How it works
Each channel's strength is also its ceiling — so RxDune doesn't pick a side. We integrate with trusted channels at the foundational level, and Dune — our Dynamic Utilization & Navigation Engine — routes every prescription to its lowest true cost in real time: right channel, right drug, right member, under your plan design. No added burden on the plan or the consultant.
One plan
One plan. No carve-outs to quarterback.
The market's answer
The market's answer to specialty drugs, GLP-1s, and high-cost claims has been the carve-out: a separate specialty vendor here, a GLP-1 point solution there, a discount-card program on the side — each with its own contract, its own eligibility file, its own support number, and its own finger to point when something breaks.
RxDune doesn't need them
Every channel is already wired into one plan, one contract, one support team, one dashboard.
And we're clear about what we won't do: we use every legitimate lever — manufacturer copay programs, foundation assistance, biosimilars, cost-plus sourcing — and capture that value for the member, transparently. What we don't do is carve drugs out of your plan to make your employees look uninsured, or import non-FDA-approved supply that puts members and your stop-loss at risk.
Formulary
Formulary, your way.
Most small groups have never been offered a choice. RxDune builds the formulary around the plan — not the other way around. Two starting points, each fully customizable:
OPTION A
Rebate-driven formulary
For groups that want rebate value — always with 100% of rebates passed through.
OPTION B
Lowest-net-cost formulary
Biosimilar- and generic-centric — drives true cost down instead of chasing rebate checks.
GLP-1s
GLP-1s, handled like adults.
GLP-1 coverage is the hardest call in small-group pharmacy right now: employees expect it, and unmanaged spend can wreck a plan. RxDune's answer is affordable and clinically managed. We source GLP-1s at highly competitive rates so coverage is realistic for both the plan and the patient, and we pair that with clinical criteria that gate them to appropriate use — real prior authorization that curbs off-label demand instead of rubber-stamping it.
We don't promise GLP-1s pay for themselves. We give you a way to cover them without losing control of the plan — and the data to see exactly what they're doing to your spend.
Prior authorization
Prior authorization that moves.
PA is a criteria-driven, document-heavy workflow — exactly what AI is built for. Our system handles the paperwork: intake, criteria matching, documentation, and status visible in real time instead of a fax black hole.
Criteria are evidence-based, applied consistently, and customizable to your plan. Members and prescribers see where a request stands; nobody re-faxes page one of nine.
The bright line
Licensed clinicians make the clinical calls — AI never approves or denies care.
Specialty
Specialty, without owning the building.
Specialty is roughly half of drug spend and where catastrophic small-group claims live. RxDune manages it through best-in-class partners rather than owning a pharmacy — everyday and emerging specialty through digital-native partners, complex and limited-distribution drugs through independent specialty expertise with site-of-care control, backed by our own AI triage.
Full specialty coverage, no self-dealing: because we don't own the pharmacy, we never have a reason to steer your members to it.
The operating layer
What the AI actually does.
The operational load that used to take teams of people runs on agentic systems from day one. That's the whole reason small groups get enterprise-grade service: a 200-life group is as viable for us to serve — and as well-served — as a 5,000-life one.
And the boundary is bright: AI runs the operation. Licensed professionals make every clinical decision.
Implementation
Built so switching never lands on the member.
Every implementation starts with an AI read of your claims, so we know exactly who's affected and how we'll protect them before go-live — not after. Transition fills mean no one loses a medication on day one, digital ID cards are live in the app immediately, and you watch the whole switch happen inside the dashboard.