The MutualRx Pharmacy Blockchain
Old vs. New PBM

Pharmacy Benefit Managers (“PBMs”) are an antiquated model!  There is no other way of saying it. They use old technology, out-of-date business practices and inefficient procedures. The whole “PBM-as-Middleman” no longer needs to apply. And who wins? The Plan Sponsor and their Members!

Think about it: why is there a middleman in any pharmacy-related financial transaction in 2019? The role of negotiating prices, billing, and member services cost information as provided by the traditional PBM has grown obsolete.  Technology enables the exchange of data, information and services to be delivered on new platforms with greater transparency, reduced costs, improved security, enhanced convenience and better member experience.

Old PBM Model
New PBM Model
The Mutual Rx Answer

At Mutual Rx, we are building the PBM of tomorrow. Our model is built on blockchain technology and machine learning, which eliminates the need for a central controlling middleman. The network is designed as a decentralized distributed system, where designated stakeholders are a permissioned partner to complete transactions, without the dependency on a third-party entity for authentication, transparency and pricing trust. No longer will Plan Sponsors have to wonder whether the pricing information being shared by their traditional PBM is, in fact, an accurate representation of the market or their transactional applications. Transactions will be time-stamped, verified and adjudicated without delay and payments will be automatically made. There will be no need for human processing for approvals. There will also be no need to retroactively audit, because the system is self-completing and validates the entire claims process.

Mutual Rx will bring a plan sponsor’s pharmacy benefit program into the next generation of improved decision support, reduced costs and improved outcomes for particpants.

The Mutual Rx Blockchain:
  • Offers interoperability; security; transparency; expediency
  • A decentralized ledger that operates on a cloud-based permissioned network
  • Provides access to real-time patient pharmacy data without the burden and cost of data reconciliation
  • Our smart contracts are triggered by specific events and are traceable and auditable without human effort
  • We use it for automated claims adjudication and payment processing
  • Serialization for supply chain security
  • Auditing
  • Clinical trial patient coordination in physician practices
  • Pricing comparisons