DecisionRx
DecisionRx is a value-based healthcare services company whose Medication Therapy Optimization platform combines pharmacogenomics testing, proprietary risk stratification, and clinical pharmacist reviews to reduce medication failure for Medicare Advantage plans, ACOs, self-insured employers, and self-pay consumers.
- Company typePrivate
- Founded2022
- HeadquartersDover, United States
- Headcount11–50
- GTM typeB2B
- OfferingSoftware
What DecisionRx does
DecisionRx, Inc. is a value-based healthcare services company founded in 2022 and headquartered in Dover, Delaware with primary operations in Indianapolis. The company operates a Medication Therapy Optimization (MTO) platform that combines pharmacogenomics (PGx) testing, clinical pharmacist expertise, and proprietary medication risk stratification to help prescribers select and dose medications more effectively. The platform assigns medication failure risk scores using drug interactions, contraindications, side effects, adverse events, FDA warnings, and pharmacogenomic data, then routes high-risk patients to specialized clinical pharmacists for comprehensive medication review. Outputs include a personalized Medication Action Proposal and a pharmacogenomics report covering over 200 prescription drugs, delivered to prescribers for incorporation into existing clinical workflows.
The company serves Medicare Advantage Plans, Accountable Care Organizations, self-insured employers, pharmacy benefit facilitators, and individual self-pay consumers. Under its value-based care model, DecisionRx bears the full cost of lab testing and pharmacist reviews, aligning its revenue to demonstrated healthcare cost savings of approximately $3,600 per Medicare patient per year and $1,200 for patients under 65, and achieving reported 8-12% total cost savings, 6.8% reduction in ER visits, and 14.9% reduction in inpatient days. Distribution combines enterprise field sales (led by Chief Growth Officer Michael Tilton, former Humana SVP) with channel partnerships across AmeriLife, Imperium Health, MotivHealth, Beanstalk Benefits, and BeneCard PBF, plus a $495 direct-to-consumer PGx kit.
DecisionRx is privately held, with a $100 million credit facility from The Carlyle Group (January 2024) that includes an option for Carlyle to acquire 25% of equity. The credit facility is sized to fund MTO for over 100,000 patients. The company operates with 11-50 employees, has been recognized as a 2024 Fierce Healthcare Innovation Awards finalist, and has assembled a clinical advisory board including former U.S. Secretary of Veterans Affairs David Shulkin, MD, and Beth Israel Lahey Health EVP/CCO Rob Fields, MD.
DecisionRx firmographics
Firmographics- Name
- DecisionRx
- Legal name
- DecisionRx, Inc.
- Website
- https://decisionrx.com
- Company type
- Private
- Founded year
- 2022
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- DecisionRx is a value-based healthcare services company whose Medication Therapy Optimization platform combines pharmacogenomics testing, proprietary risk stratification, and clinical pharmacist reviews to reduce medication failure for Medicare Advantage plans, ACOs, self-insured employers, and self-pay consumers.
- Ownership category
- akta.pro rank
DecisionRx industry classification
Industry- Product category
- Medication Therapy Optimization / Healthcare Technology
- NAICS
- Medical and Diagnostic Laboratories (62151)
- SIC
- Services-Medical Laboratories (8071)
- akta.pro primary industry
- Pharmacogenomics (PGx) Decision Support (HLAAANAB)
- akta.pro secondary industries
- Medication Analytics, Outcomes & Cost Optimization (HLACAKAL), Medication Therapy Management (MTM) & Clinical Pharmacy Services Tools (HLACAKAH), Medication Adherence & Therapy Management Platforms (refills, reminders, MTM) (HLALAIAG)
Keywords
Where DecisionRx is headquartered
LocationHeadquarters
- HQ city
- Dover
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
DecisionRx business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Supply Chain
Revenue model
- Value-Based Care Contracts with Payers: DecisionRx generates revenue through value-based care contracts with Medicare Advantage Plans, Accountable Care Organizations (ACOs), and self-insured employers. The company bears the full cost of delivering Medication Therapy Optimization services and generates savings from reduced medication failures, hospitalizations, and emergency department visits. Clinical pharmacists make personalized medication recommendations to prescribers, with financial outcomes tied to measurable improvements in health and cost reduction.
- Direct-to-Consumer PGx Testing: Individual consumers can purchase pharmacogenomics testing kits directly at $495 per kit, with HSA/FSA acceptance. Includes Medication Action Proposal, Comprehensive PGx Report covering 200+ prescription drugs, and free pharmacist consultation for up to 1 year.
- Partnership with Pharmacy Benefit Facilitators: Partnership with BeneCard PBF to deliver personalized, data-driven medication insights to clients and members nationwide. Offers value-based and risk-share options for plan sponsors, with financial incentives tied to measurable improvements in health outcomes and cost savings.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| One time/ perpetual license | Pay-as-you-go | Self-pay consumer PGx testing kit |
| Outcome Based/ Performance | Multi-year contract | Health plan / payer sponsored MTO |
Go-to-market motion3 records
Distribution channels6 records
Marketing channels5 records
DecisionRx product offering
Product offeringCore offering
DecisionRx sells a Medication Therapy Optimization (MTO) platform that combines pharmacogenomics testing, clinical history and medical claims analysis, and comprehensive medication reviews by specialized clinical pharmacists to help prescribers select the right medications for each individual patient. Under a value-based care model, DecisionRx bears the full cost of MTO implementation and recoups revenue from healthcare cost savings shared with Medicare Advantage Plans, Accountable Care Organizations, and self-insured employers. The company also sells a direct-to-consumer PGx testing kit at $495 with a Medication Action Proposal and pharmacist consultation.
Product overview
DecisionRx offers a unified Medication Therapy Optimization (MTO) platform supplemented by a direct-to-consumer DecisionRx Kit product. The core MTO platform leverages proprietary medication risk stratification, pharmacogenomics testing, clinical history analysis, and comprehensive medication reviews by specialized pharmacists to optimize prescribing decisions. The companion DecisionRx Kit ($495) provides individual consumers with PGx testing, a Medication Action Proposal, and a pharmacogenomics report covering over 200 prescription drugs, with free pharmacist consultation. Both products work in concert to deliver personalized medication optimization informed by genetics and clinical data science.
Differentiator
Problem solved
Functional benefit
Products and services
- Medication Therapy Optimization (MTO) Platform
- DecisionRx Kit (Direct-to-Consumer PGx Testing) A consumer-facing pharmacogenomics (PGx) testing kit priced at $495 (HSA/FSA accepted) that includes a cheek-swab test, a personalized Medication Action Proposal, a comprehensive PGx report covering over 200 prescription drugs, and free pharmacist consultation for up to 1 year. Available directly to individual consumers at decisionrx.com/purchase.
Quantifiable outcome
- Reduces total annualized healthcare costs by over $3,600 per Medicare patient per year
- +6 more outcomes
Companies that use DecisionRx
Customer profileNamed customers5 records
Segments5 records
Ideal customer profiles5 records
DecisionRx technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability4 records
Feature5 records
DecisionRx partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered core, strategic and major.
- BeneCard PBFcoreDecisionRx partnered with BeneCard PBF, the original Pharmacy Benefit Facilitator, to bring personalized medication insights to BeneCard PBF's clients and members nationwide. The partnership combines DecisionRx's pharmacogenomics and analytics platform with BeneCard's transparent, outcomes-focused PBF model. Both organizations will offer value-based and risk-share options for plan sponsors including union health funds and self-insured employers.
- MedeAnalyticsstrategicDecisionRx partnered with MedeAnalytics to power value-based medication optimization. MedeAnalytics' Health Fabric platform expands DecisionRx's ability to quantify and communicate clinical and economic impact under value-based care contracts. The partnership enables ROI quantification, cost savings tracking, performance measurement on quality metrics, and seamless integration with payer and provider stakeholders.
- Beanstalk BenefitsmajorPhiladelphia-based Beanstalk Benefits partnered with DecisionRx to offer MTO to their benefit platform members. Beanstalk offers 40+ services allowing employers of any size to access benefit resources under a single contract. The partnership targets employers with under 5,000 employees and freelance/independent contractors.
- MotivHealthmajorMotivHealth, a Utah-based health insurer focused on HSA-based plans, partnered with DecisionRx to offer the MTO program to select members. MotivHealth is revolutionizing health insurance by focusing on HSA-based plans that produce lower premiums and improved wellness. Both companies share a goal of improving wellness and eliminating wasted healthcare expense.
- AmeriLife GroupcoreDecisionRx partnered with AmeriLife to provide Medicare Advantage and Medicare Supplement patients access to its MTO platform. AmeriLife's extensive health distribution platform and commitment to quality, technology-driven healthcare solutions enables expansion of DecisionRx's MTO impact. The collaboration integrates comprehensive medication review into AmeriLife's Medicare products.
- Imperium HealthcoreImperium Health, a pioneer in creating and managing ACOs and value-based care programs, partnered with DecisionRx to deliver MTO to Medicare beneficiaries in its ACOs. A successful pilot demonstrated 78% of patients received clinically actionable medication guidance. Imperium Health organizes and manages partnerships with providers and ACOs supporting clinical and financial performance improvement.
Scale indicators12 records
Recent moves6 records
Expansion highlights6 records
DecisionRx competitors and assessment
Company assessmentDirect peers
- Myriad Genetics (GeneSight): Myriad Genetics offers GeneSight, a pharmacogenomic test that informs prescribing decisions for mental health medications. It is one of the most established PGx decision-support products and competes most directly with DecisionRx's pharmacogenomics-driven Medication Action Proposal.
- Genomind: Genomind provides a pharmacogenomic testing and clinical decision support platform focused on mental health prescribing, with similar clinical pharmacist consultation components. Its specialty-PGx model overlaps closely with DecisionRx's MTO offering for poly-pharmacy patients.
- Tabula Rasa HealthCare (CarelonRx): Tabula Rasa (now part of CarelonRx) delivers medication therapy management, risk stratification, and pharmacist-led medication safety services to health plans and PACE programs. Its MTM and pharmacogenomics-informed medication optimization directly parallel DecisionRx's MTO value-based contracts.
- Coriell Life Sciences: Coriell Life Sciences offers pharmacogenomic testing and a clinical decision support tool (GeneDose) used by providers to personalize medication selection. It targets similar provider and payer populations as DecisionRx's PGx-enabled MTO platform.
- YouScript (Translational Software): YouScript delivers pharmacogenomics decision support integrated into EHR workflows for prescribers. It competes with DecisionRx's prescriber-facing PGx and clinical pharmacist workflow at the point of prescribing.
- RxAnte: RxAnte provides analytics and intervention services that improve medication adherence and appropriate utilization for health plans, with a similar value-based alignment to payers as DecisionRx's MTO. Both operate within the medication optimization and outcomes space for at-risk populations.
Others
- hc1 Insights: hc1 Insights is a precision health analytics platform founded by DecisionRx's Executive Chairman Brad Bostic. While not a direct competitor, it is closely related through shared leadership and overlapping analytics capabilities for healthcare organizations.
- BeneCard PBF: BeneCard PBF is a pharmacy benefit facilitator and partner that distributes DecisionRx's MTO program to its self-insured employer and union health fund clients. It is an ecosystem partner rather than a direct competitor, but operates adjacent medication management services.
Broad incumbents
- MedImpact Healthcare Systems: MedImpact is a large independent pharmacy benefit manager with medication therapy management and clinical programs for health plan clients. It is a broader incumbent offering medication optimization as part of a full PBM portfolio, in contrast to DecisionRx's focused MTO offering delivered through partners like BeneCard PBF.
- Quest Diagnostics: Quest Diagnostics is a major clinical laboratory that offers pharmacogenomic testing services and broader medication-related diagnostics. DecisionRx's Clinical Advisor Steven Goldberg, MD is Quest's Chief Health Officer. As a broad incumbent, Quest overlaps in lab infrastructure but not in DecisionRx's clinical pharmacist-led, value-based delivery model.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
DecisionRx social profiles
Digital presenceDecisionRx financial estimates
Financial estimateRevenue estimate
Valuation estimate
DecisionRx leadership team
Management profileNumber of profiles
Profiles11 records
DecisionRx funding detail
Funding detailFunding overview
Funding rounds2 records
Investors1 record
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
DecisionRx M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about DecisionRx
What does DecisionRx do?
DecisionRx sells a Medication Therapy Optimization (MTO) platform that combines pharmacogenomics testing, clinical history and medical claims analysis, and comprehensive medication reviews by specialized clinical pharmacists to help prescribers select the right medications for each individual patient. Under a value-based care model, DecisionRx bears the full cost of MTO implementation and recoups revenue from healthcare cost savings shared with Medicare Advantage Plans, Accountable Care Organizations, and self-insured employers. The company also sells a direct-to-consumer PGx testing kit at $495 with a Medication Action Proposal and pharmacist consultation.
Is DecisionRx a public or private company?
DecisionRx is a private company. It is classified as venture growth investor backed and is currently operating.
When was DecisionRx founded?
DecisionRx was founded in 2022. It employs 11 to 50 people.
Where is DecisionRx based?
DecisionRx is headquartered in Dover, United States, in the North America region.
How does DecisionRx make money?
Three revenue lines are on record. Value-Based Care Contracts with Payers are the primary driver. The others are direct-to-Consumer PGx Testing and partnership with Pharmacy Benefit Facilitators.
Who are DecisionRx's main competitors?
Direct peers on record are Myriad Genetics (GeneSight), Genomind, Tabula Rasa HealthCare (CarelonRx), Coriell Life Sciences, YouScript (Translational Software) and RxAnte. Others are hc1 Insights and BeneCard PBF. Broad incumbents are MedImpact Healthcare Systems and Quest Diagnostics.
Does DecisionRx have an API?
No public API is recorded for DecisionRx.
What industry is DecisionRx in?
DecisionRx's product category is Medication Therapy Optimization / Healthcare Technology. Its primary akta.pro industry code is HLAAANAB, Pharmacogenomics (PGx) Decision Support, with a secondary code of HLACAKAL, Medication Analytics, Outcomes & Cost Optimization. Its NAICS code is 62151 and its SIC code is 8071.