Who we help · Payors
The most hands-free, high-impact way to lower drug spend
Shrink costs. Boost member satisfaction.
Cut drug spend up to 10% while improving your STARS, CAHPS, and HEDIS scores.
89% of people would view their health plan or insurance more favorably if it offered a low-cost drug benefit. RazorMetrics can help you retain and grow your member base with thousands of automatically applied cost-saving opportunities that amplify your clinical team’s efforts and complement your Real-Time Benefit Tool.
Pharmacy teams love having RazorMetrics in their arsenal to minimize manual work and make therapeutic interchange and polypharmacy management scalable.
Move fast, save fast.
RazorMetrics lets you think outside the buying cycle, deploying in under 60 days whenever you’re ready to save.
There’s no implementation cost, no integration, and as a clinically and HIPAA-compliant solution that’s consultant-approved, trust, speed, and performance come standard.
Simply sign up, start saving, and become a hero in under 120 days.
Take a new approach with dramatically different results.
Nine out of ten people will take a new medication originating from their healthcare provider. By connecting directly with prescribers, not members, RazorMetrics saves time, increases medication adherence, and eliminates frustration generated by the standard pharmacy care loop.
Our unique physician-focused approach results in a 76% response rate, with 41% acceptance, and never burdens members with opt-ins or app downloads.
Cost containment solutions for payors and healthcare decision-makers
Pharmacy spend is no longer a line item you can passively manage. It’s one of the fastest-moving cost drivers in health plans, shaped by evolving treatment protocols and rising expectations from members and regulators. You’re expected to control costs, protect outcomes, and maintain member satisfaction without adding operational drag.
Whether you are setting strategy, managing pharmacy benefits, tracking financial performance, or evaluating implementation, you need cost containment solutions that deliver results without disrupting your current ecosystem.
Our technology-driven pharmacy benefit optimization can help you reduce prescription drug costs and support broader medical cost containment—all with minimal lift.
The challenges payors face in controlling pharmacy spend
Few cost categories test your strategy as much as pharmacy. Costs rise fast, and what looks manageable on paper often proves harder to influence in practice. Specialty medications and biologics now drive a large share of overall spend, and even with formulary controls in place, a lower-cost option only works if it is clinically appropriate and actually recommended by the prescriber.
Then comes the follow-through. A more cost-effective therapy does not create value if the member does not stay on treatment, or if the switch creates confusion. It can be difficult to get prescribers to review and act on cost-saving recommendations, especially when outreach happens outside their workflow.
All of this is happening while you’re balancing cost control with performance on STARS, HEDIS, and CAHPS—and dealing with increasing scrutiny from employers and regulators. Controlling pharmacy spend is not just a pricing issue. It’s a clinical, operational, and strategic one.
How pharmacy benefit optimization fits into your existing ecosystem
RazorMetrics is designed to strengthen your existing ecosystem. You do not need to replace your PBM or undertake a major systems transformation to get value from the platform.
Our approach to pharmacy benefit optimization works alongside the infrastructure you already have in place. With minimal IT involvement and a fast deployment timeline, RazorMetrics quickly adds a layer of intelligence that helps your current systems perform more effectively. The platform also automates both opportunity identification and physician outreach, reducing the need for manual workflows and internal coordination.
By surfacing clinically appropriate savings opportunities that might otherwise go unnoticed, we make medical cost containment more actionable and efficient.
Why payors choose RazorMetrics
Most pharmacy programs already generate insights. The challenge is acting on them—consistently and without adding friction. RazorMetrics closes that gap, helping payors move beyond passive reporting with technology and clinical workflows built to drive meaningful change.
Physician-directed model
Every opportunity is routed directly to the prescribing physician. Recommendations are delivered within the prescriber’s workflow, so decisions stay clinically driven.
Automated cost optimization
Our AI-driven engine continuously analyzes claims and formulary data to flag where changes can reduce spend, whether through switching, deprescribing, or optimization. Each case is automatically routed to prescribers for review, so savings don’t rely on periodic audits.
Actionable intelligence
We turn data into physician-ready recommendations and deliver them directly for review. Instead of asking your internal teams to interpret reports or manage outreach, RazorMetrics presents prescribers with specific, clinically appropriate alternatives.
High-impact savings potential
We focus on major cost drivers, including polypharmacy and non-optimized therapies. By targeting avoidable costs tied to drug selection and regimen inefficiencies, RazorMetrics helps you reduce prescription drug costs where they matter most.
Seamless integration
You don’t need to replace your PBM or overhaul your infrastructure. Our platform fits alongside your existing systems, adding a complementary layer of intelligence that enhances performance without disrupting operations.
Enhanced member experience
Members are engaged only after physician approval. This ensures that changes come from a trusted clinical source, improving acceptance and reducing the need for members to navigate cost decisions on their own.
Guaranteed simple, fast, and effective
Go from signup to savings quickly and effortlessly with RxEdge™. There’s no implementation cost, no integration, and no worry with our money-back guarantee. Learn more about the RazorMetrics™ approach to cost containment, powered by our proprietary RazorCodex™.
Explore RxEdge™
As the member companion to RxEdge™, RxAdvocate™ provides easy online access to medication, savings, and claims information—without an extra app to manage. Learn more about our transparent and friction-free member experience.
Explore RxAdvocate™The small investment that will help you win big.
Learn more about the easiest way to cut drug spend by up to 10%.