Pharmacy-based plan expands hormone coverage, menopause-trained Care Guides and analytics to deliver a clinically proven approach to pharmacy benefits
BETHESDA, Md., December 03, 2025–(BUSINESS WIRE)–LucyRx, an independent pharmacy benefit manager (PBM) known for simplifying access to prescription care, has introduced the LucyRx Women’s Health Benefit, launching January 1, 2026. The life-stage program is among the first from an independent PBM to combine an expanded menopause formulary, AI-powered analytics, and dedicated women’s health support in a single solution. It is designed to support women during perimenopause and menopause and to close gaps in medication coverage, education and proactive care.
“Women deserve ready access to education and pharmaceutical options to treat their symptoms and improve their long-term wellness, and employers feel the impact when that does not happen,” said Susan Thomas, RN, chief commercial officer at LucyRx. “Too often, formularies carve out the therapies women need most. Our goal is to remove those barriers and give employers a clear way to support women’s health.”
Why improving menopause care matters
Menopause is not just a clinical issue; it’s a workplace and cost issue that affects retention, productivity, and total health spend.
Women now account for nearly half of the U.S. civilian labor force, according to the U.S. Bureau of Labor Statistics, and in a Mayo Clinic study of nearly 5,000 women ages 45–60, 34 percent reported moderate to very severe menopause symptoms, yet only about one in four were receiving any treatment.
For employers, untreated symptoms can show up as missed work, lower productivity, and higher health costs. A Boston Consulting Group analysis estimates that menopause-related symptoms cost U.S. employers tens of billions of dollars each year in lost productivity and health care spending.
Expanded access and one-to-one support
The LucyRx Women’s Health Benefit offers a broader range of pharmaceutical options, including hormone replacement and related therapies often excluded from formularies. The benefit is designed to make prescription care easier to navigate and to support symptom management, hormonal imbalance, and related conditions. It gives employers a more comprehensive way to offer a benefit that supports women’s health with clinical oversight and affordability.
The benefit also provides one-to-one support from LucyRx Care Guides, consisting of nurses, pharmacists and certified pharmacy technicians who help members understand complex therapies, navigate affordability programs including manufacturer assistance and alternative payer options, and stay on track with the steps that drive better outcomes. Care Guides receive additional training in perimenopause and menopause care and conduct outreach to prescribers to highlight evidence-based options available on the formulary.
LucyIQ analytics track measurable outcomes
LucyIQ, LucyRx’s AI-powered analytics platform, turns claims data into clear, actionable insights so employers can design smarter benefits, protect their people, and control spend. For the Women’s Health Benefit, LucyIQ helps identify midlife women who may be at higher risk for cardiovascular and metabolic complications related to menopause by analyzing diagnosis codes, medication patterns, and, where available, biometric and clinical data such as weight, cholesterol, blood pressure and glucose.
Care Guides use these insights to provide private, tailored outreach, including medication reviews, affordability options, prescriber coordination, nutrition resources, and adherence programs. For employers, LucyIQ tracks utilization and adherence trends to curb waste, manage high-cost drugs, and support appropriate use. It links benefit design decisions to outcomes and total spend and shows how the Women’s Health Benefit is affecting adherence, symptom-related indicators, and cost trends over time. In a similar LucyRx wellness-focused program, LucyIQ tracked an estimated $3.2 million in multi-year savings for an employer health plan as a result of the integrated formulary and patient support model.
“Our clients have been asking for a simpler way to support women’s health that actually fits into their existing plan,” said David Blair, chief executive officer at LucyRx. “This benefit lets them expand evidence-based coverage, support midlife women, and see the impact on cost and outcomes in one place.”
LucyRx’s own employees will be the first to receive the new coverage and resources, reflecting the company’s commitment to treating client and member funds with the same care as its own and modeling what equitable, whole-life prescription care can look like in practice.
Next steps for employers
Employers and their consultant partners interested in offering the LucyRx Women’s Health Benefit as an integrated, pharmacy-based alternative to stand-alone menopause point solutions can work with their LucyRx representative to review formulary options, Care Guide support, and reporting. Additional information and an FAQ are available at LucyRx.com.
About LucyRx
LucyRx is a fast-scaling, independent, next-generation pharmacy benefit manager (PBM) redefining prescription care. Fueled by innovation and decades of leadership experience, LucyRx delivers better outcomes through its Connected Specialty Care Network, Formulary Marketplace, and next-day home delivery solutions. Powered by its proprietary AI platform, LucyIQ™, the company provides real-time insights that support evidence-based clinical decisions, clear pricing, and exceptional service from U.S.-based certified pharmacy technicians. Partnering with more than 60,000 pharmacies, LucyRx serves more than 3,000 clients nationwide.
This is prescription care, brilliantly reimagined.
