How Cash Pay Paves the Way for Smarter Pharmacy Benefits Spend

By Chris Crawford, Founder of RxSaveCard

Prescription drug costs—especially GLP-1s and specialty medications—are overwhelming self-insured

employers and their members. But what if cash pay options could work alongside your pharmacy

benefits to lower costs, reduce risk, and strengthen fiduciary compliance?

I recently talked to Scripta’s CEO Eric Levin about how cash pay methods help self-insured employers

better control Rx costs without sacrificing care for their members. Here’s what you should know:

---

The Problem with the Status Quo

For years, plan sponsors have been told that Pharmacy Benefit Managers (PBMs) protect them with

aggregate discount guarantees. On paper, these deals promise savings. In practice, they create an

environment where some drugs are grossly overpriced—sometimes costing plan sponsors thousands of

dollars more than the true market value.

We’ve been taught to believe that an aggregate discount guarantee is a form of protection. But when

you take a step back, what are you really being protected from? PBMs are the ones setting the rates.

The result? A member may pick up a drug at their pharmacy counter for $6,000 through their PBM,

while the exact same medication is available for $40 cash.

---

The Growing Cash-Pay Landscape

Employers and employees alike are embracing the idea that paying cash is cheaper than going through

insurance. Platforms like GoodRx and SingleCare, pharmacies like Cost Plus Drugs, and manufacturer

direct-to-consumer models like Lilly Direct and Novo Care are all part of a growing cash-pay

marketplace.

Generics and biosimilars are where cash pay shines. These are drugs with no rebates attached. If you

can buy the exact same drug for less, why wouldn’t you?

This creates a unique opportunity for plan sponsors: instead of funneling every claim through the PBM,

they can design benefits that direct members toward lower-cost alternatives without going through

insurance.

---

How RxSaveCard Works

The challenge, of course, is making cash-pay seamless for members. That’s where RxSaveCard comes in.

At its core, RxSaveCard is a debit card issued in the employee’s name, backed by employer funds to

subsidize cash Rx purchases. Instead of swiping their personal debit or credit card at checkout, members

use RxSaveCard to pay for the prescription.

The member gets the drug they need, often for free. The employer avoids unnecessary spend. No PBM

switches. No further disruption to the plan or the member.

---

The Power of Partnership: Scripta + RxSaveCard

RxSaveCard and Scripta both share the same goal: making sure that people get the treatment they need

at the best price while keeping employee benefit costs down.

While RxSaveCard solves the payment problem, Scripta solves the navigation problem. Together, we’ve

created a powerful one-two punch of a solution for plan sponsors.

Scripta guides members to the most cost-effective medication options available, whether that means

choosing a covered drug through their health plan, switching to a more affordable proven alternative, or

using a trusted cash pay source like RxSaveCard. When RxSaveCard offers the lowest price for a

member's medication, that option is included in the member’s Personalized Savings Report along with

step-by-step guidance on how to capture the savings.

As a fiduciary, you’re also doing your part by ensuring members have access to the most affordable

prescription options.

This partnership ensures savings are captured in real time, without friction for the member and without

waste for the plan.

---

Why It Matters for Plan Sponsors

For self-funded employers, the stakes are high. Pharmacy costs aren’t an abstract line item — they’re

real dollars coming out of the business.

If I can buy the same exact drug for less, why would I overpay through my PBM? My member wins, my

plan wins.

In a world where GLP-1s and specialty drugs are exploding in popularity, that mindset isn’t just

innovative—it’s essential.

---

The Bottom Line

The future of pharmacy benefits is about choice, transparency, and smart plan design. By embracing

solutions like RxSaveCard and Scripta’s Rx Navigation, employers can manage costs, reduce waste, and

keep members on the medications they need.

Having optimal pharmacy benefits is all about making sure you’re helping members get the care they

need without making the member or the employer overspend. Together with Scripta, we’ve got you

covered on all of that.

---

Chris Crawford is CEO & Founder of RxSaveCard, an innovative pharmacy benefit cost-containment and

payment solution. Chris founded RxSaveCard with a mission to make prescriptions more affordable for

employers and their employees. He recognized the complexities and frustrations often associated with

changing Pharmacy Benefit Managers (PBMs) and sought a better way. He also recognized that in many

cases, prescriptions cost more when someone uses their insurance than what is available through “cash”

and discount card options. RxSaveCard is the solution: a simple way to unlock lower cash and discount

card prices without requiring a PBM switch, all while ensuring compliance with ERISA fiduciary

standards.