PBM Serve You Rx Adds Biosimilars to Formulary, Partners with Waltz Health for Specialty Pharmacy

In a move set to shake up the pharmacy benefit management (PBM) landscape, alternative PBM Serve You Rx has announced the addition of two biosimilars for the popular drug Stelara to its specialty formulary. This strategic decision, coupled with a new partnership with Waltz Health, aims to generate significant savings for clients and streamline the specialty pharmacy experience for members.

Biosimilar Integration and Cost Savings

Serve You Rx will incorporate Otulfi, dispensed by Mark Cuban Cost Plus Drugs, and Yesintek into its formulary. The PBM estimates that Otulfi will offer members over 96% in annual savings compared to Stelara. Similarly, Yesintek is projected to generate more than 90% in annualized savings for plan sponsors.

Justin Jasniewski, CEO of Serve You Rx, emphasized the company's commitment to member accessibility: "The members are able to access these lower cost biosimilars immediately, without any friction and without having to be confused about what's coming from where, because they have one source for where all their medications are coming from."

To further support member access, Serve You Rx will implement "robust" copay assistance programs for these medications.

Waltz Health Partnership and AI-Powered Platform

The integration of these biosimilars will be facilitated through Waltz Health's specialty pharmacy network. This partnership, announced in early April, involves the implementation of Waltz Connect, an artificial intelligence-powered platform designed to enhance the specialty pharmacy experience.

Mark Thierer, CEO of Waltz Health, described their approach as "flipping the model on its head." The Waltz Connect platform utilizes AI to track critical data such as clinical outcomes and patient eligibility, providing personalized insights and recommendations to members.

Jasniewski highlighted the significance of this collaboration, stating, "We look forward to finding more opportunities to flip the industry kind of on its head and look at things from a different angle. And working with an organization that's committed to innovating and moving quickly, so that's been a huge advantage for us we're going to continue to leverage."

This partnership and the addition of biosimilars to the formulary demonstrate Serve You Rx's commitment to innovation and adaptability in the rapidly evolving PBM sector. As the industry continues to face pressure for increased transparency and cost reduction, such initiatives may set new standards for PBM operations and member-focused care.