Pharmacy Benefit Management
Offering a Better Solution
Pharmacy Benefits Management
Our modern, alternative solution leverages a powerful PBM engine built on a transformative pass-through approach, lowest net-cost philosophy and outstanding clinical model that works smarter and harder to deliver greater results. With this engine in place, ordinary PBM tools – such as utilization management, formulary, and networks – perform at a higher level to improve health more effectively and generate even more savings.
We pass 100% of all discounts or rebates we receive directly back to you. All of our revenue is based on a set admin fee.Learn more
While rebates and discounts are important, we focus on all factors to reduce overall cost, including formulary and drug mix.Learn more
Clinical Care Model
Our patient-centered model works to improve health outcomes, which also improves long-term financial performance.Learn more
How We Do It
Our Transformative Pass-Through Approach
Like any PBM, we work with manufacturers and pharmacies to secure the best pricing, rebates and discounts possible on behalf of our clients. In a traditional arrangement, the PBM may take a spread and charge the client more than the pharmacy was paid. Or, the PBM may keep some of the rebate as a way to make money.Learn more about 100% Pass-Through
How We Do It
Our Lowest Net-Cost Philosophy
Your formulary or drug mix can make a huge impact on overall plan costs. Our lowest-net-cost philosophy provides clinically sound, cost-effective alternatives, such as generics or less expensive brands, creating a high-performance formulary that consistently delivers the lowest net cost. While rebates alone are not the goal of our business model, our formulary, with its lower average wholesale price (AWP) starting point and focus on lowest net cost, makes it possible to achieve substantial rebates, without paying more, which lowers PMPM costs.Learn more about Lowest Net-Cost
How We Do It
Our Outstanding Clinical Care
Our robust patient-centered clinical care model, which is URAC accredited, enables us to deliver high-touch support to promote adherence, close gaps in care and improve health outcomes. Using our highly informative claims data and 360-degree view of the patient, we can identify patients who can benefit from additional support. By combining this knowledge with evidence-based guidelines, and leveraging our relationships with members, pharmacists and prescribers, we can deliver meaningful interventions that improve health.Learn more about our Clinical Care Model
What it's like to work with us
Managing your pharmacy benefit is no small task. That’s why you need a PBM partner who can offer guidance and support along the way. Our service and support starts with a seamless implementation, followed by insightful reporting, regularly scheduled account reviews and consultative VALUE summaries to ensure we meet your goals. Our highly experienced account managers will help you make decisions to fine-tune your pharmacy benefit whether it includes flexible plan design changes, adding new programs or tweaking existing services to meet your goals.
- Receive dedicated support from expert advisors that truly understand pharmacy and financial data and can help you meet your goals
- Get flexible plan design options to fine tune performance mid-contract and beyond
- Gain insight and actionable information through our advanced reporting and decision support tools
- Receive consultative plan reviews and recommendations to improve performance in areas such as formulary, networks, utilization management and more
We cannot say enough positive things about transitioning our specialty pharmacy services to Lumicera. The Navitus account team had a high level of engagement prior to and post migration to ensure quality continuity of care. L.A. Care is delighted with the smooth transition and our members have provided extremely positive feedback. We know we are in good hands with Navitus and couldn’t be happier with our new specialty partner, Lumicera.
Chief Pharmacy Officer, L.A. Care
With this insight into Navitus’ operations and access to data, I am able to make sensible decisions with the best interest of the Trust in mind.
Administrative Manager, San Diego Electrical Health and Welfare Trust
Navitus made my job so much easier and less worrisome. They assisted us in ensuring our significant formulary change went smoothly. The financial savings we experienced have exceeded what we anticipated. Navitus has lived up to its promises.
Chief Human Resources Officer, West Tennessee Healthcare
Our holistic approach to well-being will always include solutions with innovative partners like Navitus that allow our staff to save money while enhancing their quality of life. The integration of pharmacy benefits and our other well-being solutions are key to our staff's success.
Benefits Manager, Compassion International