EVERSANA’s Intelligent Copay Solution Recognized with PM360 Innovation Award

EVERSANA is proud to announce that our Intelligent Copay Solution has been recognized as a winner in the Core Business Processes category of the PM360 Innovation Awards. The award recognizes innovations that are helping transform how the life sciences industry operates and serves patients.

Modernizing Copay Assistance for Today’s Market Access Environment 

Copay programs play a critical role in helping patients afford and access their therapies. However, evolving market access dynamics, increasing operational complexity and growing fraud risks are exposing the limitations of traditional approaches.

EVERSANA’s Intelligent Copay Solution was designed to address these challenges through a technology-enabled platform that helps manufacturers optimize gross-to-net performance while maintaining uninterrupted patient access to savings and support. The solution combines a dynamic marketplace of pharmacy benefit adjudicators, built-in redundancy, advanced fraud mitigation capabilities and enhanced data transparency to help clients make more informed decisions and improve program performance.

How EVERSANA’s Intelligent Copay Solution Works

Built on EVERSANA’s patient services infrastructure supporting more than 80 active copay programs, processing 12 million claims annually and serving 1.5 million patients, the Intelligent Copay Solution brings together machine learning, intelligent automation and operational resilience to modernize how copay assistance programs are managed.

Dynamic Marketplace Model

Claims are routed through a network of eight pharmacy benefit adjudicators, automatically selecting the adjudicator offering the lowest reimbursement rate for each claim. This helps manufacturers identify cost-saving opportunities while maintaining a seamless patient experience.

Advanced Fraud Detection and Prevention

Using machine learning and automated business rules, the platform identifies anomalous behavior before claims are processed, helping reduce fraud, waste and abuse before financial leakage occurs.

Reliable Access Through Built-In Redundancy

With more than 69,000 contracted pharmacies and multiple adjudication partners, the solution helps eliminate single points of failure and supports uninterrupted patient access.

The impact is already being seen in practice. For one biopharma client, the platform’s fraud detection capabilities blocked 44 fraudulent pharmacies and 21 discount BINs before claims were processed, helping reduce significant gross-to-net misspend.

We’re honored that PM360 recognized the Intelligent Copay Solution as an innovation helping shape the future of patient affordability and access.

Learn more about the Intelligent Copay Solution