Pharmacy Solutions

The value of pharmacy in healthcare redefined

SS&C Health Pharmacy Solutions is redefining the value of pharmacy in healthcare for plans of all sizes through outcomes-based solutions that include the integration of advanced analytics, clinical insights, and transformative digital capabilities.

We operate independently, without channel conflicts or competition with clients – so that means your strategy and success come first. Building on our legacy of strong technology and pharmacy benefit administration, our flexible model can help you navigate the complexity of the healthcare industry while driving the most cost-effective clinical, financial, and operational outcomes for you and your members.

Formulary and Rebate Management

By integrating our formulary management platform into our claims adjudication system, we deliver enhanced self-service and full-service solutions that help to align your rebate strategy with your managed formulary, and provide unit cost price protections across key drugs.

Specialty Drug Management

We offer a unique, patient-centric set of specialty drug management tools and services – including medical benefit drug management, site of care strategies, and specialty pharmacy benefit – to help health plans manage quality of care and optimize spending.

Real-Time Benefit

Real-Time Benefit helps you give prescribers complete visibility into your members' benefit information — providing price transparency to your members at the point-of-care, saving them and your plan on drug spend, and enabling you to make better, faster decisions with actual outcomes analysis and data visualization.

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Network Management

We provide retail, specialty, and mail order pharmacy network solutions and management at competitive rates transparent to our clients. We work closely with you to help determine the network strategy best suited to provide members optimal access while also working to operate cost effectively – helping you build networks that meet your needs.

Utilization Management Strategies

We provide an integrated approach to drug utilization management that can help health plans manage the complexity of utilization management and reach their objectives. Our standard utilization management edits are designed to promote the safe, rational use of drugs in areas such as quantity limits, age edits, gender edits, duplicate therapy, and drug interactions.

RxNOVA™

Agile, reliable, and beyond the core capabilities of claims processing, RxNova™ is a high performance technology platform designed to manage the complexity of pharmacy benefit management.

RxNova provides interoperable solutions that can manage evolving benefit designs, support increasingly complex pharmacy claims adjudication, power sophisticated reporting and analytics, and present data visualization that can deliver actionable insights that help drive a holistic population health strategy.

Drug Discount Card Programs/Drug Discount wrap

Our card program provides your members competitive discounts on cash claims for retail prescriptions that are not covered under the pharmacy benefit plan.