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2025 SafeGuardRx value announcement

SafeGuardRx delivered meaningful results for both plans and members—helping individuals manage complex conditions with greater confidence while supporting overall plan performance.

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2025 SafeGuardRx value payment

As a result of participation in 2025, eligible clients will be issued a payment on March 31, 2026, reflecting the value generated through continued investment in member care. Below are key consultant considerations:

Value payment timing

Eligible clients will receive their 2025 SafeGuardRx® payment in the coming weeks.

What drove the value

SafeGuardRx delivers impact through condition‑focused programs, tools, and personalized support that help members manage their health more effectively.

Enterprise impact

Across participating plans, SafeGuardRx delivered direct value in 20251, reinforcing its ability to improve outcomes while helping manage plan costs. 

Client action

No immediate action is required to receive the payment. Consultants can proactively engage clients interested in additional savings and performance opportunities for 2026.

Previous updates

As part of our ongoing commitment to plans and members, we are retiring a selection of SafeGuardRx® programs and components to focus our resources on those that demonstrate the strongest measurable impact for clients and members. 

What you need to know:

Effective January 1, 2026, the following key changes will take place:

HIV Care Value® Program

In 2024, HIVCV contributed less than 1% of the overall value that plans received from SafeGuardRx. This program will be retired, and we will continue to support at-risk members through other patient-centric nonadherence solutions within our organization.

Pulmonary Care Value ProgramSM

In recent years, utilization has shifted from brand-name medications to more affordable generics and average manufacturer price caps have also reduced the cost of several drugs included within the program. As these market changes have organically solved most of what PCV was designed to address, this program will also be retired.

Specialty Adherence Protection Program

After a careful review of outcomes and performance, we’ve decided to sunset this program. We remain committed to improving patient adherence and do so through the following specialty programs: Inflammatory and Atopic Conditions Care Value, Multiple Sclerosis Care Value Program, Oncology Care Value Program® and Rare Conditions Care Value® Program.

Weight Management Care Value® Program

The 120-day threshold for discontinuation credit will be removed to remain consistent with other programs within the platform. Plans will receive discontinuation credits per month per 30-day prescription for a total of 90 days if a member falls off therapy. Early discontinuation rates will be revised as part of an ongoing commitment to platform organization.

Effective December 20, 2025 (as previously communicated in November 2024)

BCR-ABL genetic testing for patients with chronic myeloid leukemia will no longer be included in the Oncology Care Value Program due to low utilization.

The standard terms and conditions are available to view below.

Standard Terms and Conditions

Questions? Contact our team.

Contact us

Source

  1. 2025 SafeGuardRx data