Simply Save RxSM
The simpler way to spend less.
High-Cost Generic Management
Beginning in 2025, Simply Save Rx will include High-Cost Generic Management. This program will target high-cost generics, triggering a reject at point-of-sale, which allows members to switch to lower cost generic alternatives.
Unique capabilities of this enhancement include:
Ongoing generic marketplace monitoring
Continuous clinical support through coverage reviews
Evolving target drug lists based on the changing market
Managing the pharmacy benefit has never been more complex
Wasteful drug spend is a painful reality that continues to persist across the market. With low clinical value brands and high-cost generics gaining more traction and adding to the complexity, members, prescribers and pharmacies need a more straightforward way to optimize drug spend—without compromising on clinical effectiveness.
While formulary and utilization management remain key pillars of drug optimization, a robust strategy must also include educating key stakeholders of savings opportunities in a meaningful way.
Individual drug optimization solutions only solve part of the problem. A simple, end-to-end solution that delivers results for plans is now a reality.
Simply Save Rx: The simpler way to spend less
Express Scripts by Evernorth is deploying a single, holistic package of industry-leading capabilities that drive drug cost savings for plans.
Simply Save Rx gives plans an easy path to lowering their drug spend. No need to navigate across an array of drug optimization solutions. No obstacles. No detours. All clear.
This one-stop-shop offering spans across the pharmacy supply chain to ensure that members have access to the lowest cost, most clinically appropriate therapies available. It’s the simpler way to solve the complex problem of wasteful drug spend.
Delivering greater savings for all
Our scale and capabilities enable us to identify savings opportunities at each touchpoint:
Pharmacy directed strategies identify savings opportunities at the point-of-sale and create targeted drug interventions
Soft pharmacy messages at point of sale alert the pharmacy on cost savings opportunities for their patients
For select high-cost generics, members are provided the lower net cost brand medication at the generic cost share
Prescriber and patient directed strategies inform and encourage the use of alternatives that generate savings for the member and plan
Dedicated pharmacy team performs live and digital outreach to prescribers and patients on non-preferred medication to drive lower cost alternatives at retail and home delivery
Benefit directed strategies ensure stronger utilization controls and rapid responses to market events are in place
Block drugs and devices that are not approved by the FDA, at time of market availability, preventing wasteful utilization
An evolving target drug list which triggers a reject at point-of-sale if a member is filling a high-cost generic, allowing them to switch to lower cost generic alternatives.
Unleash the power of drug optimization
Pharmacy, prescriber and patient directed strategies through Simply Save Rx are integrated into the Savings Advisor engine, driving an enhanced member experience. Savings Advisor is enabled for all clients today. This fully integrated experience uses unmatched data available only to the PBM, connecting product experiences and medication pricing into one simplified savings solution.