ceremony on April 12. Keep your fingers crossed!

Make Sure You Never Miss an Update

Want to stay up to date with Capital Rx as more news comes out? We’ve got you covered. Subscribe to our monthly newsletter and get expert insights on pharmacy benefits delivered straight to your inbox.

You can also check out our podcast, Astonishing Healthcare – either on our podcast page or via Apple or Spotify -- which focuses on the biggest issues affecting healthcare, consumers, benefits, plan sponsors, and health plans.

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