Pharmacy Benefits Transparency

Your PBM is keeping
millions that belong
to your clients.

AlethRx uses AI-powered analytics to expose hidden PBM spread pricing, rebate retention, and contract violations — and translates complex findings into plain English your employer clients actually understand.

AI Analysis · Live Preview
$847K
Hidden costs identified · 500-member employer
↑ 34% above benchmark spread
62%
Rebate retention rate · PBM kept $312K
↑ Industry benchmark: 40–50%
47
Anomalous claims flagged by AI
✓ Reviewed and validated

How It Works

From raw claims data
to actionable insight

Three steps from data upload to a findings report your employer clients can act on immediately.

01
Connect Your PBM Data

Upload claims files from CVS Caremark, Express Scripts, OptumRx, or any PBM. Our AI automatically maps and normalizes the data — no manual configuration needed.

AI Column Mapping
02
AI Runs the Analysis

Machine learning detects anomalous billing patterns, calculates spread and rebate gaps, benchmarks against true peer employers, and flags contract guarantee violations.

ML Anomaly Detection
03
Plain-English Report

AI writes the findings summary automatically. Every report reads like a senior pharmacy analyst wrote it — ready to share with an employer CFO in minutes, not days.

Claude AI Narrative

Your AI pharmacy
analyst on staff

Give your 3-person brokerage the analytical firepower of a dedicated pharmacy benefits team — without the headcount.

Ask AlethRx Anything

Type any question about an employer's pharmacy data in plain English. "Why did costs spike in March?" answered in 3 seconds with data-backed context.

🔍
Anomaly Detection

AI flags unusual PBM billing patterns your competitors miss entirely. Systematic spread manipulation, duplicate claims, unusual pharmacy patterns.

📄
Auto-Generated Reports

Polished PDF findings reports with AI-written executive summaries. Share directly with employer CFOs. No manual writing required.

Client Portfolio
AI ACTIVE
Meridian Manufacturing
487 members · Renewal in 62 days
87
URGENCY
Lakewood Services Group
312 members · Renewal in 148 days
54
URGENCY
Northgate Technologies
891 members · Analysis complete
22
URGENCY
AI detected 12 anomalous claims for Meridian Manufacturing — potential $62K overbilling. Review recommended before renewal.

The only platform that gets
smarter with every employer

Every competitor uses rules-based engines. AlethRx is AI-native — the more employers we analyze, the more accurate the anomaly detection becomes.

🤖
NL Query Engine

Ask any question about pharmacy data in plain English. AI converts to SQL, runs the query, returns a plain-English answer in seconds.

SS-07 · Week 13
📊
Anomaly Detection

Isolation Forest ML model trained on PBM billing patterns. Catches systematic manipulation that rules-based engines miss entirely.

SS-06 · Week 10
✍️
AI Narrative Engine

Claude AI writes the executive summary, key findings, and broker talking points for every report. Analyst-quality at software scale.

SS-09 · Week 12
🔮
Predictive Forecasting

Prophet ML generates 12-month pharmacy spend forecasts with confidence intervals — 85%+ accuracy vs 60% for linear trend models.

SS-08 · Week 20

Request your
free AI analysis

We'll run a complimentary AI analysis on one of your employer clients' claims data. No commitment. See what your PBM has been keeping from you.

For independent benefits brokers · Response within 24 hours