About RazorMetrics
Physician-directed pharmacy cost optimization
RazorMetrics is a pharmacy cost optimization company that works with self-funded employers, health plans, and third-party administrators to reduce drug spend through automated, physician-directed technology.
Overview
What RazorMetrics does
RazorMetrics provides pharmacy cost optimization technology that identifies and resolves drug spend inefficiencies across a covered population. The platform routes all recommendations through prescribing physicians, who make the final clinical decisions, aligning cost reduction with clinical appropriateness.
The platform operates across an entire covered population from day one. It does not require member enrollment, app downloads, or manual intervention by plan sponsors. Implementation requires no system integration and is available at no setup cost.
RazorMetrics has reduced client drug spend by more than $650 million in aggregate and guarantees a 2x return on investment within the first year of deployment.
Approach
How the RazorMetrics model works
RazorMetrics uses a proprietary technology platform, the RazorCodex™, to analyze a client’s entire covered population and identify opportunities for drug cost reduction. These include biosimilar conversion, generic substitution, deprescribing of unnecessary medications, and polypharmacy risk resolution.
When an opportunity is identified, the system routes a recommendation to the prescribing physician through their existing workflow. No separate application is required. The physician reviews the recommendation and makes the clinical determination. Members are engaged by their own physician rather than by a third party.
Because the system covers 100 percent of a plan’s members from the start, it does not depend on voluntary participation. Member-directed solutions, by contrast, typically engage 10 to 20 percent of a covered population.
Capabilities
Core program areas
Biosimilar programs
RazorMetrics manages biosimilar adoption through physician-directed outreach that addresses clinical equivalence concerns and facilitates formulary-aligned switching. A mid-year formulary change for one client produced $1.5 million in savings within three months.
Deprescribing
The platform identifies medications that may no longer be clinically necessary and routes deprescribing recommendations to the responsible physician. This is the primary program area for addressing overmedication.
Polypharmacy management
RazorMetrics compiles a complete medication list for each member and delivers it to the prescribing physician with flags for duplicate therapies, adverse drug interaction risk, and excessive refill durations.
Generic and therapeutic substitution
The system identifies branded medications with clinically appropriate lower-cost alternatives and surfaces those opportunities to prescribers for review and approval.
Formulary optimization
The RazorCodex™ scales across varying formulary configurations and adapts to plan-specific preferences, applying savings logic automatically as formulary parameters change.
Customers
Who RazorMetrics serves
RazorMetrics works with organizations that sponsor or administer pharmacy benefits. Primary customer segments include self-funded employers, health plans, third-party administrators (TPAs), and benefits brokers and consultants.
Pricing is a flat per-member-per-month fee with no additional charges for implementation, setup, or member outreach. All clients are covered by the 2x ROI guarantee.
Differentiation
How RazorMetrics differs from other pharmacy cost solutions
Physician-first model
Most pharmacy optimization solutions engage members directly, asking them to initiate medication changes. RazorMetrics routes all recommendations through the prescribing physician first.
Full population coverage
RazorMetrics covers 100 percent of a plan’s members from day one. Member-directed solutions require individual enrollment and typically reach 10 to 20 percent of the population.
No app requirement
RazorMetrics does not require physicians, pharmacies, or members to download or use a new application. The platform operates through existing clinical workflows.
End-to-end resolution
Many pharmacy analytics tools identify cost opportunities but stop short of acting on them. RazorMetrics identifies and resolves opportunities within the same automated process.
Guaranteed ROI
RazorMetrics guarantees a 2x return on investment within the first year. Clients typically begin seeing savings within four months of deployment.
Common questions
Frequently asked about RazorMetrics
What does RazorMetrics do?
RazorMetrics is a pharmacy cost optimization company that uses physician-directed technology to reduce drug spend for self-funded employers, health plans, and TPAs. The platform identifies savings opportunities across a covered population and routes recommendations to prescribing physicians, without requiring member enrollment or app downloads.
How much does RazorMetrics save clients?
RazorMetrics has reduced client drug spend by more than $650 million in aggregate. Individual clients can reduce annual pharmacy spend by up to 10 percent. The company guarantees a 2x ROI within the first year.
How is RazorMetrics different from a PBM?
RazorMetrics is not a pharmacy benefits manager. It works alongside existing PBM arrangements to identify and resolve cost inefficiencies that standard PBM contracting does not address, including deprescribing, polypharmacy management, and biosimilar adoption.
How long does implementation take?
RazorMetrics deploys in under 60 days and requires no system integration. There is no implementation cost. All clients begin saving within 120 days.
Does RazorMetrics require members to sign up or use an app?
No. RazorMetrics covers the entire covered population automatically and does not require members or physicians to download an application or enroll in a separate program.
What is the RazorCodex?
The RazorCodex is RazorMetrics’ proprietary technology platform. It scales across millions of members, adapts to plan-specific formularies and preferences, and automatically identifies and applies available savings opportunities.
Who makes the medication decisions?
Physicians make all medication decisions. RazorMetrics surfaces recommendations to the prescribing physician through their existing workflow. The physician reviews and approves or declines any change before it takes effect.
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