This Company Aims To Bring Down The Cost Of Your Medicine With Price Transparency

hen your doctor writes a prescription for medication, A.J. Loiacono thinks that one of the biggest mysteries in life is how the pharmacy arrives at the price you end up paying.

It was at that point, in 2017, that he decided “enough’s enough.” Loiacono and two of his colleagues, Joseph Alexander and Ryan Kelly, founded pharmacy benefit manager Capital Rx with a goal of offering more transparency for prescriptions. To that end, his company announced Wednesday that it now has a consumer prescription card, Capital Rx Advantage.

But it’s not always easy to figure out where drug prices come from, says Loiacono. That’s thanks to some of the convoluted connections between insurers, plan providers, suppliers and pharmacies. “When I read my first PBM contract, I was like, ‘Is there an amendment? Is there a schedule? Where are the drug prices?’ Because if you’re coming from manufacturing and the supply chain, everything has a price. And my colleagues on the payer side would be like, ‘We don’t have drug prices.

Capital Rx, which now serves as a PBM for organizations and manages costs for over 500,000 people so far, has made the first step in managing drug price transparency. Rather than rely on complicated formulas, the company bases its prices on the National Average Drug Acquisition Cost pricing, a benchmark developed by the federal government. This benchmark is married with its pricing model, which the company says provides visibility into drug unit pricing with minimal variability.

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