EmpiRx Health

EmpiRx Health is a pharmacy benefits management (PBM) company that operates on a value-based, clinically-driven model rather than the traditional volume-based approach. The company places pharmacists at the center of its PBM service model, utilizing AI-powered technologies and advanced population health analytics to coordinate patient care. Their proprietary population health engine, based on the Johns Hopkins ACG model, provides risk stratification and predictive modeling to enable evidence-based medication therapy decisions. In May 2024, EmpiRx Health launched Clinically, an AI-powered platform that integrates pharmacy claims adjudication, clinical reviews, and population health management into a unified system to enhance patient care delivery. The company's open formulary approach allows access to medications based on clinical appropriateness rather than predetermined restrictions. Between 2020 and 2021, while experiencing a 9.4% increase in behavioral health claims, the company achieved a 1.8% reduction in per-claim spend for antidepressants and a 9.1% decrease for ADHD medications. The company reported a 93.5% medication adherence rate as of October 2022.

Key customers and partnerships

EmpiRx Health serves various industries including grocery, retail, and healthcare sectors. One of their notable customers is the UFCW National Health and Welfare Fund, for whom they embedded a member care advocate within the Fund's benefit team, resulting in over 1,200 member engagements and more than USD 2 million in clinical savings. The New England healthcare Employees Welfare Fund 1199NE is another customer utilizing their clinically-driven PBM model. Approximately 2.6% of EmpiRx's patient population consumed 48% of its services through their Member Care Program for complex disease management.