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PredictRx

PredictRx provides accurate pricing, dosing, and clinical appropriateness of care regarding the most costly Specialty Drugs

A comprehensive solution for Specialty Drugs that evaluates cost data, FDA approved indications, notable off-label usage, dosing regimens, specialty drug coding, and critical physician commentary.

 

 

Features:
  • FDA Approved Indications
  • Notable Off-label Usage
  • Adult/pediatric dosing regimens
  • Specialty Drug coding
  • AMS Cost Projection
  • AMS Risk Threshold
  • Southern Scripts (PBM) Pricing
  • Average PBM Costs
  • NDC Information
  • Manufacturer Rebates
  • Specialty Drug Price Trends
  • Additional physician researched information

 

 

Benefits:
  • Capacity to analyze complex high dollar claims for medical appropriateness, standard of care treatments and costs
  • Negotiate contracts from a position of strength by understanding current cost trends
  • Applications for Reference Based Pricing
PredictRx
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PredictRx provides our specialty pharmacy nurse case managers with real time, actionable data on what we should expect for reasonable costs for these expensive drugs. We are able to take prompt and effective action on the problem drugs to deliver positive results for our clients saving them big dollars right away—a win for our customers and a win for our stop-loss partners.

PredictDx offers bountiful context around large claimants which helps lower laser exposure or unreasonable increases in stop-loss premiums for our customers. It is also helpful when we are providing self-funded quotes to prospects that are coming from a fully insured program where claim data is limited. PredictDx can help us paint a picture with that limited data regarding the risk. This helps us guide the underwriting process to a better outcome for all.

Both PredictRx and PredictDx produce results that are dramatic and immediate.

Brooks Goodison, President of Diversified Group November 7, 2017

PredictRx Highlights

425+

Pharmaceuticals

Up-to-date financial and clinical information on 425+ high dollar pharmaceuticals

2017

Indications

Currently 860 FDA, 1,025 off-label, 132 on the horizon

259

HCPCS

Healthcare Common Procedure Coding System (“HCPCS”) mapped codes with Medicare reimbursements

100’s

NDC Codes & Rebates

NDC Package Codes and Manufacturer Rebate Information

Make Smarter Assessments

With an extensive directory of high-cost pharmaceuticals, you can confidently carry out claim assessments. The PredictRx directory is accessible through any web browser. The up to date clinically reviewed information on hundreds and hundreds of drugs is available at any time. 1, 2, 3 clicks and you’re there. All it takes is a simple search.

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