Capital Rx: Over $50 Million Raised To Improve Drug Price Visibility

By Annie Baker • Oct 17, 2023

Capital Rx – a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) advancing healthcare infrastructure to improve drug price visibility and patient outcomes – recently announced the closing of a strategic investment round totaling over $50 million with participation from more than 10 of the leading health systems in the nation, including Atlantic Health System, Banner Health, Hawai’i Pacific Health, Inova Health System, Lehigh Valley Health Network, Memorial Hermann Health System, Nebraska Medicine, Novant Health, Ochsner Health, WellSpan Health, Transformation Capital, and several others. Health systems recognize the strategic importance of collaboration to accelerate the pace of innovation in the PBM industry, including the need to improve the affordability of drugs in the U.S. and bring transparency to drug costs.

Capital Rx’s JUDI is now the new standard for backend claims processing platforms in the PBM and PBA industry. And the funds raised in this round will support R&D related to JUDI’s modules and capabilities, the growth of Capital Rx’s award-winning member/client service teams, and hiring in other key areas of the company.

The blend of JUDI and a Single-Ledger Model enables Capital Rx to drive savings for plan sponsors while providing patients with the most appropriate care at the lowest available price. This offering represents a unique opportunity for the health systems, which combines their resources and expertise to address the opacity and price volatility that has plagued the pharmaceutical supply chain and driven costs higher for plan sponsors and patients for over a decade.

KEY QUOTES:

“Capital Rx has made incredible progress with its JUDI platform since we led the Series B funding round in late 2020. They can now administer pharmacy benefit programs with unparalleled efficiency and customization across commercial, Medicare, and Medicaid plans, which makes Capital Rx an ideal strategic investment or partner for health systems who want us to serve their employees as well as the members of their provider-sponsored health plans. We are thrilled to invest further in Capital Rx alongside this luminary consortium of innovative health systems.”

— Jared Kesselheim, MD, Managing Partner at Transformation Capital

“We are humbled and appreciative of the confidence our investors and partners have in our technology. Legacy infrastructure lacks operational efficiency to reduce costs or enable the delivery of a best-in-class experience for members. I’m thankful for the hundreds of colleagues who have contributed to JUDI and continue to develop new solutions to deliver superior savings and a better healthcare experience for plan sponsors, payors, and patients across the country. I’m also grateful to the team at the Health Management Academy for recognizing the opportunity to connect the leaders of so many health systems to ignite a collaboration that will continue to accelerate the pace of innovation to reduce pharmacy costs, improve patient access, and deliver better outcomes for millions of Americans.”

— Capital Rx Co-Founder and CEO AJ Loiacono

“They also recognize the need for change in the PBM industry, with a focus on aligning toward a more transparent, next-generation enterprise health platform like Capital Rx’s JUDI. The clear pricing, operational efficiencies, control over pharmacy spend, and ability to refocus resources on patient care to drive better outcomes are aligned with every health system’s core mandate.”

— Health Management Academy SVP of Strategy Matt Gunther

“Inova makes strategic investments in healthcare companies that have the potential to drive meaningful transformation. Capital Rx’s ability to leverage technology to bring clarity and consistency to drug prices for its clients and to broaden access to medication for members while providing exceptional service represents a paradigm shift in the PBM industry.”

— Alice Pope, Chief Financial Officer at Inova

“Novant Health strategically partners with and invests in organizations that are transforming the healthcare industry. In Capital Rx, we found a like-minded partner that is committed to the patient experience and purposeful innovation. Together, we are discovering ways to reduce pharmacy costs, improve operational efficiency, and make medication more accessible so patients can thrive.”

— Dean Swindle, Executive Vice President and President of Novant Health Enterprises