An Inside Look at UnivationRx, By Unison Risk Advisors

Pharmacy is one of the biggest drivers of employer healthcare costs today. It is also one of the most complex.  

What used to be a relatively predictable aspect of health spending has evolved into a rapidly shifting landscape, accelerated by rising specialty and high-cost drug utilization, opaque pharmacy benefit manager (PBM) contracts and rebate structures, and regulatory and market pressures.   

For employers, navigating this intricate web can be confusing and deeply frustrating. There is often a lack of clarity around why pharmacy costs are increasing and what can be done to control them. Many plan sponsors feel stuck in a system where their costs continue to rise without a clear path forward.  

Employers don’t have to manage these challenges alone. There is an alternative path, independent of PBMs and the insurance companies, which puts employer needs at the center of its pharmacy benefits strategy.  

Enter UnivationRx: a proprietary program that leverages all aspects of the pharmacy contract, enabling our clients to secure market-leading pricing terms and financial results. Our team understands the complicated, evolving nature of pharmacy benefits and the crucial role they play in managing healthcare costs. With years of consulting experience and a deep knowledge of the market, we’re here to bring clarity, independence, and confidence to your pharmacy benefit strategy.  

A Complex Environment

Multiple factors are coming together to create the challenges we see in today’s pharmacy space.  

• Specialty drug growth has risen sharply, with some gene and cell therapies costing more than three million dollars for a single dose  

• PBMs, companies that serve as intermediaries between pharmacies, drug manufacturers, and plan sponsors, have been accused of engaging in murky practices that inflate drug prices  

• Vertical integration has reshaped the pharmacy landscape, allowing insurers and PBMs to exert more control over drug prices and patient access   

These factors create an environment where employers may be paying more than they should without even realizing it. Even though these challenges exist, there are still opportunities for organizations to gain better control over their costs and improve member outcomes.  

An Independent, Data-Driven Strategy

Addressing the complexities of today’s pharmacy market requires a partner who brings independence, transparency, and clinical insight to the table. 

That’s where UnivationRx comes in.  

Our team is built on the philosophy that pharmacy benefit strategy should work for the employer, not the vendor. By remaining independent from PBMs, our team can make strategic recommendations based solely on what is best for the organization and its members. This objective guidance can help employers gain a clearer view of their options.  

But our work doesn’t stop there. Delivering real impact to our clients means turning insight into measurable action. UnivationRx combines clinical experience, advanced analytics, and extensive market knowledge to help employers take a more strategic approach to their pharmacy benefits.  

Strategic, Not Transactional Pharmacy Benefit Procurement

Pharmacy benefit procurement is a complex process that must align with an employer’s long-term goals. Yet it is not always treated as such.  

The UnivationRx team evaluates PBMs from a financial, clinical, and operational perspective. We help our clients secure disciplined contracts that protect their interests over time.  

But signing the contract is only the start. Without consistent monitoring, even the best agreements can fall short. That’s why UnivationRx provides ongoing financial and operational oversight. We hold PBMs accountable for their commitments, ranging from rebate guarantees to clinical performance.  

Our goal is to help employers achieve the total value of their agreements and avoid costly missed guarantees.  

Clinical Insight to Drive Better Outcomes

One of the most overlooked areas in pharmacy benefit management with tremendous opportunity for cost savings is the role of clinical strategy.  

Our team evaluates medical and pharmacy data to look for opportunities for optimization while continuing to provide the right care for members. This could include identifying lower-cost alternatives or biosimilars, managing site-of-care strategies, or reviewing high-cost therapies for clinical appropriateness.  

The financial impact of effective clinical strategy can be substantial. Biosimilars, for example, have the opportunity to reduce pharmacy spending significantly in high-cost areas, such as oncology and rare diseases.   

We also know that pharmacy benefits don’t exist in a vacuum. Rather, they are connected to healthcare utilization and population health outcomes.  

By integrating medical and pharmacy claims data, UnivationRx delivers a more holistic view of cost drivers and opportunities, enabling employers to make smarter decisions. This perspective is key to identifying trends early and managing risk.  

Empowering Employers

Ultimately, UnivationRx aims to empower employers to take more control of their pharmacy benefit strategy. We do this by replacing opacity with clarity and reactive decisions with proactive strategy.  

Pharmacy benefits don’t have to be a source of frustration. Instead, they can serve as a powerful tool for managing costs and improving outcomes.