Direct Drug Access - Simplified.
The drug program operating system with configurable rules, real-time eRx routing to the lowest net cost across all channels, medical claims settlement, decision-level reporting, and VIP member experience - built to work alongside your PBM and TPA with full structural independence.
Trusted by employers and health plans covering 500K+ lives
Covered Lives
NPS Score
Cost Reduction on High-Cost Drugs
Employers Overpay. Manufacturers Lose. Members Suffer.
Employers & Health Plans
Overpay by 20-40%
Complex benefit structures, multiple pricing layers, and no independent way to verify that each prescription was routed to the lowest net cost across all available channels. Plan fiduciaries face personal liability for drug benefit decisions they cannot independently prove were optimal.
Manufacturers
Lose Market Share
Manufacturers invest billions in copay programs, patient assistance, and direct pricing, but these programs sit outside the benefit, with no way to evaluate them alongside traditional channels at the point of decision. Clinically valuable options go unused because no infrastructure exists to bring these programs inside the benefit at scale.
Members
Get Lost in Chaos
Surprise costs, unclear requirements, poor experience. Members navigate between their doctor, insurance, and pharmacy with no coordination and no one helping them through the process.
ApalyRx closes this gap with real-time independent routing, decision-level documentation, and turn-key manufacturer infrastructure
Who We Serve
For PBMs
Strengthen Your Program With Independent Routing
Add a real-time independent routing layer that evaluates every high-cost prescription across all channels - including your own pharmacies - and produces decision-level documentation for your clients.
Learn More →For Health Plans
Operate Targeted Drug Carve-Out Programs
You select what drugs are included in your drug programs. Set your own program rules and controls. Access direct, pass-through, net pricing - no rebates, no hidden spread. Every routing decision independently documented with full audit trail.
Learn More →For Benefits Consultants
Change the PBM Conversation
Move client evaluations from pricing comparisons to structural accountability and integrity. Introduce a standard that differentiates your advisory practice.
Learn More →For Manufacturers
Turn-Key Direct-to-Employer Infrastructure
Deploy direct-to-employer drug access programs at scale - eRx intake, eligibility, cost-share collection, accumulator reporting, medical-claim billing, and supplier settlement. No need to build the plumbing.
Learn More →For Independent Pharmacies
New Revenue. Fair Reimbursement. No Clawbacks.
Dispense prescriptions or serve as pharmacy of record in manufacturer-direct models. Fair reimbursement from a platform with no competing channel interests.
Learn More →How It Works: Configure, Route, Settle
A seamless process from prescription to delivery
Configure Programs & Pricing
Set up your customized drug program
- Employers and health plans define drug programs - scope, eligibility, cost-share, PA requirements, and channel controls
- Manufacturers integrate direct pricing, copay programs, and patient assistance into the routing evaluation
- Platform configured and ready to receive prescriptions through the e-prescribing workflow
Validate, Route & Fulfill
Real-time all-channel eRx routing
- Prescriptions received directly through the e-prescribing workflow
- Every in-scope eRx evaluated across all available channels - PBM specialty, PBM mail, retail, manufacturer-direct, and independent pharmacy
- Routed in real time to the lowest net cost based on actual pricing across all channels
- Fulfilled through independent community pharmacies or shipped direct to member in manufacturer-direct models
Collect, Pay & Report
Closed-loop financials and decision-level records
- Collect member cost share and report to plan accumulators
- Bill plan portion through medical claim to TPA for data continuity
- Pay suppliers via ACH with transparent, pass-through economics
- Decision-level record produced for every prescription - channels compared, rules applied, routing rationale, net cost components
Your PBM and plan stay untouched. ApalyRx operates alongside existing infrastructure - routing high-cost prescriptions to the lowest net cost and documenting every decision.
Five Reasons to Choose ApalyRx
Independent
No ownership in any dispensing channel. Routing decisions are structurally independent - the evaluation has no financial interest in the outcome.
Real-Time
Every prescription routed at the point of decision - not sampled retrospectively, not reported after the fact. Real-time all-channel evaluation.
Documented
Decision-level records for every script - channels compared, rules applied, routing rationale, and closed-loop financial reconciliation. Audit-ready by default.
Compatible
Works alongside your existing PBM and TPA. Carve out only the high-cost drugs where routing optimization has the greatest impact. Nothing else changes.
Manufacturer-Ready
Turn-key infrastructure for manufacturer direct-to-employer programs - eRx intake, eligibility, billing, settlement, and accumulator reporting built in.
Built on the Drug Benefit Integrity Standard
Drug Benefit Integrity (DBI) is an independent industry standard with five structural requirements for ensuring that pharmacy benefit decisions are made in the plan's interest. ApalyRx meets all five.
ApalyRx is the only entity that meets all five requirements.
Ready to Take Control?
Let's Define Your Key Problem Drugs.
Tell us which drug categories are driving your costs. We will show you how ApalyRx can route those prescriptions to the lowest net cost alongside your existing PBM and TPA - with decision-level documentation for every script and real savings projections based on your population.
Request a Conversation