America's healthcare system has been claiming to put patients first for decades. Miriam Paramore, founder and CEO of RX Utility, has spent 42 years in health IT watching that claim go unmet — and she built her company to fix the part where patients get hurt most: what they pay out of pocket at the pharmacy.

The math is stark. Employers pay the negotiated net price on medications after rebates. Consumers with high-deductible health plans pay the full list price. Eliquis: $600 at the counter for a consumer with a $10,000 deductible. The employer's net price after rebates: $300. 

That cost-shifting has happened quietly for years while payers have kicked the can on price transparency requirements they were legally required to meet in 2022.

RX Utility's answer is two APIs: one covering 100% of pharma copay coupons (about $30 billion in annual consumer savings that only 10% of eligible patients ever access), and one with real-time cash prices for every drug at every pharmacy in the country. Not another consumer app, a utility layer that flows through EHRs, pharmacy tools, and telehealth platforms so prices show up wherever patients and clinicians already are. 

Key Moments:

• [00:01:36] The mission in one line: "We help people save money on medicine."
• [00:05:44] $30 billion in pharma copay coupons go unclaimed every year — 90% of patients never access savings they're entitled to.
• [00:07:12] Real-time cash prices for every drug at every pharmacy, updated throughout the day — now in an API.
• [00:08:50] The deductible math: $25K family premium plus $10K deductible has broken the insurance model.
• [00:12:13] Price transparency as the healthcare Glow Up of 2026 — and why payers have been ignoring a 2022 mandate.

Recorded live from the Vive 2026 event. 

Miriam's frame is blunt: if people can't afford the drugs they need, outcomes will be worse. That's not a policy argument. It's arithmetic.

Watch the full conversation on YouTube → https://youtu.be/6UNGeWm9KvU

About Miriam Paramore

Miriam Paramore is Founder and CEO of RxUtility, a real-time medication affordability toolkit. RxUtility is the only company to connect providers, pharmacists, employers, payers and digital health partners with access to all medication prices through its AI-powered platform. 

By embedding prescription affordability and transparency in these tech workflows, RxUtility reduces patient payment confusion, drives medication adherence and ensures equitable access to prescription drugs. 

She has been influencing the direction of the healthcare technology industry for more than 35 years. Her contributions have had significant impact on the major healthcare business sectors – providers, payers, pharmacy, life sciences and, most importantly, patients. It has been Miriam’s life’s work to improve the U.S. healthcare system through the power of information. 

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