Breaking Health Podcast

Candid Conversations with Digital Health Innovators & Business Leaders


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Conversations between VCs and entrepreneurs typically occur in boardrooms or coffee shops. In the Breaking Health Podcast, you get a seat at the table. Healthcare VC Stephen Krupa, Managing Director of the Psilos Group, brings his investor insight to revealing conversations with the most disruptive CEOs in healthcare. Listen to understand how these leaders are building the companies – and fostering the cultures – that will change everything.


A. J. Loiacono on Capital Rx’s Mission to Remodel the American Drug Pricing System as a Tech-Based Pharmacy Benefit Manager

February 21, 2023
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AJ Loiacono’s experience in supply chain consulting for pharmaceutical manufacturing afforded him a world-class education in supply chain logistics, drug pricing, and software implementation. However, it wasn’t until he worked with healthcare payers that he realized the glaring problems in the U.S. drug pricing system and that pharmacy benefit managers retained much of the control and profit. He says, “The reason why our drug pricing is the way it is today… is because no one has either had the resource, bravery, or perseverance to stand up and say, ‘This is what’s wrong, and we’re going to fix it instead of profiting off of the system.’”

Looking to disrupt the status quo, Loiacono founded Capital Rx. As one of the fastest growing healthtech companies in America, Capital Rx reconstructs prescription pricing and puts savings back in the patient’s hands. Loiacono speaks with host Steve Krupa about his desire to simplify drug pricing and increase transparency, how Capital Rx’s novel cloud-native enterprise pharmacy platform, JUDI, reduces labor costs by up to 80%, how they maintain a 99.5% retention rate with their clients, and why their books have demonstrated a negative drug trend for the past three years.

 

A. J. Loiacono

Founder and CEO

Capital Rx

AJ Loiacono is a 20-year veteran in the pharmacy industry and a fiery advocate for drug reform. He’s spent the past few years on Capitol Hill educating policymakers, including Senators Grassley, Alexander, and Wyden, about the inner workings of pharmacy benefit managers (PBMs) and the pharmacy supply chain.

AJ previously co-founded two other companies that enhanced the pharmacy supply chain: Truveris and Victrix. He spent his early career in pharmaceutical manufacturing (supply chain software) and later moved to the payer (employer/carrier) market to develop claim processing software. Coming from pharma, he believed drug pricing was incredibly stable in the US, with brand drugs only changing price twice a year and generic drugs deflating every quarter. However, when he looked at a claims file from any payer, including the federal government, it looked like drug prices changed every hour, of every day, for every drug, in every pharmacy. In reality, drug prices are incredibly stable in the US, but prices are artificially manipulated by carriers and PBMs to maximize profit.

AJ founded Capital Rx to transform a stagnant $600B industry. As part of his strategy, he recognized this was not just a supply-chain problem (drug pricing) but an infrastructure issue (how to process, administrate, and pay for claims efficiently). This mission propels AJ and his company forward.



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Meet Our Host

STEPHEN KRUPA

Healthegy Contributing Host Stephen Krupa is CEO of Healthedge, a software company focused on providing next-generation, business-transforming technology products to the healthcare payor market.


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