Rx Savings Solutions (RxSS) exists to help members find and switch to prescriptions that can treat their conditions at a lower cost. How in the world can we do that for millions of members and cover the spectrum of thousands of different drugs?
In fact, RxSS members filled prescriptions for 8,400 different medication products in 2024.1 Our clinical engine contained at least one suggestable alternative for 7,139 of them.2 That’s more than 65,000 possible suggestions across the board. For any given drug, these could be:
- One or more available generics
- Multiple forms—tablets, capsules, liquids, gels, creams
- Multiple formulations—extended release (XR or ER) and immediate (IR)
- Different dosages
- Therapeutic alternatives in all the above
Our suggestion count has grown steadily over the past decade thanks to new drugs entering the market and being approved for new indications. The number also reflects the efforts of an expanded RxSS Pharmacy team with more expertise, specialties, and resources. The clinical engine can identify more savings opportunities today than it could even one year ago. That’s a good thing for RxSS members and clients. More suggestions mean more possibilities to spend less.
A Job Only a Pharmacist Could Love
Each suggestion is the result of tedious curation by RxSS pharmacists. We use the same peer-reviewed, evidence-based guidelines that federal health agencies, health plans and pharmacy benefit managers use to create their coverage criteria and approved indications.
All recommended clinical suggestions are reviewed and approved by the RxSS Pharmacy and Therapeutics (P&T) committee. No one is trying to build the number for numbers’ sake. Each addition is made with care, caution and the confidence that when a member chooses an RxSS suggestion, their doctor is likely to approve the switch. (Which they do 88% of the time.3)
Evolving with Medicine and the Market
Just because a clinical suggestion makes it into the engine doesn’t mean it stays there. Continuous review and updating by RxSS pharmacists ensure suggestions align with:
- Therapeutic advancements across a wide range of disease states
- New medications entering the market, offering fresh alternatives
- Updated medical guidelines, especially in fast-moving areas like oncology and autoimmune care
Clinical guidelines can shift for traditional and specialty medications at any time, so our suggestions shift accordingly. When existing drugs receive approval to treat additional conditions, chances are they will be added to the engine. On the other hand, something recommended a year or even six months ago might not make the cut today .
The Power of Clinical Suggestions
To be clear, not all 65,000-plus suggestions come into play for every member or client. Factors like a particular health plan’s pharmacy benefit design, formulary, and negotiated prices for any covered drug all affect whether an RxSS suggestion applies. However, when the pool of possibilities expands, so does the potential to identify savings opportunities.
For example, based on what our members and clients spent on prescription drugs in 2024, we determined that our engine contained clinical alternatives for 94% of the total spend.4
The goal is always to help every member take advantage of every savings opportunity. Because when members know their options, they’re empowered to better navigate the medication journey and control prescription costs. They can discuss a suggested alternative with their doctor or automate the process through RxSS.
Either way, a lower-cost prescription can lead to more affordable treatment, improved adherence, and ultimately, a healthier employee or plan member. And smarter spending for plan sponsors that want to offer meaningful health benefits.
Learn more at rxss.com/what-we-do/.
1 RxSS internal data; prescribable products utilized by RxSS members, total population, January-December 2024; accessed July 2025.
2 RxSS internal data; total clinical suggestions in database mappable to member-utilized products, January-December 2024; accessed July 2025
3 RxSS internal data; approved prescription change requests submitted to prescribers by RxSS, March 2023-March 2024; accessed July 2024.
4 RxSS internal data; total dollars paid by RxSS members and clients for filled prescriptions for which a clinical alternative suggestion exists in the RxSS engine, January-December 2024; accessed July 2025.
