Our AI-Enabled Clinical Efficacy Platform lowers speciality pharmacy spend by certifying + recertifying only therapies that work.

​

Specialty drugs are expensive.

Only pay for the ones that work.

Legacy prior authorization approves drugs. We help you determine if they actually work. By continuously assessing patient data against clinical guidelines, eliminating ineffective therapies, and “gold carding” members on the right ones, plans reduce specialty pharmacy spend, improve clinical outcomes, lower administrative costs, and deliver a far better overall experience.

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.

Very expensive

US new drug launch prices rose from $31,700 in 2011 to $228,700 in 2022.

In 2024, median annual cost of treatment for new drugs launched exceeded $350,000.

Often ineffective

Many specialty medications have been pulled from the market due to ineffectiveness.

Others continue to be prescribed even though the drug is not effective as measured by intended clinical endpoints.

Potentially harmful

Specialty medications also carry potential risks, such as acute liver failure (e.g. Elevidys), pancreatitis or thyroid cancers (e.g. GLP-1s) or other serious adverse effects.

Introducing

The Ethicos Health Clinical Efficacy Platform

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:

  • Lower specialty pharmacy costs

  • Improve member experience

  • Manage Prior Authorizations efficiently

  • Accurately predict costs

  • Enable Value Based Drug Contracting

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?