PBMI Innovator Raechele (Rae) McMahan, MBA

Raechele (Rae) McMahan, senior vice president of payer solutions at Prescryptive Health Inc., says her path into the pharmacy industry began not in a boardroom but in a hospital room when she was diagnosed with Hodgkin lymphoma at age 17.

“Confronting real time and not having a prior authorization on file to be able to get a needle biopsy done when you already know that you have a cancer diagnosis is challenging for a 17-year-old,” McMahan said. The diagnosis, more than three decades ago, exposed her family to the same prior authorization and cost barriers many patients still face today, and it pushed her toward a career in health care.

McMahan’s son, Pierce, now 10, added a second, ongoing lesson in the system’s gaps. He was diagnosed with type 1 diabetes at age 4, and his care now spans seven prescriptions that cross both the pharmacy and medical benefit, along with devices such as insulin pumps. “That really pushes you to understand that there’s a lot more room that is needed, or a lot more growth that is needed, to allow a situation like that to be much easier,” McMahan said, adding that she was able to navigate the system because of her pharmacy background but recognizes many families cannot.

Those experiences inform her work at Prescryptive, a healthcare technology company with 150 to 200 employees that operates across the pharmacy ecosystem. The company builds pricing tools meant to give patients, health plan members and beneficiaries clear, upfront information on medication cost and access before they reach the pharmacy counter. Its clients include drug manufacturers, health systems, employers and other pharmacy benefit managers.

McMahan described her guiding principle as the idea that a structural problem cannot be solved with a tactical fix. She said recent federal PBM transparency requirements and FTC guidance have validated that approach, aligning regulatory expectations with tools Prescryptive had already built to make drug pricing and coverage clearer to patients.

In this video, McMahan discusses how her own experience navigating prior authorization and multi-benefit prescription coverage shapes Prescryptive Health’s approach to pharmacy price transparency.