In early 2024, CarelonRx introduced EnsureRx, a solution designed to make medication more affordable for our members. This program compares prices for hundreds of covered generic medications against several cash discount cards, and automatically applies the lowest price available at the pharmacy counter. In the first seven months since its March 2024 launch, EnsureRx helped more than 1.2 million Commercial plan members* save more than $11 million on 1.5 million prescriptions filled.
The need for easy, affordable access
Prescription pricing is often complex, but EnsureRx takes the guesswork out, ensuring members don't have to hunt for coupons, research, or go off benefit. This matters broadly, considering that six in ten adults are taking at least one prescription drug, according to a recent Kaiser Family Foundation poll.1
Additionally, the CDC reports that about 9.2 million Americans have skipped medication doses to save money,2 and IQVIA data shows that 39 percent of commercially insured individuals used a discount card instead of their insurance at the pharmacy.3
How it works for your plan members
EnsureRx streamlines this process, integrating savings options without any extra steps. Members can simply use their pharmacy ID card at retail pharmacies, and EnsureRx will find and apply the lowest cost for hundreds of select generic medications.
Unique to EnsureRx, we have created a curated network of discount cards from multiple companies, we compare the discount costs to our plan benefit cost, and then automatically apply the lowest price to our members’ medications – a feature not found in many of the leading discount programs. What’s more, members do not need to go to multiple pharmacies, as the lowest cost will automatically be applied no matter which retail pharmacy they prefer.
These purchases still count toward deductibles and out-of-pocket maximums, helping to ensure members remain on benefit for enhanced pharmacy care, and adding to the savings overall:
- Members are made aware of what they will pay in advance when using the Price a Medication feature, which displays a value message when EnsureRx has found the lowest cost under the benefit.
- We provide easy visibility into those cost savings when members are viewing their CarelonRx claims summaries online or via the mobile app.
- Capturing the claim with EnsureRx as part of the benefit plan, versus using another discount card directly, helps prioritize a whole health approach to safe and effective use of medications.
At CarelonRx, we remain focused on our goals to reduce prescription costs, improve medication adherence, and promote better health outcomes. We look forward to continuing to support our members' health and financial well-being with programs like EnsureRx.
*This program is available to commerical plan members only at this time, and not available to Medicare, Medicaid, or home delivery members.
1 KFF: Public Opinion on Prescription Drugs and Their Prices
2 CDC: NCHS Data Brief No. 470 June 2023
3 IQVIA: Pharmacy Discount Card Utilization and Impact
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