Government Sponsored Plans

TPAs & Coalitions

Partnering to provide the benefits you need, while positioning for growth

Why Elixir is the Right PBM Partner for TPAs & Coalitions

Elixir isn’t your typical pharmacy benefit management (PBM) company… In fact, we’re working very hard to be not just different than the rest, but better. Here's How

Scale & Flexibility: Large enough to compete and flexible enough to deliver on client requirements

Retail, mail and specialty pharmacy services. We are part of Rite Aid, a Fortune 200 company, which not only gives us the strength to compete aggressively on discounts, rebates and anciliary fees, it also creates enterprise-wide pharmacy services. This means over 2,000 retail stores in 17 states and over 6,300 pharmacists corporate-wide who deliver multiple opportunities for a high-touch member experience throughout the pharmacy value chain, through counseling in our specialty and mail facilities, virtual online chat, in a retail setting or in our call centers.

Scalable market support. Elixir provides tailored pharmacy benefits to sell as off-the-shelf plans that can be implemented within 30 days. We support unique and custom plan designs and financial arrangements in 90 days or less. Plus, we offer co-branded or white label marketing and sales playbooks and provide comprehensive reporting for book of business, group level and plan level.

Transparent data steward. Transparency isn’t just a pricing option with us. It means contract language that’s easy to understand, with straightforward definitions and exclusions, and you have full data rights. We provide you with ALL of your data because it belongs to you.

Industry Knowledge & Expertise: Pharmacy benefits veterans recognized as a top 10 PBM1

Over half our book of business is employer clients. We’re not new to pharmacy benefits. When we were founded over 20 years ago, we were a pioneer in rebate transparency and the first to provide point-of-sale rebates. Our TPA and coalition clients have an average tenure of more than seven years with us. Over the past two decades, we’ve partnered with TPAs and coalitions to mutually grow businesses, creating unique solutions for the variety of target industries you focus on—not a 'one size fits all' approach.

Full pharmacy care experience. As a full-service PBM, we have been purposely built and own all the assets needed to give your pharmacy program control, stability, scale and privacy:

  • Industry leading adjudication platform, offering flexibility, efficiency and data privacy protection
  • Accredited mail and specialty pharmacies, creating an exceptional member experience, waste reduction and cost savings
  • Population health services through our sister company, Health Dialog
  • Prescription discount programs for uninsured and under-insured individuals and groups

More quality accreditations than most PBMs. Elixir is one of only two PBMs to earn all four core PBM accreditations by URAC. Additionally, we have several accreditations from the National Committee for Quality Assurance (NCQA), Accreditation Commission for Health Care (ACHC) and National Association of Boards of Pharmacy (NABP).

Consultative & Trusted Advisor: Our real strength is our people.

Dedicated account teams. Elixir has over 1,500 associates—true pharmacy professionals—who work toward our mission of helping achieve whole health for life. With hundreds of years of combined healthcare experience, a dedicated account team puts their expertise to work for you. This means those you work with are well versed in the challenges you face every day and offer solutions that work.

The team collaborates regularly with you to support sales plans, client retention strategies, quarterly business reviews, open enrollment meetings and more. We help you become knowledgeable about pharmacy benefits to better serve your clients.

All groups, no matter the size, are supported by a dedicated account executive, account manager and clinical account executive, who meet with you regularly for ongoing alignment, strategy and interventions to drive goals. Our clients have rated our responsive account teams with a 99% client satisfaction rate and a 100% satisfaction for client implementations, including our success with group on-boarding in under 90 days.

Industry leading specialty solutions. With specialty approaching 50% of drug spend, Elixir has created industry leading specialty solutions, which include our own specialty pharmacy, a best-in-class network, access to limited distribution drugs, and a unique and proven process for working with alternative payers.

Medical Specialty Rx strategies. Elixir can help TPAs and coalitions with transparency between medical and pharmacy benefits in order to make cost-effective decisions. With charges from hospitals sometimes being more than three times the cost of the drug itself, Elixir’s Medical Drug Channel Management program (or J-code block) provides substantial savings for plans with significant spend under the medical benefit. Similarly, we have a Medical-Only Drug list that pushes medications to the medical benefit from the pharmacy benefit when it is more cost effective.

Most importantly, we spend the necessary time per member assessing and closing gaps in care, enabling behavioral change and improving health outcomes. Proving that our specialty care management works, we have achieved a Net Promoter Score (NPS) of 82, which is eight points higher than the national average.*


* NPS is one of the most used satisfaction indicators in all industries, based on one question, “would you refer Elixir Specialty to someone else?”