The 4PillarsRx Difference

4PillarsRx Drug Spend Optimization is an aggressive and proactive data processing service that maximizes your overall drug costs and identifies additional savings opportunities through advanced claims analysis and manufacturer alignment.
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When you partner with 4PillarsRx, you partner with prominent pharmaceutical, GPO, and PBM industry experts.

PHARMACY DRUG SPEND OPTIMIZATION​

Data processing opportunities exist for care delivery organizations that purchase, dispense, or administer medications. Our program is simple to adopt and enables organizations to capture available formulary savings and manufacturer incentives on a wide range of medications, creating a substantial new revenue stream for the facility.

Since 2019, manufacturer and PBM scrutiny of drug spend and reimbursement has increased. With the utmost diligence and respect for your data, we only pursue eligible claims processing in full alignment with manufacturer and PBM guidelines.​

More than half of specialty drugs are administered by physicians. There are 108 injectable medications and 1500 unique NDCs that currently offer untapped savings opportunities seldom captured by eligible organizations.​​​

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We provide Drug Spend Data Processing & Optimization services to a wide range of organizations, including:

​• Hospitals
• Long-term care facilities
• Hospice providers
​• Mental health facilities

​• Specialty Pharmacy
​​​• Infusion Centers
​• Correctional facilities
​• Government healthcare 

• State Institutional Pharmacy​• Managed care plans ​
​• Workers’ comp  plans 
​​• Third-party administrators​

• Ambulatory pharmacy
• Discount card programs
​• Commercial group plans

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MAXIMIZE YOUR OVERALL DRUG COST & REBATE POTENTIAL

4PillarsRx's proprietary data processing platform helps hospitals, outpatient facilities, and other healthcare organizations maximize their formulary savings potential. Traditional purchasing processes often miss these opportunities, which can represent significant value.
Our proprietary platform captures these savings without conflicting with any GPO/wholesaler or 340B agreements. These opportunities can provide a substantial new revenue stream for an organization with no additional investment or risk.

​WHAT WE DO 

4PillarsRx’s drug spend optimization program provides a proven, highly effective, and extremely simple way for healthcare providers to increase revenue, improve profitability, and remain competitive in today’s rapidly evolving healthcare marketplace.

• Work directly with pharmacies, healthcare settings, health plans, and providers to obtain appropriate claims data
• Our Patent Pending RxLogix System collects data, applies AI review to submitted files, corrects formatting, and submits to drug manufacturers through a robust and proprietary IT platform
• We leverage our purchasing power to negotiate manufacturer incentives and savings alignments
• Send monthly or quarterly payments with claim-level transparent reporting to our clients
• Secure savings opportunities often left uncaptured by pharmacy wholesalers
• Implement our state-of-the-art data processing solutions without disrupting your members or plan benefits

FORECASTING

Our data processing platform is minimally invasive and doesn't require healthcare organizations to share PHI or integrate with our systems to generate a proposal. To get started, we only require an executed mutual NDA and 15 data elements. These data elements can be easily exported from the facility's electronic medical records in a CSV or Excel format and securely transferred via our SFTP website. Our team will then process the data and present the results within 7-10 business days.

INTEGRITY & COMPLIANCE

While other services may promise higher recoveries with fewer data fields, 4PillarsRx prioritizes compliance with manufacturers through its rigorous vetting process. By requesting more data fields upfront, we can prevent potential audits or recoupments. Our software enables us to direct each claim to the aggregator with the highest recovery value for that NDC, ensuring we always maximize our clients' returns. This is an essential factor, as relying solely on an aggregator's formulary could limit the savings received.

BREAKDOWN & ANALYSIS 

Healthcare delivery organizations have traditionally captured ‘buy side’ or bulk purchase discounts through medication purchases via GPO or wholesaler agreements. The common misconception among healthcare executives is the belief that these traditional purchasing processes ensure the capture of all available drug savings. The reality is that these traditional processes do capture conventional bulk discounts; however, they always fail to capture formulary or ‘sell side’ savings on the dispense or administration of medications. These formulary savings are less familiar in the hospital and healthcare setting market, and due to fluctuating levels and types, many providers are unknowingly missing out on their full opportunity.
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Considered trade secret by PBMs, formulary or ‘sell side’ savings are outside the traditional purview of hospitals and healthcare settings. Unbeknownst to many healthcare executives, these formulary opportunities can comprise 5%-60% of Wholesale Acquisition Cost (WAC) on brand and specialty medications. Because of this, an opportunity exists for Care Delivery Organizations that purchase and dispense or administer medications while being reimbursed for said medications outside of a PBM.