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DISCOVER NAVITUS

Our Company

We’ve spent more than 20 years providing plan sponsors and health plans with an alternative to spread-based PBMs, and today we proudly serve almost 18 million members through almost 800 clients.

Pass-through Model

Financial and Operational Transparency

Commitment to More Affordable Medications

About Us

Our Legacy

We’ve led the way as a market-ready model for transparent, fully pass-through pharmacy benefits management for more than 20 years—successfully disrupting the industry and setting the bar for financial and operational transparency.

We’re proud of the work we do and our strategic offerings that:

Return 100% of all negotiated rebates, discounts and fees back to our clients

Provide full financial and operational disclosures

Lower overall drug spend and cost of care

Improve medication adherence and member health

Offer alternative treatment options that can reduce long-term drug reliance

Our Culture and Values

About Us

Founded in 2003, Robert Palmer believed that the PBM model needed to evolve to better align with plan sponsor needs. This meant going against the norm by implementing a 100% pass-through business model that drove out needless costs.

For nearly two decades, we have stayed the course with this unique model that differs from other established PBMs. We are driven by a shared commitment to help humans, and to make prescription medications more affordable for the people who need them. 

Our Vision Statement

We build trust through honesty and open communication

Our Mission Statement

We make medications more affordable for the people who need them, so they can live their lives more fully.

aligned values

100% Pass-through Approach

No rebate chasing. No spread chasing.

Just a clear, easy-to-understand, set fee.

Which means as a pass-through model PBM, we’re able to make decisions that align with your organization’s goals, regardless of the potential impact to spread, margins or rebate dollars.

Because we don’t benefit when medication prices increase, our actions are guided by lowering overall drug spend, supporting your organization’s unique financial and operational needs, and ensuring that members can receive the care they need at a price they can afford.

true partnership

100% Financial and Operational Transparency

Transparency is more than just a buzzword. It’s our standard.

Without spread pricing to influence things, our clients experience transparency that empowers them to make well-informed decisions for their plans and their members.

Our clients have a clear understanding of their contract, terms, claim-level data and reporting, our financials and access to participate in our formulary management process.

a clear choice

How Transparent is Your PBM?

Think you have a clear understanding of what it means to operate with complete transparency? See how your current PBM stacks up against some of our core requirements for financial and operational transparency:

Revenue sources

  • Does your PBM generate zero spread revenue on pharmacy or manufacturer claims?
  • Does your plan immediately benefit and receive 100% of all network and pharma contract improvements?
  • Does your plan receive 100% pass through of all rebates and discounts, including any upside or increased savings through the contract?
  • Are 100% of all pharmacy costs passed back to your plan (in retail, mail and specialty channels)?
  • Is formulary product selection based on a lowest-net-cost philosophy (not focused on higher costs to get more rebates)?

Contract Definitions

  • Does your PBM use independent, publicly verified third-party definitions for brands and generics?
  • For generics, is a single MAC list applied across all distribution channels?
  • Is your PBM contract free of any incentives that benefit the PBM from the relationship between plan sponsor, PBM and patient?
  • Do your utilization management (UM) programs have appropriate prior authorization (PA) approvals and step therapy used to manage cost, not generate revenue for PBM?

Contract Transparency

  • For three-year contracts (or longer), are plan admin costs the same for each year and are they known up-front (rather than a contract where year two and three costs escalate after year one)?
  • Do you have complete control over all aspects of your pharmacy benefit, including network/distribution channels and formulary?
  • Do you have the ability to terminate the contract without cause after the first year and keep your rebates?
  • Do you have unrestricted access to pharmaceutical manufacturer and pharmacy contracts?

Access to Data

  • Do you have access to your data at any time with the same data sets used for auditing or financial guarantee true-ups?
  • Do you have access to all claims data down to the NDC-11 level?
  • Do you have access to all MAC lists used and clarity to how and when they’ll be used?

Auditing

  • Do you have access to review and audit all documents and data pertaining to your benefit program?
  • Do you have access to view and audit all network pharmacy arrangements?
  • Do you have access to actual and total claim files for audit purposes (rather than separate and partial claim files)?
  • Do you have access to actual net claim files for audit purposes including all claim calculations?
  • Do you have access to view and audit all manufacturer contracts?

Service Excellence

Commitment to Care

Without the influence of chasing spread, we’re able to better position ourselves and our clients to do what matters most: help human beings get the care they need at a price they can afford.

Members are more than just a number

At Navitus, we know that affordable prescription drugs can be life-changing—and lifesaving. We are on a mission to make a real difference in our customers’ lives. Because behind every member ID is a real person, and they deserve to be treated like one.

Our Team

We work relentlessly to increase affordability and access to the medications people need. This commitment takes courage, persistence and a dedication to doing what’s right for the people we serve.

When you choose Navitus, your team expands to include experts committed to this mission who align to support your goals. Because for us, our business isn’t just business. People’s livelihoods and well-being depend on it.

  • Laura S. Kaiser

    Chair of the Board

  • David Fields

    Board Member

  • Richard Stephens, RPh

    Vice Chair of Navitus

  • Randy Combs

    Board Member

  • Lisa Erickson

    Board Member

  • Brad Hanna, PharmD

    Board Member

  • Joseph Swedish

    Board Member

  • David Fields

    President & CEO

  • Carrie Aiken

    Senior Vice President and Chief Administrative Officer

  • Sharon Faust, PharmD, MBA, CSP

    Chief Pharmacy Officer, Lumicera

  • George Hepburn

    Chief Financial Officer

  • Diana G. Gibson Pace

    Chief Growth Officer

  • Darryl Munden

    Chief Operating Officer

  • Paul Page

    Chief Legal Officer

Interested in learning more about Navitus?

Latest Insights

Our latest insights, testimonials and more:

Achieving Outstanding Results with Tailored Network Strategies

Achieving Outstanding Results with Tailored Network Strategies

A medium-sized city in Michigan with 1,350 members was seeking ways to lower its pharmacy benefit costs, which were growing under its existing traditional pharmacy benefit manager (PBM). With its member covered by a two-tier, open formulary including

Breaking Through Barriers with Value-Based Plan Design

Breaking Through Barriers with Value-Based Plan Design

Facing increased pharmacy benefit expenses, Blain’s Farm and Fleet, a Midwestern employer group, desired to improve plan performance. Specifically it was interested in educating eligible members about the benefits available to them, promoting cost-effective

Finding a Solution to Lower Prescription Drug Costs

Finding a Solution to Lower Prescription Drug Costs

The Rural Arizona Group Health Trust (RAGHT) wanted to gain better control of its escalating drug trend with its large, traditional pharmacy benefit manager (PBM). Having only worked with traditional PBMs in the past, RAGHT was interested in exploring

Empowered by Strategic Opportunities and Service Excellence

Empowered by Strategic Opportunities and Service Excellence

Putnam | Northern Westchester Health Benefits Consortium (PNW HBC) was the first municipal cooperative health plan in the state of New York to become certified by the Department of Insurance. They are dedicated to meeting — and exceeding — the standards

QUALYiQ Program Delivers Significant Savings for Both Members and Health Plans

QUALYiQ Program Delivers Significant Savings for Both Members and Health Plans

As part of their treatment plan for hypophosphatasia (HPP), a rare genetic disorder affecting bone and teeth development, one of our members required Strensiq, a medication designed to manage HPP. However, Strensiq’s annual treatment costs ranged from

Gaining True Transparency With a Pass-Through PBM Model

Gaining True Transparency With a Pass-Through PBM Model

Texas Association of Counties (TAC) was established to provide a cohesive voice for all counties and their officials. The counties joined together to establish a group health plan and employee benefits program known as the Health and Employee Benefits

Reducing Costs and Improving Service

Reducing Costs and Improving Service

Over time, one university grew increasingly dissatisfied with the service level it was receiving from its traditional pharmacy benefit manager (PBM). Despite the long-term relationship with its PBM, something needed to change.

Why Aligning With the Right PBM Ensures Timely Access to Medications

Why Aligning With the Right PBM Ensures Timely Access to Medications

Mail delays have little impact upon Navitus members. Find out why. Since March, we have seen an uptick in the number of members participating in retail extended or mail order prescriptions. At the same time, there have been anecdotal accounts of delays

Generating Plan and Member Savings Through Tailored Pharmacy Benefits

Generating Plan and Member Savings Through Tailored Pharmacy Benefits

Seeking Customization and Cost Management for a Retiree Population Kentucky Rural Electric Cooperative (KREC) is a consortium of 13 nonprofit electric utility cooperatives. With a member population that includes retirees on the Medicare Part D prescription

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