About us
Built by a physician.Running since 2018.
Apaly Health Inc. builds benefit infrastructure for self funded employers. ApalyRx is the pharmacy layer built on top of it.
Where this came from
We built the on-benefit rails first.The drug problem came later.
Apaly Health Inc. started in 2018 on a different problem. We were building subscription based primary care for self funded employers, and we hit a wall. Carriers and third party administrators could not process a subscription payment. Their systems only understood claims.
So we built a platform that converted subscriptions into claims. The same platform honored high deductible health plan rules under IRS logic, collected member cost share, and reported to deductibles and out of pocket maximums. It worked because it spoke the language the carriers already spoke.
That work put us in front of HR teams at Fortune 500 employers, and the same problem kept surfacing. Not primary care. High cost drugs, and at that moment, GLP-1s.
The question was whether we could aim what we had already built at that problem. An engine that finds the lowest price wherever it exists, while still billing on benefit through the TPA or carrier. That became ApalyRx. We added supply sources beyond manufacturer direct, and the model now saves employers 20%+ against their PBM drug prices.
The reason ApalyRx can run on benefit is that we did not build it for drugs. We built it for primary care in 2018, and the hardest part was already finished.
What we believe
Four convictionsbehind the model.
- 01Independence has to be structural
A party that earns more when a script goes one way cannot be trusted to decide where it goes. The only real fix is to own no channel at all.
- 02The record has to be made at the time of the decision
Reporting assembled from claims months later tells a plan what happened. It does not show that the decision was sound when it was made.
- 03Members should not pay for the savings
If a program lowers the plan's cost and raises the member's, it has moved money rather than saved it.
- 04This belongs inside the benefit
Anything running outside it breaks accumulators, breaks HSA treatment, and leaves a plan sponsor with nothing to point to.
Together these are what the industry is beginning to call Drug Benefit Integrity.
The particulars
The structure,plainly stated.
- Apaly Health Inc.
- is the company. A Delaware corporation, operating since 2018.
- ApalyRx
- is the service.
- ApalyRx LLC
- is the licensed pharmacy subsidiary. A Texas Class G centralized prescription processing pharmacy, NPI 1912873969.
Now you know us.Let's talk about you.
Thirty minutes. Tell us where you sit and we will bring the right people to the conversation.