Transforming prior authorization to make it more clinically meaningful while also lowering the cost of specialty pharmacy.
Specialty drugs are expensive.
Only pay for the ones that work.
Ethicos Health’s AI-Enabled Clinical Efficacy Platform reduces costs for plan sponsors by eliminating inappropriate or ineffective medications while “goldcarding” patients for appropriate medications, providing a better patient experience and less administrative burden on clinicians.
Specialty medications, including GLP-1s, can be lifesaving, but come with challenges: high costs, variable effectiveness and potential for harm.
They can also be very expensive, often ineffective and potentially harmful.
Introducing
Leveraging our AI-enabled platform, Plans instantly convert their existing clinical guidelines into machine readable algorithms, evaluate longitudinal patient data against each medication’s intended outcome, and automate provider outreach to close data gaps and communicate results.
By continuously assessing patient data against clinical guidelines, eliminating ineffective therapies, and “goldcarding” members on the right ones, plans can:
Let us transform your prior authorization process to make it more clinically meaningful while also lowering the cost of specialty pharmacy.
By continuously monitoring longitudinal patient data against real clinical endpoints, we give health plans clear insight into what matters most: is the medication working for each member?