This summer, Navitus celebrated its 20th anniversary as an organization. In honor of that, we sat down with David Fields to reflect on the company's legacy and to look ahead to its future.
Q: Tell us about the beginnings of Navitus.
A: When Navitus was founded in 2003, it was purpose-built by a customer to resolve a specific business challenge. The founders believed the existing PBM model needed to better align to the needs of the plan to take cost out of the benefit while still taking care of members. This meant going against the grain and building PBM capabilities founded on 100%, cost-based pass-through. This meant the health plan paid exactly what the PBM paid a pharmacy for the medication. This model eliminated the incremental cost that traditional spread-based PBMs added to the drug supply chain.
Q: What are some of Navitus' biggest milestones over the last 20 years?
A: A few stand out. First, winning and onboarding the Texas Association of Community Health Plans (TACHP) and LA Care were notable steps within the first decade to increase the scale of our PBM business.
Second, the establishment of Lumicera Health Services in 2014. This was a natural expansion of our core capabilities, as the company again sought to solve a client challenge and uniquely improve the affordability of specialty medications. Lumicera operated a cost-plus model, where payors or cash-pay patients are billed the same amount Lumicera pays to acquire the medication, plus a patient management fee. To-date, Lumicera remains the only known U.S. specialty pharmacy to deploy that model.
Third, the acquisition of EpiphanyRx in 2021 expanded the organization's core PBM capabilities, bringing a targeted solution for employers with less than 3,000 covered lives. Culturally the organizations were a fit, given a shared commitment to a transparent, pass-through business model. And, EpiphanyRx had an automated and comprehensive copay assistance program that augmented our service offerings.
Lastly, in 2022 we announced Navitus had joined CivicaScriptTM as a founding member. Our organizations are aligned in efforts to tackle medication affordability and the challenges health care consumers encounter due to a lack of competition in the market. With CivicaScript, we are engaging with like-minded organizations to further drug price transparency and access to affordable medications. When CivicaScript launched its first generic drug, abiraterone, in August 2022, Lumicera was one of two pharmacy distribution partners. By partnering across the drug delivery system and deploying our capabilities, we can have increasingly meaningful impact.
Q: What are the biggest challenges you see in the industry?
A: It will be no surprise to say that the cost of healthcare and long-term affordability looms large. Can people and organizations really afford it? What actions will need to be taken to do so? I continue to believe that the path forward includes fundamental improvement in payor understanding of where the money goes and what the outcome of that investment is. I would also note the challenge of the continued consolidation and concentration in the marketplace, from PBMs to GPS to retail pharmacy chains. This furthers competitive scale and contracting power.
Q: What is your vision for Navitus as the company embarks on its next 20 years? Any predictions to share?
A: I continue to be bullish in my expectations for our company. I believe many opportunities exist to enhance core capabilities and deliver additional value. I believe trends in the PBM industry will continue to be favorable to the business model operated by both Navitus and EpiphanyRx and that imperatives for specialty cost management will position Lumicera and Archimedes well. In addition, we are still early in our partnership with Costco. New opportunities for collaborating at scale are being explored and uncovered. Lastly, I feel our organization must take an expanded role toward clinical outcomes. We have the opportunity to improve payer visibility to cost and associated outcomes.
Q: What final thoughts would you like to share?
A: I'm honored to lead this organization and am incredibly proud of our people that activate our mission each and every day. Navitus is one of those rare companies that has charted a course and continues to challenge the status quo toward a vision of greater health for the communities in which we serve. Each day, we actively strive to enable people across the nation to access affordable prescription drug coverage. I'm excited for what is to come!
MORE ABOUT DAVID
David Fields is the President and CEO at Navitus Health Solutions. He provides enterprise leadership and strategic direction for Navitus, collaborating with the executive management team to maintain Navitus strategic plan and to develop and direct its goals, policies and execution. David has held leadership positions on a number of boards, including the American Heart Association, American Red Cross, Labor-Management Council and the National Conference of Christians and Jews. To learn more about David, view his bio on Navitus.com here.