BIRMINGHAM, Ala. – October 28, 2026 -- Illuminate Rx, a low-net-cost pharmacy benefits manager (PBM) and affiliate of RxBenefits, will make Sempre Health's manufacturer-funded savings available to its members on January 1, 2027, at no additional cost to employers or members.
Sempre uses pharmacy claims data to find eligible members
Manufacturer copay assistance exists for certain medications, but consumers must know it exists, locate it and enroll. Sempre removes that step by using pharmacy claims information to identify eligible Illuminate Rx members.
When a member fills a participating medication, Sempre flags the savings opportunity and contacts the member directly. The savings are then applied at the pharmacy, which lowers the member's out-of-pocket payment.
Sempre reports 45% to 65% out-of-pocket savings and 15% to 25% better adherence
Sempre says participating members achieve approximately 45% to 65% estimated savings on out-of-pocket prescription costs. It also reports an average 15% to 25% improvement in medication adherence. Both figures come from Sempre's own book-of-business data.
High-deductible plan members face the largest upfront costs
Employers are managing rising pharmacy costs, and employees feel the same pressure at the counter. Members in high-deductible health plans may face greater upfront prescription costs. According to the companies, cost barriers that stop members filling or continuing a prescription can raise broader healthcare utilization.
Illuminate Rx says the Sempre integration draws on savings sources outside PBM formulary, network and contracting tools. Ritu Malhotra, PharmD, President of Illuminate Rx, said the arrangement removes the burden of finding and tracking savings from members.
Sempre CEO says PBMs are making point-of-fill affordability a core offering
Anurati Mathur, Co-founder and CEO of Sempre Health, said PBMs are moving quickly to make point-of-fill affordability central to their offerings. She said the Illuminate Rx partnership extends Sempre's support to more members nationwide.
Malhotra said Illuminate Rx will keep searching beyond traditional PBM sources for additional on-benefit value.