Who we help · PBMs
Meet the PBM’s new best friend.
Effortless savings within your pricing strategy
Cut drug spend for your clients without sacrificing rebate revenue or contract terms.
Our solutions are creatively designed to optimize savings while tailoring to your goals. RazorMetrics helps PBMs meet their financial targets and satisfy guarantees faster, so you can take on additional risk and new business with confidence.
Streamline healthcare’s most complicated experiences.
Let our automated services do the heavy lifting so you can simplify communication and conserve resources.
RazorMetrics doesn’t just add a sharper edge to your drug cost containment, we optimize communication and savings for all your stakeholders through automation at scale. We help PBMs conserve resources and scale services by automating outreach to physicians and members—within the clinical workflow and without weighing down members with another app. More than a win-win, this fosters happier providers, healthier patients, and more highly-rated PBMs.
We improve the process so you get better results.
RazorMetrics has up to a 76% response rate with physicians and 41% acceptance rates because we present cost-saving options at the right time and place: the prescriber’s workflow.
Our unique physician-focused approach helps PBMs replace inefficient efforts aimed at busy members with a solution that’s more convenient, seamless, and cost-effective for everyone. Plus, you’ll effortlessly increase transparency, medication adherence, and NPS scores—not to mention revenue.
Pharmacy cost management solutions for PBMs
PBMs are being asked to cut drug spend further every year, without disrupting existing rebate deals or contract terms that businesses depend on. RazorMetrics helps you cut that spend without reopening a single contract or rebate deal.
We uncover and apply cost-saving opportunities that your existing programs are missing. The process is straightforward: we review your pharmacy claims, identify brand-name prescriptions with more cost-effective clinical equivalents, and work with the prescriber to make the switch. RazorMetrics helps reduce prescription drug costs for your clients and strengthens your relationships with them at every renewal.
A smarter way for PBMs to cut pharmacy costs
Most PBMs already run formulary management, rebate optimization, and step therapy. Those programs cover a lot of ground, but they tend to miss the prescriptions where a doctor would choose a lower-cost drug if the information reached them before the prescription was finalized.
RazorMetrics finds those prescriptions in your active claims and gets the recommendation to the prescriber at the right time. All of that happens without changing your formulary design or rebate contracts, and without adding work for your teams.
Designed to work within your existing pricing strategy
Many pricing strategies are built around specific rebate arrangements. A switch recommendation that ignores them can cost you more than it saves.
Before any outreach goes out, RazorMetrics checks each opportunity against your rebate position. We only act on switches that work financially for the PBM. That way, you meet client savings guarantees without giving up rebate revenue, and your account teams have a stronger savings performance to report to new clients and renewals.
Reduce manual outreach and operational burden
Most pharmacy cost containment programs scale by adding more individuals. The increase in claim volume means more clinical reviewers and more outreach staff are needed to keep up.
RazorMetrics automates physician outreach by delivering recommendations directly to prescribers through the tools they already use, so a single analyst can manage switch opportunities across thousands of claims without adding headcount.
Your clinical operations and account management teams produce more savings per headcount and spend less time chasing prescribers or fielding member questions about formulary alternatives.
Engage physicians at the right time
Most programs try to change prescriptions by contacting the member or the prescriber’s office. By the time either attempt reaches the prescriber, the prescription has already been written.
RazorMetrics presents the cost-saving option during the prescribing decision, not afterward. Our response and acceptance rates come from reaching the prescriber with the clinical and pricing details they need to approve or decline the switch to help their patient.
This shifts the cost-containment strategy for PBMs from a member-side marketing problem to a clinical decision-support problem, which is what produces savings that show up on the claims report.
Support better client retention and growth
At renewal, plan sponsors want measurable savings they can point to in the claims data, along with a clear explanation of how the cost-containment strategy produced them.
Every switch RazorMetrics generates is reportable at the claim level, which gives your account teams a defensible number for client reviews and guarantees reconciliations, and a pharmacy benefit optimization story to bring into new RFPs.
For PBMs looking to expand into more complex risk arrangements, a proven cost-containment strategy that does not disrupt rebate economics is a straightforward way to support that growth.
Improve member experience without adding another app
Members are already managing too many plan tools. Adding another app or login to hit a savings number usually hurts the member experience scores PBMs work to protect.
RxAdvocate™, the member-facing companion to RxEdge™, gives members online access to medication, savings, and claims information without a separate app to download or a new account to create. The switch itself is handled between RazorMetrics and the prescriber before the member sees it, so when they arrive at the pharmacy, the lower-cost prescription is ready to fill.
Members can see the lower-cost alternative already prepared at their usual pharmacy and pull the underlying details online if needed. That delivers PBM transparency without adding steps for the member to manage.
Who this is for
RazorMetrics works with PBMs of different sizes and structures, from regional PBMs building out their clinical programs to national PBMs managing complex book-of-business mixes. What these PBMs share is a team that needs to produce more savings per claim without compromising rebate economics or adding headcount to do it.
Internal stakeholders typically involved in a RazorMetrics implementation include executive leadership, pharmacy benefit strategy, clinical operations, account management, finance, and member and provider engagement teams. The implementation design accommodates all of them without asking any single function to carry the program.
PBM FAQs
Does RazorMetrics compete with or replace a PBM?
No. RazorMetrics is a cost-containment layer that runs alongside the PBM. We do not hold formulary, manage the network, or touch rebate contracts. We work with PBMs to drive incremental savings on top of their existing programs.
How does RazorMetrics protect rebate revenue?
Switch opportunities are evaluated against the PBM’s rebate position before any outreach occurs. Recommendations that would produce a net-negative financial outcome for the PBM are filtered out of the queue.
How long does implementation take?
Most PBM implementations are complete in under 60 days. No integration project is required, and there are no implementation costs.
What are the response and acceptance rates with prescribers?
RazorMetrics reports a 76% physician response rate and a 41% acceptance rate for recommended switches. Both come from reaching prescribers during the prescribing decision, rather than after the prescription has been filled.
Do members need a separate app?
No. RxAdvocate™ delivers savings and claims information through existing member channels without a new app or account.
Give your cost-cutting toolkit a new edge.
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™Request a demo
The fastest way to see whether RazorMetrics fits your book is a short scoping call. We’ll walk through your current savings profile and show what an incremental cost-containment layer could produce on top of your existing programs.