94% of large, self-insured employers rank high-cost pharmacy and medical claims as the top threat to employer-sponsored healthcare coverage.
Specialty medicines now account for 55% of net spending, up from 28% in 2011.

Bridging Access & Affordability:
Redefining Healthcare Financing

PayRx significantly lowers costs for self-insured employers and health plans to enable greater patient access to high cost advanced therapies.

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Healthcare Payors are Struggling
SkY Rocketing prices

The number two expense on business P&Ls is healthcare costs which is addressed by PayRx

DRUG PRICING

Per Reuters, median annual price for new U.S. drugs in 2024 is over $370K, with some costing more than $4M 

CLAIM COST

The cost of a single claim can be financially devastating for patients, employers and health plans 

BUSINESS MODEL

The pharmaceutical industry business model is rapidly changing from blockbusters to precision medicines such as cell and gene therapies 

Resources

Bridging the Gap: Addressing the Financial Challenges of High-Cost Medical Therapies with PayRx
Bridging the Gap: Addressing the Financial Challenges of High-Cost Medical Therapies with PayRx

As medical science advances, we are witnessing a surge in therapies.

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Orchard sets out to sell world’s priciest gene therapy
Orchard sets out to sell world’s priciest gene therapy

The role of analytics in enhancing content management strategies.

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US FDA approvals bounce back in 2023, sparking hopes of a biotech recovery
US FDA approvals bounce back in 2023, sparking hopes of a biotech recovery

Key strategies for optimizing your CMS for mobile users.

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Here's how we work for you

Pills laid out on a table spilling from a bottle

Making the unaffordable
affordable

We address the budget-breaking impact of high-cost therapies with a unique, cost-effective approach that ensures affordability and guaranteed outcomes

Our solutions are tailored, easy to implement, and can be deployed anytime within a benefit year.

Solving the challenges self-insured employers and health plans face 

Unpredictable high-cost claims are putting a strain on resources and creating an uneven playing field for payers. For many, the cost of a single event can be financially devastating. Unfortunately, existing healthcare business models and other risk management products are not suited for this growing problem.

Healthcare Payors are Struggling

That's where PayRx comes in.

>Significant reduction in healthcare benefits PMPM
>No lasers or exclusions
>Immediate and long-term savings strategy
>Can be deployed at any time in a benefit year

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Clinical and business intelligence

Powered by our data science and predictive analytics capabilities, we work with health plans and employers to monitor, plan, and pay for high-cost pharmacy and medical benefits therapies

PayRx Financing Dashboard
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  • Delivers not just analytics, but more importantly, actionable insights
  • Utilizes real world claims experience on costs, utilization, and outcomes
  • Makes the previously unpredictable nature of high-cost pharmacy and medical claims more predictable

"The PayRx team took the time to understand me and my team’s needs, then provided a comprehensive solution that exceeded our expectations. It was clear the PayRx team possessed the breadth and depth necessary to understand the challenges we face in healthcare. The insights PayRx provided have significantly accelerated our strategies and, as a result, we are looking to the future for further engagements that will be shared across the greater organization."

Raymond Tarr

Senior Director

US Commercial Diagnostic Strategy Alexion Pharmaceuticals, Inc.

"The recommendation of PayRx to my clients has helped them save money in addition to empowering them with tools and strategies to better navigate the complexities of large healthcare expenses. This proactive approach can lead to better financial flexibility and cash flow for my clients in the short and long term."

Tammeisha D. Smith

Insurance Consultant

Fairview Insurance

Precision medicine is Pharma’s future and it’s here today

Quick Facts

1 in 10

Americans suffer
from a rare disease

7,000

rare diseases

500

types of rare cancers

800

next-generation
biotherapeutics
in R&D
Learn how PayRx can help you and your customers address the challenge of high-cost pharmacy and medical therapies. 
Need more help?
Contact us

PayRx is an industry leader in delivering tailored, on-demand precision risk financing solutions and analytics for self-insured employers and health plans to enable greater patient access to high-cost advanced therapies. We leverage data science, purpose-built technology and financial engineering to manage the cost impact of advanced therapies in a unique way that is significantly more affordable, flexible, and provides greater benefits.

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