2026 Partner Summit Insights Report

Welcome to the Judi Health Partner Summit

Ushering in a new era of healthcare.

AJ Loiacono

Co-Founder & CEO

Ryan Kelly

Co-Founder & CTO

Summit details

Location

New York, NY

Meeting Venue: 1 World Trade Center

Date & Time

March 24 - 25th 2025

Starting at 12:30 PM

Accommodation

Conrad New York Downtown, 102 North End Avenue, New York, NY 10282

Capital Rx will reserve and cover costs for your hotel stay

2026 Agenda

The agenda is subject to change.

The market's adoption of transparent PBM solutions is accelerating.

New Client Partnerships For 2026
80+
Total PBM Lives
> 5M
> 1M
New PBM Lives Implemented 1/1
27,112
Average Size of New Client

America’s Largest Employers, Unions, and Leading Health Systems Evolve Their Benefits Strategies

The surge in demand reflects the increasing recognition that transparent PBM models paired with enterprise health technology can reduce complexity, improve member experience, and deliver meaningful cost management.

Delivering quality care and support across the healthcare ecosystem.

400+

Total Clients

1,691

Total Plan Designs Created for the 2026 Benefit Year

100%

Implementation Success

> 35,000

Lives Added to our Unified Claims Processing Platform

Client Count By Sector

With over half of our portfolio in the Employer segment and strong representation across Public Sector, Labor, Health Systems, and TPAs, our balanced Book of Business demonstrates both stability and mass‑market appeal. Clients consistently choose our transparent Single-Ledger Model™, industry‑leading service, and unified claim platform, Judi, for it unmatched accuracy, efficiency, and clinically optimized decision‑making.

Employer Accounts
53%
Health Systems/Hospitals
21%
TPA/Health Plan
13%
Public
8%
Labor/Union
5%
Capital Rx

Capital Rx Book of Business: 2025 Adjusted Claims and Gross Spend*


With a specialty utilization rate of just 0.8% — an industry‑leading benchmark — our Book of Business demonstrates the impact of strong clinical alignment and success guiding members to lower-cost, clinically appropriate medications.

Book of Business
Drug Classification
Adjusted Claim Count %
Gross Spend %
Brand
9.3%
47.2%
Generic
89.9%
10.2%
Specialty
0.8%
42.6%



*Adjusted claim counts and gross spend exclude the following categories: over‑the‑counter (OTC) claims; coordination of benefits (COB) and other secondary‑payer claims where Capital Rx is not the primary payer; direct member reimbursement (DMR) “paper” claims; compound medications; vaccines; and COVID‑related products and test kits.

Setting a Platinum Standard for Member and Client Service in 2025

Our Account Management and Customer Care teams have been able to consistently rise to the challenge of delivering exceptional care to a rapidly growing population of plan members.

1,100,000+

Interactions Handled

87

Member NPS
26s

Average Speed of Answer (ASA)

97%

First Call Resolution (FCR)

98%

Customer Satisfaction (CSAT)

86

Client NPS

98%

Customer Retention

Top Drugs Driving Net Cost Changes Year Over Year

Top inflation drivers were led by Zepbound, Humira 2‑pen, Xdemvy, and Cosentyx and reflect rising demand for metabolic therapies, new specialty entrants, and shifting immunology markets.

Deflation was primarily driven by Humira, Stelara, Eliquis, and GLP‑1 competitors, influenced by biosimilar pressure, improved contracting, and formulary optimization.

Together, these trends highlight how competitive supply chain dynamics and formulary alignment shape PMPM performance across key therapeutic classes.

PMPM Inflation (top drugs)

*Top drivers of inflation are drugs with the largest increase in net cost PMPM from 2023 to 2025

1. Zepbound
2. Humira (2 pen)
3. Xdemvy
4. Jornay PM
5. Cosentyx UnoReady
6. Sutab
7. Adbry
8. Dexcom G7 Sensor
9. Sulflave
10. Paxlovid (300/100) 10. Dupixent
PMPM Deflation (top drugs)

*Top drivers of inflation are drugs with the largest increase in net cost PMPM from 2023 to 2025

1. Humira Pen
2. Wegovy
3. Stelara
4. Eliquis
5. Trulicity
6. Ozempic (0.25 or 0.5 MG/DOSE)
7. Trikafta
8. Ozempic (1 MG/DOSE)
9. Tremfya
10. Dupixent

A Picture of NADAC Deflation is Worth 1,000 Words

Generic drug prices have steadily declined, dropping 38% from 2020 to 2025. On the other hand, AWP has stagnated. This growing divide shows how NADAC‑based pricing helps capture real market value and deliver reliable savings on many everyday medications.

* Based on the Capital Rx 2025 client generic drug spend repriced at applicable NADAC and AWP pricing for 2020-2025 .

Utilization Impact Report: A 19% Savings Opportunity

Representative sample of 145 clients (1.4M lives) that moved to Capital Rx in 2024 and 2025.

Formulary Shift: Transition of patients from non-formulary products to formulary products with lower net cost.

Prior Authorization: Clinically appropriate PA protocols for biologics, GLPs, Migraines Androgens, Anabolic & Retinoids.

Quantity Utilization Management & Refill-Too-Soon: Claims identified in the client's data where dispensed quantities exceed UM protocols.

Copay Maximizer: Optimization of cost share to leverage available specialty and retail copay card or coupon savings.

6.9%
2.6%
4.8%
12.2%

% of Impacted Members

8.7%
4.3%
0.9%
5.6%

Year 1 Total % Savings

Clinical Success Stories

Rx Activate

A Capital Rx member with depression, anxiety, obesity, and high cholesterol joined Rx Activate’s Obesity Step Solution, OSS. They started OSS already taking a GLP-1 for weight loss, but reported significant side effects to the Vida Care Team during enrollment. The member’s registered dietitian worked to personalize an intensive medical nutrition therapy and care plan to help the member achieve their health goals. Within 5 months, the member achieved 17% weight loss* and reported reduced symptoms of mild depression and anxiety.

*Results may vary. Research indicates the typical overweight or obese participant willexperience a body weight reduction of 7.2% and 7.5%, respectively.

Rx Helix

I was identified for Capital Rx's Rx Helix program because of medications I was taking. My pharmacogenetic test results showed a few moderate drug-gene interactions, but I hadn't experienced any side effects from them. During the review, a pharmacist saw I was using three different anti-inflammatory medications at the same time, one of which was Ketorolac for migraines. The pharmacist explained that using Ketorolac for more than five days increases the risk of serious complications, including gastrointestinal issues, bleeding, and kidney damage. She contacted my doctor to recommend discontinuing the Ketorolac, and the doctor agreed. No further refills have been issued. I was very satisfied with my experience in the Rx Helix program. - Texas-based Plan Member

Rx Smart Save, Level 2

In just one day, four plan members were supported in transitioning to more affordable therapy options through the Rx Smart Save Level 2 program. Thanks to collaboration with prescribers and pharmacies, these members are now benefiting from a combined annualized savings of $3,403.44, plus $8,964.08 in annualized savings for the plan.

A History of Innovation

To improve how benefits work behind the scenes - operating efficiency and administrative workflows - we developed our own technology: an open, secure, scalable, and easy-to-use enterprise health platform, Judi®. The rest is history.

2025
  • Judi Health™ - healthcare’s first Unified Claims Processing™ platform – launched
  • Amino Health acquired (now Judi Care)
  • Capital Rx announces funding round of $400M
  • Capital Rx rebrands to Judi Health to reflect expansion beyond pharmacy
  • Judi Health becomes the jersey patch partner of the Charlotte Hornets
2024
  • Capital Rx becomes New York City FC’s official sleeve partner
  • Strategic alliance with Prime Therapeutics announced
  • HITRUST i1 Certification Earned
2023
  • Capital Rx closes $50M+ strategic investment round
2022
  • Closed Series C funding
  • Launched Medicaid / Medicare Processing
2021
  • Launched our Enterprise Health Platform, Judi®
  • Launched our Discount Card solution
  • Received URAC Accreditation
2020
  • Capital Rx closes Series B funding
2019
  • Launched first NADAC retail network
2017
  • Founded to transform the future of prescription management

Thank you for joining us at the Judi Heath 2026 Annual Summit

Tackling the most challenging problems in healthcare requires collaboration at every level and across the continuum of health benefits. We are glad you’re on this journey with us.