For pharmaceutical manufacturers

A direct-to-employer
channel you control.We are the infrastructure.

The manufacturers who moved first proved the model.
ApalyRx helps you reach more than 150 million self-funded lives through a channel you own, on benefit, and fully within your existing PBM contracts.
Your drugs, your pricing, your data, factory to patient.

Yours
Your drugsYour pricingYour data
ApalyRx, the infrastructure beneath
Pharmacy operationsEmployer contractingReal-time settlement
5
Manufacturer programs
312K
Lives since 2018
92
Net promoter score
On-benefit
Every claim
SOC 2
Type II certified

The direction

Direct-to-employer is no longer the experiment.It is the direction.

The largest manufacturers moved first and proved direct-to-employer works at scale.
Across the industry, others are following, because the logic is hard to argue with: a channel you own, a direct relationship with the self-funded market, and a hedge against depending on any single path to your own customers. The question facing every manufacturer now is not whether direct-to-employer happens. It is whether you own a channel when it does.

The cost of a single channel

A channel you don't controlis a channel at risk.

Humira was a $20+ billion franchise, still effective, still preferred, still in demand. Within twelve months of biosimilar entry it lost material share across the top formularies, because there was no direct manufacturer-to-employer relationship. Biosimilar loss is the loud version. The quiet version runs on every product that depends on a single channel: net price erodes, formulary position shifts with little warning, rebate dollars sit in float for months, and your own prescription data reaches you late, if at all. The lesson the industry took from Humira is simple: own a direct path to the customer, before you need one.

$20B+
Humira franchise, before biosimilars.
12 months
Material share loss across top formularies after biosimilar entry.

What control looks like

A channel you controlchanges everything downstream.

Imagine reaching the self-funded market directly: your pricing strategy intact, a rebate structure you own, prescription data arriving in real time instead of bought back months later, and commercial relationship with the member preserved end to end. No wholesale spread. No formulary auction for preferred position. No dependence on a single intermediary to defend your product.

The strategy is not the hard part. Everyone agrees on the destination. The problem is that the paths to get there have not existed.

The two walls

Manufacturers try to build an alternative channel.Two walls stop most of them.

The contract wall
Your own contracts make direct net pricing impossible.

PBM exclusivity, MFN clauses, and Medicaid best-price reporting make a direct net price to employers structurally impossible.

The off-benefit wall
The vendors approaching you are off benefit.

The direct-to-employer vendors now approaching you are almost all off benefit, cash-pay, card, or D2C, which sophisticated employers reject outright because it breaks accumulators, HDHP and HSA treatment, manufacturer terms, and fiduciary defensibility.

The strategy is right. The available paths do not work.

The reframe

ApalyRx operates the infrastructure.The channel is yours.

You do not have to choose between your PBM relationship and a channel of your own. ApalyRx adds the second channel beneath your existing arrangements, not against them. The self-funded market, more than 150 million lives, is reachable through a structure that respects your constraints: you sell at WAC, the discount is delivered as an instant rebate at the point of dispense rather than as direct net pricing, and the contracting party with the employer is a drug program administrator that operates the infrastructure. ApalyRx offers two entry paths, Complete DTE and Partial DTE, which differ in how distribution works and are detailed further down.

Yours
Your drugs
Your pricing strategy
Your rebate structure
Your data, factory to patient
Your commercial economics
Your field enablement
ApalyRx runs beneath
Licensed pharmacy operations
Employer contracting
Real-time settlement
Eligibility and benefit verification
Accumulator reporting
CAA-compliant reporting

What makes it adoptable

The only direct-to-employer channelthat operates on benefit.

You are being approached by direct-to-employer vendors, clinical vendors included, and almost all of them are off benefit. Sophisticated employers reject that outright.
Others claim to run on benefit through the PBM, which defeats the purpose of a manufacturer-direct program.
ApalyRx is the only infrastructure that operates fully on benefit, which is the distinction that large, sophisticated employers, and one their fiduciary, CFO, and legal teams require.

What on benefit actually requires
Off-benefit card / D2CApalyRx
Adjudicates through the TPA or PBMNoYes
Posts to the deductible and MOOPNoYes
HDHP and HSA compliantNoYes
Manufacturer-terms compliantNoYes

This is so central that clinical vendors pitching their own direct-to-employer models contract with ApalyRx to win large, sophisticated employer deals, because they cannot operate on benefit without us.

A different kind of distribution

Not retail distribution.Targeted, like e-commerce.

The standard model is retail distribution: push product to every pharmacy in the country so it is on the shelf if someone needs it. Direct-to-employer is different. Because every script routes to ApalyRx first, we know which members are on a product, and which pharmacy they use, before an employer even activates. Distribution becomes targeted instead of blanket.

And unlike the mail-order model most direct-to-employer programs rely on, members fill through their own local, preferred pharmacy. They keep the pharmacist who knows them, which means better adherence, real clinical support, and a relationship, not an anonymous nationwide fill. For your product, better adherence is not only a member benefit. It is fills, outcomes, and revenue.

The economics

Regain controlof your gross-to-net.

In the standard channel, your gross-to-net is shaped by intermediaries and by rebate terms negotiated for formulary position, much of it outside your direct control and visible to you only after the fact. A channel of your own changes that. You set the economics, the value that intermediaries hold today stays in your control, and you decide where it goes: higher net retention, a lower list price, better member affordability, or a mix.

In the standard channel
Wholesale and distribution
PBM rebate negotiations
Formulary position bidding
Visible to you only after the fact
In a channel you own
You set the economics
The value stays in your control
Transparent, not revealed after the fact
You decide where it goes

What your channel delivers

Four things a channel on ApalyRxgives you.

01
Channel control
The manufacturer-to-member relationship is preserved end to end. No wholesale, PBM, or specialty spread.
02
Gross-to-net control
You set your rebate structure and keep pricing authority in both entry paths. In Complete DTE, the rebate settles at the moment of dispense with zero float, and WAC is preserved at invoice. MFN-safe by design.
03
Real-time data and field enablement
Rx-level dispense, prescriber attribution, and member adherence in real time. No more buying it back from third-party aggregators. Reps notified within hours.
04
340B and duplicate discounts structurally eliminated
In Complete DTE the drug never enters the wholesale channel, so the mechanism never triggers. Engineered out, not scrubbed.

You are not building alone

One counterparty.An employer base already live.

ApalyRx is your single counterparty across every employer, so you negotiate and operate once, not employer by employer. And you are not starting from zero. You inherit an established base of covered lives already on the platform, with more in the pipeline, and every employer and every product added makes the channel more valuable for the next one.

Because ApalyRx addresses the large majority of an employer's fills, not a handful of drugs, and every script routes here first, adding your product to live rails automatically drives volume. There is no formulary competition and no paying for preferred position. Once the rails are in place, adding a product is easy.

The member experience

One member experience.Multiple manufacturer programs.

A plan member cannot reasonably sign up with four different manufacturer programs separately, four apps, four logins, four cost-share collections. That model fails before it starts. ApalyRx provides one experience for the member and one enrollment for the plan sponsor, and every manufacturer on the platform benefits from this network effect. The member is already there, already enrolled, already trusting the experience. Adding your drug is adding it to a functioning channel, not building one from scratch. Members fill through their own local preferred pharmacy, for better adherence and a real pharmacist relationship, not an anonymous mail-order channel.

Implementation

Complete DTE and Partial DTE.You choose.

Both paths route every script to ApalyRx first. The difference is distribution.

Complete DTE

Establishes a separate distribution channel with custody-without-title, eliminates 340B and duplicate discounts, delivers a true instant rebate at dispense, and gives full real-time data from factory to patient.

Partial DTE

Keeps your existing wholesale distribution, with ApalyRx as the drug program administrator. Faster to launch, but wholesale spread, 340B risk, and the loss of data at the distributor dock carry forward.

How it runs

End to end,in four steps.

01
Program design
Net price, eligibility rules, and rebate structure are agreed in your supply agreement with ApalyRx. Once. Then it scales across employer populations.
02
Script intake
The e-prescription routes to ApalyRx. Real-time eligibility and benefit verification, and the member is engaged for pharmacy choice and cost-share collection.
03
Fulfillment
In Complete DTE, the ApalyRx 3PL partner ships the drug to the member's local preferred pharmacy or to their home, with the local pharmacy as the pharmacy of record. In Partial DTE, the member's local preferred pharmacy dispenses from its own inventory.
04
Settlement
A single adjudication event settles four things: TPA medical claim billing, accumulator update, manufacturer rebate at dispense, and pharmacy ACH.

Data and evidence

Real-world evidence,built into the channel.

Because ApalyRx works directly with employers, members, and their TPAs, we can access claims data before a program goes live and periodically afterward. That supports robust health economics and outcomes research for your team, with the supporting data to back it.

And because every plan member creates an account and consents to receive education, the platform can educate members about the conditions your products treat. Not product promotion, condition-level education, delivered to the population that needs it.

Questions your team will ask

Answers for everystakeholder.

Operations Team

Finance Team

Legal Team

Commercial and Market Access Team

Get started

Start with a conversation.Bring your toughest channel question.

A focused 30-minute working session. We come ready to talk about where direct-to-employer fits your portfolio.