CDPHP Selects Capital Rx as New Pharmacy Benefit Manager

ALBANY, N.Y. – May 12, 2022 – Capital District Physicians' Health Plan (CDPHP) is thrilled to announce that Capital Rx has been selected as the health plan’s new pharmacy benefit manager (PBM). This game-changing decision, which takes effect on January 1, 2023, catapults the CDPHP pharmacy strategy ahead of its competitors, ensuring quality, cost, access, and transparency for patients, providers, and small and large businesses alike.

With more than 150 active clients covering more than 1 million lives, Capital Rx is one of the fastest growing health care companies in America and offers game-changing technology in both claims processing and benefit configuration.

“CDPHP has long sought a PBM partner that aligns with our mission, vision, and values, and I am proud to say we found the perfect fit with Capital Rx,” said CDPHP Chief Pharmacy Officer Eileen Wood, MBA. “With Capital Rx, we have full transparency into the pharmacy supply chain and are able to innovate in ways that bring affordability, efficiency, and ease of use to all of our members.”

By partnering with Capital Rx, CDPHP aims to stem the tide of rising drug prices through greater price transparency, as well as a new pricing model that more accurately and fairly sets the cost of drugs. Capital Rx sets its prices with full transparency using actual unit drug costs based on the National Average Drug Acquisition Cost, which is maintained by CMS. 

“Our partnership with Capital Rx deconstructs the traditional PBM model by deploying game-changing technology that allows us to be more agile, giving us the ability to modify formularies in days rather than weeks. With Capital Rx, as new, more affordable drugs come to market, CDPHP will be able offer those products more quickly to our members, providers, pharmacies, employers, and partners in government.” added Wood.

CDPHP will leverage Capital Rx’s intuitive, cloud-native, enterprise pharmacy platform (EPP) JUDI™ to increase efficiency and achieve the highest standards of clinical care for its members. The platform enables real-time communication among physicians, pharmacies, patients, and plans, and facilitates faster and more efficient prescription processing for members.

The health plan’s decision to move its PBM services to Capital Rx is yet another step in the process of creating an integrated delivery system in New York’s Capital Region. CDPHP recently opened the doors to three retail pharmacies, with the goal of providing its members and the community-at-large with a suite of services to meet all of their health care needs.

“Our partnership with Capital Rx further cements our mission of building an integrated delivery system, where payers, providers, and pharmacies are all aligned around delivering an improved quality and experience of care at the most affordable cost,” said CDPHP President and CEO John Bennett, MD, FACC, FACP. "Partnering with Capital Rx, we look forward to improving efficiencies, eliminating waste, and further enhancing our members’ experience of care.”

CDPHP is confident there will be no disruption in care or coverage—including no changes to our formulary—as a result of this change. In fact, they expect their members and business partners will experience an improved quality and experience of care as a result of this decision.

“CDPHP has always put patients first and isn’t afraid to challenge the status quo when it comes to offering great health care,” stated Matt Gibbs, president of Capital Rx. “We’re excited to work with like-minded people who share in our mission, vision, and values of providing the highest quality of care at the best prices for its members.”

In the coming days, weeks, and months, CDPHP will be working in a strategic and coordinated fashion to notify appropriate parties, including members, brokers, employer groups, providers, and other strategic partners, and will develop implementation workgroups, timelines, and action plans.

About CDPHP^®
Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 29 counties throughout New York. CDPHP is also on Facebook, Twitter, LinkedIn, and Instagram.

About Capital Rx

Capital Rx is built around the mission of changing the way prescription drugs are priced and patients are serviced. A health technology company daring to reimagine the pharmacy benefits industry, Capital Rx is executing on that mission through its Clearinghouse Model^®—the first equitable framework for drug pricing. Capital Rx’s enterprise pharmacy platform, JUDI™, connects every aspect of the pharmacy ecosystem in one platform, enabling patient engagement, and increasing efficiency to achieve the highest standards of clinical care. For more information, visit www.cap-rx.com.