For pharmacy benefit managers

The independent verificationyour clients are asking for.

Employers and their consultants are demanding proof of lowest cost that no PBM can produce on its own. ApalyRx is the independent layer that provides it, reinforcing your transparency, supporting your clients' fiduciary duties, and keeping the accounts that pressure puts at risk. You keep administering the benefit. We verify it, alongside you.

How it works alongside you
Every script
ApalyRx · independent verification
Every channel assessed in real time
Fills through the lowest
Your PBMfill channel
When your price is lowest, the script fills through you.
Manufacturer direct
Other channels
You keep administering
FormularyPrior authorizationBenefit design
Unchanged

The pressure you are under

Your clients are asking a questionthat is hard to answer alone.

CAA 2026, fiduciary litigation, and a wave of transparency demands have changed what plan sponsors expect. They no longer just want competitive pricing. They want proof, evidence that every script was the lowest cost available, documented well enough to satisfy a fiduciary. It is the question behind every renewal now, and the PBMs who cannot answer it are the ones losing accounts to whoever can. The pressure is real, and it is a retention problem.

The heart of it

No one can verify themselves.Not even a transparent PBM.

Transparency shows what was paid. It cannot show that the price was the lowest available at the moment the script was written, because a PBM reporting on its own pricing is still grading its own work. That is not a criticism of any PBM. It is a structural fact: verification has to come from outside the party being verified. This is the gap your clients are pointing at when they ask for proof, and it is one no PBM, transparent or not, can close on its own.

Self-reported
The party being priced
checks its own pricing
Shows what was paid. It cannot show the price was the lowest available.
Independently verified
The party being priced
An independent layer
A separate party proves the lowest option was found and chosen.
A structural fact, not a criticism. Any party grading its own work has the same limit.

The answer

The independent layerthat proves it for you.

ApalyRx is that outside party. It assesses every script in real time, across every available channel, and proves it was routed to the lowest cost at that moment, your own price included. That is integrity, not just transparency: not a report of what was paid, but independent evidence that the lowest option was found and chosen. This is the standard now taking shape in the market, Drug Benefit Integrity. Bringing ApalyRx to your book lets you answer your clients' hardest question with something you could never produce internally, an independent verification that reinforces exactly the transparent, client-first posture you want to project.

How it works with you

You keep administering.You keep every script you already win.

This is the part that matters most, and it is worth being precise about:

When you're lowest, it fills through you
Every script is assessed, and when your price is the lowest, which is often, it runs through you, unchanged. ApalyRx does not take that volume. It confirms it.
We reach only what you cannot
Manufacturer-direct pricing and channels that sit outside your adjudication are the gaps ApalyRx fills, the prices you were never able to reach anyway.
You stay the administrator
Formulary, prior authorization, benefit design, and your client relationship all continue exactly as they are. ApalyRx contracts with the employer as the verification layer. Your role does not change.

ApalyRx is not a competitor. It is the independent verification that helps you compete.

Reinforcing your posture

Help your clients meet their duty,and be the PBM that helped them do it.

Your clients are fiduciaries now in a way they were not a few years ago, and they need to show a documented, prudent process for reaching the lowest drug cost. A PBM that hands them that, through an independent layer that routes to the lowest cost every time, the PBM's own price included, becomes part of the solution to their fiduciary problem rather than a source of it. You are no longer the intermediary they are being told to scrutinize. You are the partner who brought them the verification they needed. That is a stronger position for every account you hold.

What is coming

The manufacturer-direct shift is here.Participate in it, on benefit.

Manufacturers are building direct-to-employer channels, and high-cost scripts are increasingly going to reach employers that way, with or without the PBM. The off-benefit versions, cash cards and direct-to-consumer programs, route around you entirely and break the benefit.

ApalyRx brings that same shift on benefit and keeps it orderly: manufacturer-direct pricing delivered as an adjudicated claim, inside the plan, with you still administering. Partnering with ApalyRx means being part of where the market is going, rather than watching high-cost volume leave through channels you do not touch.

The proof

Independent, on benefit,and operating at scale.

312K
Lives since 2018
92
Net promoter score
On benefit
Every claim
Independent
Verification layer

ApalyRx already runs as the independent layer alongside existing benefits, on benefit, at scale. The infrastructure is proven and ready to bring to your book.

Get started

Turn your clients' hardest questioninto your advantage.

Let's talk about how independent verification strengthens your book and keeps the accounts that pressure puts at risk.
You keep administering. We verify it, with you.