Why Scripta’s Provider Navigator Changes Everything: A Pharmacist's Perspective

During the 70s and 80s, I spent my after-school hours at my uncle's drugstore and watched him counsel farmers and General Motors workers on their ailments, giving personalized advice that went far beyond just filling prescriptions. That small-town pharmacy taught me what healthcare should be: accessible, personal, and focused on finding solutions that actually work for people's lives.

Forty years into my career as a pharmacist, I still get asked that same question by family, friends, and neighbors: “This prescription was $500, even with my insurance. Is there anything less expensive?"

It's a question I take seriously. And it's a question that should drive every care team working to serve plan members—whether you're at an on-site clinic, managing an in-house pharmacy program, or overseeing pharmacy benefits for a health plan.

The Gap Between Intent and Impact

Here's what I see across the industry: care teams genuinely want to help members afford their medications. Plan sponsors are investing in on-site clinics and in-house pharmacy programs specifically to provide better, more affordable care. Health plans are working to steer members toward cost-effective options.

But here's the disconnect: prescription medications now account for over 25% of commercial health benefit costs and 30% of overall cost increases. Scripta typically finds medication options that could save employers and patients up to 35% if the alternatives were used. Yet even with the best intentions, pharmacists and prescribers often don't have clear visibility into what a prescription will actually cost a specific member, or what affordable alternatives are available on their formulary.

That gap between intent and impact creates real problems:

For clinic-based prescribers: You're writing a prescription thinking you're helping, but you don't have real-time visibility into whether it's a $10 copay or a $500 out-of-pocket cost for that specific member. By the time you learn there's a problem, the member has already had a negative experience.

For in-house pharmacy teams: You see the sticker shock on members' faces when they come to pick up prescriptions, but coordinating with prescribers to find alternatives takes significant time and effort. Without streamlined access to member-specific formulary information and therapeutic alternatives, every intervention becomes a manual process.

For health plan pharmacy teams: You have the data on high-cost claims, but getting actionable information to the point of care—where prescribing and dispensing decisions are made—remains a persistent challenge. Members fall through the cracks between systems that don't talk to each other.

Why Scripta’s Provider Navigator Is Built for Your Workflow

That's exactly why we built Provider Navigator at Scripta—to bridge the gap between the care teams who want to help and the real-time information they need to actually make it happen.

The Provider Navigator gives prescribers and pharmacists real-time access to member-specific medication pricing, formulary options, and cost-effective alternatives—right at the point of care.

For Plan-Sponsored Clinic Providers

When you're seeing a member at an on-site clinic, Provider Navigator integrates cost and formulary information directly into your prescribing workflow. Before you write the prescription, you can see what it will actually cost that member and identify clinically equivalent alternatives that fit their budget and your plan's formulary.

This means you can have a different conversation with your members: "I'm prescribing this because it's clinically appropriate and it's going to cost you $15 instead of $300. Here's why this option works just as well."

That's the kind of proactive, transparent care that builds trust and improves medication adherence—because members can actually afford to fill and refill their prescriptions.

For In-House Pharmacy Teams

Provider Navigator transforms how pharmacists can support members. When a member reaches out about an unaffordable prescription—whether at the pharmacy counter, over the phone, or through a portal—the pharmacist has access to:

• The exact cost for that member's specific plan

• All formulary-covered alternatives in the same therapeutic class

• Clinical equivalency information to ensure quality of care

• A streamlined way to facilitate prescriber communication

  
  

No more playing phone tag with clinics. No more manual research to piece together formulary details. Your pharmacists can confidently recommend alternatives and help members request changes through the platform, with all the documentation prescribers need to make quick decisions.

This isn't just about answering questions faster—it's about enabling your pharmacy team to be proactive medication therapy advocates, reaching out to members with high-cost prescriptions before they even pick them up.

For Health Plan Pharmacy Teams

Provider Navigator gives you something that's been missing: a way to operationalize your cost-savings strategies at the point of care.

Your analytics tell you where the opportunities are. Provider Navigator ensures that prescribers and pharmacists across your network—whether they're in plan-sponsored clinics, in-house pharmacies, or community settings—have the tools to act on those opportunities.

The Scripta Physician Portal displays all savings opportunities for each prescriber's patient panel in one convenient location. This means:

• Prescribers can review and address cost issues for multiple patients efficiently

• Care coordination happens within the platform, reducing administrative burden

• You get visibility into which opportunities are being addressed and which need additional intervention

• Members receive consistent, proactive support regardless of where they access care

Most importantly, you can move from reactive problem-solving to proactive cost management, identifying high-cost prescriptions before they generate claims and member complaints.

What This Means for Members

When I help my family members navigate expensive prescriptions, I don't just give them information—I help them take the next step. I call their doctor. I facilitate the change. I make sure they actually get the medication they need at a price they can afford.

Every member in your plan deserves that same level of support. Provider Navigator makes it possible for your entire care team—from clinic prescribers to pharmacy staff to health plan coordinators—to deliver that kind of personalized, solution-focused care at scale.

We're not just showing care teams their options. We're integrating cost transparency into clinical workflows. We're removing the barriers that prevent prescribers from making cost-effective choices in the moment. We're giving pharmacists the tools to be true advocates for members, not just dispensers constrained by information gaps.

We’re also empowering members to be true consumers of healthcare, enabling them to comparison shop for Rx the same way they do for travel, electronics, cars and more. Through the Scripta app, they’re able to proactively request a switch that saves from their care team.

Why This Matters Now

With prescription costs climbing and health plan sponsors facing some of the largest rate increases in years, the pressure to control pharmacy costs has never been greater. But this isn't just about bending the cost curve—though that matters enormously to your bottom line and your members' premiums.

This is about making your investment in integrated care actually work. Plan-sponsored clinics and in-house pharmacy programs exist to provide better, more affordable care. Provider Navigator ensures that promise becomes reality by giving your care teams the information and tools they need to deliver on it.

I'm proud to work for a company that takes this responsibility as seriously as I do. We're here to help—not just with words, but with solutions that integrate into your workflows, support your care teams, and deliver measurable results for your members and your organization.

Because at the end of the day, that member asking "Is there anything less expensive?" deserves the same answer I'd give my own family: "Yes, there is. And your care team has everything they need to make sure you get it."