Rohan Kulkarni — Executive Research Leader, HFS Research[00:21]
Greetings and welcome to HFS Unfiltered. I am joined today by Anuj Agrawal, who is the Chief Transformation Officer at LucyRx, and Vishal Kapoor, who is the Chief Growth Officer at Veltris. We’re going to dig into the technology enablement and the opportunities in the PBM space. The PBM, or the Pharmacy Benefits Management space, has been rather interesting in the recent past with regulations and changing business models and distribution models and the enablement of technology in order to facilitate all of that. So, Anuj, let me start off with you by asking you, as a practitioner in the industry, and you’ve been in the industry for a long time now, what are sort of the top three opportunities and challenges for the PBM industry at large, and how is LucyRx navigating through those?
Anuj Agrawal — Chief Transformation Officer, LucyRx[01:14]
I guess I would start with specialty affordability at scale. That’s one of the things that we, that the industry at large, is kind of grappling with. So things like the use of biosimilars, you know, site of care optimization and concierge savings. So a lot of people have heard of things like patient assisted care and also co-pay assistance to help reduce that cost. What folks don’t actually realize, I think, is that these can actually improve adherence by ensuring affordability. So, affordability so that it’s not a barrier to health, right? So one of the ways that LucyRx is addressing this is through our care guides model. And these care guides basically are folks that are proactively enrolling members in various different programs. They coordinate with prescribers and they really provide a smooth therapy transition, right, to some of these biosimilars. So that’s one area. Another would be around the member experience modernization. And that’s kind of the lead into what Vishal is going to talk about, I think, why you have both of us on, is users have, by and large, become more sophisticated in their expectations. They expect omni-channel service. They expect mobile transparency, right? They expect that what they experience is something that they can trust inherently. And there’s a lot of distrust in the healthcare system. So having really, and being able to provide an experience that can also help drive clinical adherence, things like faster connect times and high first call resolution. Essentially, LucyRx is committed to, and we are providing, a warm human-first tone, right? So in everything that we’re doing, there’s a human-first tone that’s applied, whether it’s on our mobile app or whether it’s on a portal and within our service workflows, that’s something that is helping us drive better trust with our member experience. I think another one would be around rebate dynamics versus net cost strategies. So programs like international sourcing really helped reduce reliance on rebates. So I think that’s something you and I have chatted about before in the past, right, while still delivering lower net cost, right? So just making sure that all of that can be delivered, I think, is something that LucyRx is really committed to.
Rohan Kulkarni — Executive Research Leader, HFS Research[03:50]
Fantastic. And Vishal, since Anuj laid up an opportunity there for Veltris in terms of what you’re doing, delivering the enablement of some of those bright ideas that he was talking about, talk to us a little bit about what exactly are you doing and where are they in the journey, if you would.
Vishal Kapoor — Chief Growth Officer, Veltris[04:12]
Sure, thanks, Rohan. And once again, Anuj and the LucyRx team, thank you for being a fantastic and collaborative customer with Veltris. We’ve had just a phenomenal last, I’d say, eight months in this relationship. And we continue to see this focused and collaborative approach going forward as well, in line with some of the outcomes that Anuj was speaking of. We’ve had a lot of success in building out a few key initiatives for LucyRx. The first one, which, of course, Anuj also mentioned, was just around the overall member experience. And driving a complete overhaul of the omni-channel experience, including the web and mobile platforms, and really reducing any legacy limitations and improving member experience overall. So that’s one. The second is across really organizational alignment as it relates to bringing the right actionable insights and dashboards for LucyRx to make insightful and outcome-based actionable decisions. That has been the other large initiative that we’ve been working on. Of course, all of this has helped us create more scalable and more targeted outreach through the core operating platform for LucyRx, which has in it the most important and most critical aspect, which is the member engagement and driving some of that engagement. But beyond that, helping in really the cross-sell, up-sell from a growth strategy perspective in terms of the monetization of the core platform. And then, of course, at the same time, reducing the overall cost for drugs for its members. The last one I’d kind of mention is driving what we call their client operations and transforming their entire experience through platformization and unification of what used to be legacy systems into really very simple client and member management experiences that are easily consumable by members and clients for LucyRx today.
Rohan Kulkarni — Executive Research Leader, HFS Research[06:29]
Anuj, you operate at the intersection of business and technologies. Because in so many ways, I feel this is an opportunity for industry-wide transformation, because I, as a researcher, look at LucyRx as a disruptor in the space. So as you work with Veltris, I’m curious about what your views are in terms of the technology-enabled solutions that have been deployed. Can you talk a little bit about that, please?
Anuj Agrawal — Chief Transformation Officer, LucyRx[06:53]
Sure. So, I mean, Vishal touched on the same couple of, you know, solutions. I think the two that I think are going to be radically, they’re not unique in themselves. So you’d find that a lot of PBMs will have a member experience. Yeah, that’s a given, right? They’ll have some sort of a clinical program. That’s a given. I think the difference here is in how we’re going about it. And the real transformative part is that it is driving better outcomes. And I know a lot of people say that. And it’s an easy word to throw around, right? We’re getting better outcomes. But how do you actually measure that? So the one thing that I was really gratified that we were able to do together is literally the pace at which those products and solutions were developed. So, I mean, coming up with an idea is great, but then if it takes you oodles and oodles of time to get it out to the marketplace, you’re not really helping and serving our members. So having that ability to drive that level of productivity gain through the use of AI, I think that we’ve all been there, I think, from a development standpoint. I think that’s what has been really key. And being able to deploy a solution, get a reaction, to see what’s working, what’s not working, the speed at which we’re able to do it in partnership with Veltris has been seriously amazing. And that, we believe, is a game changer in this industry that has historically been extremely heavyweight, has been extremely heavyweight, right?
Rohan Kulkarni — Executive Research Leader, HFS Research[08:40]
Indeed, indeed. You know, I’ve had the pleasure of working with Vishal and the broader Veltris team over the last several months. So your words bring to life a lot of the capabilities and investments that they continue to make in terms of AI, but also the broader services-as-software, a notion that HFS has been evangelizing these last several months at this point in time. So Vishal, let me ask you then, with all of the solutions that you’ve deployed at LucyRx at this point in time, talk to us a little bit about what kind of outcomes have you seen at this point in time? And what should Anuj and LucyRx expect in terms of those outcomes going forward?
Vishal Kapoor — Chief Growth Officer, Veltris[09:27]
So as a company, our North Star has been to deliver three very critical aspects, right, from an outcome perspective. How can we help our customers build? How do we help our customers monetize and modernize, right? Those three are really key elements of how we look at driving KPIs for ourselves and our customers in terms of the outcomes that we deliver. Now, in context to LucyRx, for us, there have been a few that truly stand out, right? One is we’ve talked about member experience. But if you think about how that has improved the outcome, it is now simple, cleaner, more intuitive experiences for the members. B, you think about the overall, just the reduction in the support overload by simplifying and streamlining workflows, which has actually helped in reducing what we call member confusion and has reduced the operational overhead that was in the past just because of the legacy systems that did not allow you to do that. And the simplification helped in driving some of these outcomes. The other I’d say, very importantly, from a monetization perspective, is driving revenue opportunity, right? Better targeting and personalized engagement to drive more effective cross-sell opportunities for LucyRx on the core platform from a simplification, but also providing the ability to drive these outcomes in line with, you know, and intersecting with their client and member experiences. The last would be, you know, making LucyRx what I call a future-ready digital, right, from a foundational perspective into the future. And I think that is really important because one of the most important critical aspects, along with Anuj and the LucyRx team, we together put an endeavor in front of us, almost like an audacious goal into the next year and the future, was to say, what does all of this mean at the end of the day in the ability for us collaboratively to develop a platform which would be scalable? And that would then help you foundationally create the ability to expand and continue the ongoing transformation that LucyRx is on in terms of the outcomes that they want to deliver both to their members and their clients. So I think that has been most critical in terms of foundationally just relooking and recreating how this will become a catapult moment for us to develop anything on top into the future for LucyRx.
Rohan Kulkarni — Executive Research Leader, HFS Research[12:13]
Excellent. Excellent. Very good. Anuj, bring us home, please. The PBM space is continuing to evolve. It is becoming more and more interesting. In some ways, we’ll argue that it is ripe for disruption across the healthcare ecosystem. So I’m curious, from your standpoint, what’s next for LucyRx?
Anuj Agrawal — Chief Transformation Officer, LucyRx[12:35]
Yes, thank you for that last question. So to round us off, what’s next for LucyRx? I think the PBM space is, like you’re saying, ripe for transformation, for disruption. I think it’s going to come, it is starting to happen already, but it’s going to come in the form of, like, a lot of disruption in the prescription workflows, right? And we’re going to see vertical AI discipline coming into those workflows. You know, measuring what matters, things like time to therapy, right? Net cost per case, member sentiment. These are things that I think are going to be extremely, you know, game changers for a PBM that wants to continue surviving in the current landscape. And I really think that this is going to be key. This approach is going to be key to realizing, I think, things like HFS has been talking about in terms of services-as-software model. There hasn’t been as much conversation in the PBM space around that. I think we’re going to see that being changed in the very near future. And I expect LucyRx is going to be right there partnering with Vishal and his team to help bring that home.
Rohan Kulkarni — Executive Research Leader, HFS Research[14:01]
Outstanding. I’m sure you will. This has been a fascinating conversation. And I just really appreciate the time. Thank you very much, Vishal. Appreciate your partnership. Thank you very much.
Anuj Agrawal — Chief Transformation Officer, LucyRx[14:11]
Thanks, Rohan.
Vishal Kapoor — Chief Growth Officer, Veltris[14:12]
Appreciate it.
