Revolutionizing the Prescription Cost Management Process: The Story of ExpionIQ Advisor

Expion, a small IT consulting firm with just six underwriters on staff, was limited in its ability to attract new business due to its limited capacity to respond to prescription cost management RFPs. In August 2023, the company’s IT team, along with support from executive leadership, embarked on an internal project to automate the intricate underwriting process for prescription cost management.

After six months of development, ExpionIQ Advisor was created by two AI developers at the company. This tool uses linear regression, multiple algorithms, and custom AI models to automate prescription RFPs. The IT team plans to enhance the application further by incorporating the XGBoost machine learning software library to forecast medication use in covered populations.

ExpionIQ Advisor has significantly reduced the time required to calculate the necessary figures for an RFP, from days to just a few hours, according to Kumar. The tool also enables employees to verify its accuracy, ensuring that any potential errors can be rectified swiftly.

Kumar states, “Now I know exactly what math we are using and what risks we are taking. Even if the model predicts something incorrectly, we are equipped with the knowledge to address the issue.” Previously, mistakes could be easily made, but now automatic alerts notify the team if the model deviates from the expected results.

A web-based .NET application serves as the front end of ExpionIQ Advisor, allowing underwriters and other users to access the system and review the data. Kumar explains, “The .NET application streamlines