Company: Capital Rx, New York, NY
Company Description: Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA). As a Certified B Corp™, the company is deploying JUDI®, its cloud-native enterprise health platform, to advance our nation’s healthcare infrastructure and improve drug price visibility and patient outcomes.
Nomination Category: Company / Organization Categories
Nomination Sub Category: Most Innovative Company of the Year - Up to 2,500 Employees
 Nomination Title: Capital Rx
- Which will you submit for your nomination in this category, a video of up to five (5) minutes in length about the achievements of the nominated organization since January 1 2023, OR written answers to the questions for this category? (Choose one):
Written answers to the questions
- If you are submitting a video of up to five (5) minutes in length, provide the URL of the nominated video here, OR attach it to your entry via the "Add Attachments, Videos, or Links to This Entry" link above, through which you may also upload a copy of your video.
Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) advancing our nation’s electronic healthcare infrastructure. Leveraging JUDI®, a purpose-built enterprise health platform, we are deploying the electronic infrastructure our nation needs to deliver the healthcare we deserve while simultaneously investing in the patient care experience.
Since its founding in late 2017, Capital Rx has pushed the envelope to achieve the impossible in health technology, including:
Capital Rx also announced its Never Move Again™ solution, which unbundles pharmacy benefits for large plan sponsors (10,000+ lives) and empowers them to use any fulfillment or clinical service with an ERISA-compliant framework. No other platform on the market has the interoperable, secure, and future proof capabilities to accomplish this besides JUDI.
In short, Capital Rx can meet the highest compliance and security standards at the lowest possible cost, becoming the new standard for pharmacy benefit administration.
- If you are providing written answers for your submission, you must provide an answer to this first question: Briefly describe the nominated organization: its history and past performance (up to 200 words):
Total 177 words used.
Since 2023, Capital Rx has experienced record growth in its Commercial book of business, and both its strategic funding round and alliance with Prime Therapeutics are largely attributable to JUDI and its industry-leading flexibility, scalability, and security. Capital Rx’s membership has grown exponentially, yet it has maintained an industry-leading approach to pharmacy benefits.
Our Client and Member NPS exemplify this dedication. At Capital Rx, we’ve maintained an NPS >80 since 2023, currently standing at 84. Similarly, our Client NPS has never fallen below 90 in the same time period.
In March 2024, Capital Rx entered into a strategic alliance with Prime Therapeutics, making JUDI the sole pharmacy claims processing platform for more than 50 million lives. We also unveiled two solutions to market. One was for the Medicare Prescription Payment Plan (M3P) program, which 15 clients have signed onto, representing more than 327,000 lives, growing our Medicare book of Business by 300%. The other, Never Move Again™ enables large plan sponsors to unbundle pharmacy benefits and use any fulfillment or clinical service with an ERISA-compliant framework.
- If you are providing written answers for your submission, you must provide an answer to this second question: Outline the organization's achievements since the beginning of 2023 that you wish to bring to the judges' attention (up to 250 words):
Total 156 words used.
The status quo PBM solution and legacy claim processing technology is no longer acceptable to plan sponsors and health plans.
In choosing to form an alliance with Capital Rx and license an instance of JUDI, Prime Therapeutics put JUDI through rigorous testing. The results were incomparable to anything in the industry.
One instance of JUDI can:
In an interview with MedCity News, Prime’s president and CEO Mostafa Kamal explained, “When we looked at everything that’s out there in the market, JUDI stood head and shoulders above anything that’s out there.”
Pharmaceutical Strategies Group (PSG) revealed in their 2024 Annual Report that PBM NPS among employers and health plans has fallen to 13 and –15, respectively. Capital Rx’s Member NPS has been above 80 since March 2023, and our Client NPS has never fallen below 90.
- If you are providing written answers for your submission, you must provide an answer to this third question: Explain why the achievements you have highlighted are unique or significant. If possible compare the achievements to the performance of other players in your industry and/or to the organization's past performance (up to 250 words):
Total 30 words used.
- You have the option to answer this final question: Reference any attachments of supporting materials throughout this nomination and how they provide evidence of the claims you have made in this nomination (up to 250 words):
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