Pharmacy Solutions

Integrated clinical programs and technology solutions grounded in pharmacy claims processing excellence

SS&C Health’s Pharmacy Solutions helps turn technology and operations into strategic advantage in today’s value-focused environment. Grounded in a 30-year legacy as a tech solution leader and as an innovator in claims processing, we are equipped to address today’s healthcare challenges.

SS&C Health’s Pharmacy Solutions redefines the value of pharmacy in healthcare through outcomes-based solutions for payers of all sizes that include the integration of advanced analytics, clinical programs, and transformative digital capabilities.

We operate independently, without channel conflicts or competition with clients – so that means your strategy and success come first. Our scalable, flexible model can help you drive the most cost-effective clinical, financial, and operational outcomes for you and your members.

Contact us to learn more about developing innovative clinical programs and/or making improvements to your specific solutions for:

Drug Spend
Specialty Drug Management
Member Satisfaction
Clinical and financial outcomes
Pharmacy claims adjudication systems

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.

Learn more

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.

Learn more

Our wrap program provides your plan members with access to competitive DDC discounts when their plans leave them exposed to list prices or high out-of-pocket costs.

Learn more

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.

Pharmacy Network Solutions

Optimize your pharmacy benefit for greater choice, and/or greater savings. Or, transcend the “choice vs savings“ network paradigm to deliver integrated health and wellness support for a high risk populations.

Learn more