It is no secret that healthcare costs have been steadily rising. However, one of the biggest contributors to this trend is often overlooked. In 2024, spending on retail prescription drugs totaled $467 billion, accounting for 9% of all healthcare spend. That’s a 7.9% increase from spending the previous year, with prescription drugs as the second-fastest growing component of healthcare spend. This trend shows no signs of slowing down. The increasing adoption of high-cost GLP-1s and other specialty medications have placed an additional strain on health plans, further contributing to rising pharmacy and healthcare costs.
Additionally, 68% of American adults take at least one prescription medication, so as a plan sponsor, how can you take back control of your pharmacy spend to provide members with the medications they need?
A Need for PBM Innovation
For far too long, traditional pharmacy benefit management (PBM) models have presented plan sponsors with opaque pricing and rebate structures that have led them to overpay for pharmacy costs. Additionally, many of these models steer members toward pharmacies they own, eliminating choice.
National employer surveys reflect the shortcomings of the traditional PBM model through the three most common PBM-related pain points they face.
Change to the traditional PBM model is on the horizon. With the recent emphasis of fiduciary responsibility of self-funded employers, many are being forced to re-evaluate the business model used by their PBM partnerships, or risk legal action. Ensuring fiduciary compliance, however, begins with a solid selection process to partner with a PBM that acts in the best interest of plan members.
Liviniti: Built on Transparency
While legislation may someday require sweeping changes to the traditional PBM model, Liviniti has pioneered transparent pharmacy benefit management since its founding as Southern Scripts in 2011.
“We built Liviniti as a force for change, to innovate new solutions, move beyond the status quo and shape the future of pharmacy benefits for the better.”
Founded by pharmacists LeAnn Boyd, CEO, and Steven T. Boyd, EVP, Liviniti is on a mission to make prescription medication more accessible and affordable by delivering savings, clinical value, exceptional service, and innovative sourcing solutions. Key to the savings that Liviniti provides is its 100% pass-through PBM pricing model. By passing through 100% of drug rebates and discounts to plan sponsors, Liviniti avoids the complexity of traditional models, giving plan sponsors the confidence that they are truly paying the lowest cost for prescription drugs. With real-time client access to data, and purpose-built technology that connects the dots from claims activity to drug costs to benefit plan details, plan sponsors can easily verify savings, identify trends, experience accountability, and ultimately make the best pharmacy decisions for their plans and members.
RxCompass is Liviniti’s industry-leading drug-sourcing program that combines the power of multiple pathways for drug savings without shifting costs to members. This approach has generated real results. Employers who enroll in the program have typically seen a decrease in prescription costs on the highest-cost drugs by 10-20%. For new groups, a 28-40% reduction in plan costs can be achieved by choosing Liviniti with the RxCompass solution.
Beyond savings and transparency, Liviniti also places a premium on member support. Instead of complex phone trees and robotic prompts, Liviniti employs a human member service team that answers members’ calls in an average of 15 seconds. Providing this level of support gives members the information they need, when they need it, resulting in higher satisfaction and fewer headaches for the benefits team.
“Our service team understands people call us during a variety of life’s circumstances, sometimes planned for but often unpredictable. We deliver a smooth experience for every caller, with a personal touch. Members are always greeted by a friendly person, not a phone tree or robot at the other end of the line.”
Liviniti in Action: Solutions for School Districts
Liviniti’s 12+ year partnership with a major school district is a testament to the impact of the company’s transparent approach and RxCompass solution.
With 2,000+ plan members, the district has remained committed to balancing financial responsibility with the health and well-being of its employees and their families. To ensure long-term affordability, the district implemented key cost-saving strategies, coupled with Liviniti’s 100% pass-through pricing and strong clinical management to promote transparency and efficiency. In year 10 of the partnership, the district introduced RxCompass to their plan to address high-cost drugs and help reduce plan expenses while lowering members’ out-of-pocket costs.
In total, the savings Liviniti was able to create, through a combination of its 100% pass-through approach, clinical impact and drug sourcing amounted to nearly $4 million – or a savings of 36% on the district’s pharmacy spend. This significant cost-savings allowed the district to repurpose funds to enhance its overall benefits offering, resulting in the addition of valuable wellness programs such as NOOM and Liviniti’s weight-loss support.
Beyond providing the plan with significant pharmacy savings, Liviniti worked with the school district to support the local community. By utilizing local pharmacies, the district ensured that healthcare dollars stayed within the community while providing members with convenient access to care. Additionally, the introduction of an off-site Variable Copay Program (VCP), supported by pharmacist training, further strengthened these partnerships and improved member experiences.
“In pursuing a transparent PBM business model, our goal was to successfully bring a much-needed, new approach to the marketplace. We decided to do things differently because we believed there was an opportunity to do things better – and we continue to innovate to this day. We are always enthusiastic about sharing our bold thinking and innovative approaches to greater savings, higher value, and more choice.”
A Testament to Transparency
The Liviniti model is a testament to the fact that full transparency pays off in real savings – all while promoting member satisfaction.
We are proud to feature Liviniti on The Granite List.