Capital Rx, the health technology company changing the way prescription drugs are priced and patients are cared for, and type 2 diabetes (T2D) reversal leader Virta Health have partnered to introduce Rx Reverse. Available to all of Capital Rx's customers, Rx Reverse is a high-touch, provider-led, integrated clinical program designed to help members reverse T2D and fight obesity without costly medications.
The problem is clear: 37+ million Americans have been diagnosed with diabetes, and over 90% of them have T2D (including one-third of the population over 65 years old).1 At the same time, the prevalence of obesity is over 40% of the U.S. population2 and is expected to reach nearly 50% by 2030.3 During a June 15, 2023 webinar, Rethinking Obesity Strategies: The Rise of GLP-1 Drugs and Lifestyle Programs for Weight Loss, Virta revealed new survey data highlighting that diabetes and obesity are the #1 and #2 concerns of health plan leaders in 2023 because of rising costs and downstream health impact.
The launch of Rx Reverse comes as demand for GLP-1 drugs approved for diabetes and weight loss is rising rapidly, and employers and health plan leaders focus on managing the cost of diabetes and obesity. Rx Reverse combines Capital Rx's tech-enabled pharmacy benefit management (PBM) service model, powered by JUDI®, and Virta's solution – personalized nutrition therapy, physician-led deprescription, remote monitoring, and one-on-one coaching – to help health plans reduce costs and improve members' health.
"Leveraging JUDI, our proprietary next-generation claim adjudication platform for Medicare, Medicaid, and commercial plans, we have the ability to seamlessly connect with vendors like Virta, sharing actionable member information efficiently in real-time, and providing the connectivity plan members need to improve their overall health," said Sara Izadi, PharmD, Senior Vice President of Pharmacy at Capital Rx. "Our Single-Ledger Model™, coupled with JUDI's capabilities, enables us to partner with Virta on a solution focused on deprescribing and health equity."
Virta reports lowering HbA1c for patients by 1.3% on average after one year, and 60% of patients enrolled one year attained an HbA1c below 6.5% without using diabetes medications other than metformin. Moreover, patients experience an average of 12% body weight loss at two years. And like Capital Rx, which saves payers 10% - 30% in the first year, on average, after switching from a traditional PBM model, Virta emphasizes positive financial outcomes, including demonstrating an estimated $503 per engaged member per month gross savings for T2D reversal participants.
Three Rx Reverse options are available for plan sponsors to choose from
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Type 2 Diabetes Reversal: Helps plan members achieve lower blood sugar – often to sub-diabetes levels <6.5 A1c – and clinically significant weight loss alongside safe deprescription of diabetes medication.
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Provider-Led Weight Loss: Helps plan members without diabetes who are considered overweight (BMI ≥ 25) or obese (BMI ≥ 30) achieve clinically significant weight loss.
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Type 2 Diabetes Reversal & Provider-Led Weight Loss
"The rapidly rising utilization and cost of obesity and diabetes drugs is putting extreme pressure on healthcare payers," said Kevin Kumler, President at Virta Health. "Capital Rx's tech-forward, value-based approach – a needed evolution from the traditional PBM model – aligns both incentives and systems to help payers control drug costs while members get healthier."
About Virta Health
Virta Health is the leader in type 2 diabetes reversal and is creating a new standard in medical care for people living with type 2 diabetes, prediabetes, or obesity. The company's virtual approach combines personalized nutrition therapy with continuous provider-led support to empower members to eliminate medications, lose weight, and take back their lives. Virta has earned the trust of the nation's largest organizations, including Humana, AutoZone, and Blue Shield of California, delivering industry-leading cost savings of over $6,000 per member per year while putting our fees at risk based on health outcomes.
About Capital Rx
Capital Rx is a healthcare technology company changing the way prescription drugs are priced and patients are cared for in America. As a Certified B Corp™, Capital Rx is executing its mission through a Single-Ledger Model™, the industry's first ethical framework for drug pricing. The company's cloud-native enterprise pharmacy platform, JUDI®, connects every aspect of the pharmacy ecosystem, servicing over 2.4 million members for Medicare, Medicaid, and commercial plans.