Payer Matrix, Cecelia Health, and Blue Genes Lab today announced the launch of a new integrated medication management program, PreciselyRx, to assist self-insured employers in managing GLP-1 coverage from the first prescription to the first year of treatment.
Obesity is an important contributing factor to chronic diseases such as diabetes and heart disease. GLP-1 Medications can help many people achieve significant weight loss, but their cost—up to one-third of an employer's annual prescription drug expenses—poses a difficult decision for employers regarding coverage. Managing this expense requires not only controlling the price of each prescription but also making informed treatment decisions and providing support throughout the treatment process. PreciselyRx is designed to allow employers to obtain the health benefits and medical cost savings brought by brand GLP-1 medications at about half of the standard GLP-1 coverage cost.
PreciselyRx addresses four major sources of drug-related waste by implementing strict approval controls, pre-treatment genetic screening, procurement at the lowest achievable net cost, and 12 months of clinical support. The company states that these services together help to reduce the initiation of ineffective treatments, lower the cost per dose of medication, mitigate adverse side effects that may lead to additional medical use, and increase the sustained medication rate, thereby giving treatments a better chance of achieving the desired results.
By integrating these capabilities into a single project, PreciselyRx provides greater price transparency and initial cost savings, eliminates the complexity and delays associated with rebate calculations, and offers continuous clinical support to members throughout the entire treatment process.
For employers, this means a more cautious approach to GLP-1 coverage, aligning clinical appropriateness with financial responsibilities. Genetic screening can provide additional insights into members' responses to treatment, aiding in the formulation of prescriptions and care plans. Prescribing physicians still retain full authority to make final decisions regarding medically appropriate treatment.
Members who join PreciselyRx will receive ongoing support led by clinicians, aimed at improving compliance, helping to manage side effects, and reinforcing healthy behavior changes that contribute to long-term success. The company states that this personalized, lifestyle-oriented approach helps members to remain engaged in treatment, and also gives employers more confidence that their investment in GLP-1 treatment is producing meaningful results.
"Employers should not have to choose between covering GLP-1 and controlling pharmacy budgets," said Payer Matrix CEO Jennifer Hoefner. "We help employers obtain lower-cost GLP-1 medications for their employees and support them throughout the treatment process to help improve compliance and monitor for any adverse side effects."
“Employers are paying for GLP-1 that doesn’t work at all for some members,” said Blue Genes Lab CEO Nick Glimcher. “We can identify many of these members before the first prescription is issued, saving employees’ time, frustration, and out-of-pocket expenses, as well as reducing costs that are of no benefit to anyone.”
Starting correct medication treatment from the very beginning is just the first step. The clinical team at Cecelia Health helps members manage side effects, establish healthy habits, and maintain treatment participation, while also collaborating with the medical providers who prescribe the treatments to support safe and effective care, said Mark Clermont, CEO of Cecelia Health. “With personalized support led by clinicians, members can achieve meaningful results – on average, those who receive our care lose 18% in weight.”
PreciselyRx is now available to self-insured employers nationwide, as well as health and welfare funds.
For more information, please visit PreciselyRx.com.
Genetic test results reflect statistical correlations, not definitive predictions. They cannot diagnose any diseases, nor can they replace the judgment of prescribing clinicians. The tests are conducted by GTI Laboratories, and this laboratory is certified through CLIA and recognized by CAP.
About Payer Matrix
Payer Matrix is a provider of concierge-style drug cost control solutions that has been focusing on high-cost specialty drugs since 2016. The company is currently expanding its services to include GLP-1 solutions for non-specialty drugs. Payer Matrix collaborates with over 40 PBM and 30 TPA organizations to provide a highly engaging, member-centered experience for program initiators and participants, helping to reduce prescription costs.
About Blue Genes Lab
Blue Genes Lab provides genetic testing to help health plans, employers, and consumers choose more effective medications and health products. Its pharmacogenomics platform can screen for drug-gene interactions in over 500 medications, including GLP-1 and 65 high-cost specialty drugs. The testing is conducted by GTI Laboratories, a laboratory that is certified by CLIA and recognized by CAP. Blue Genes Lab is headquartered in Phoenix, Arizona. For more information, please visit bluegeneslab.com.
About Cecelia Health
Cecelia Health is a national virtual specialized medical institution that provides services covering the entire continuum of care for patients with chronic diseases. The company helps patients achieve sustained participation and lasting results by expanding access to care and providing personalized clinical support. Leveraging digital tools and unique data capabilities, its integrated care approach focuses on proactive and coordinated support, addressing the clinical, behavioral, social, and emotional needs in cardiometabolic and related diseases. In accordance with evidence-based guidelines and clinical best practices, this solution can be extended to health plans, healthcare providers, medical systems, and life science companies.
