Navitus Helps Industry Prepare for Biggest Pharmacy Standard Change in Decades

New requirements will modernize all pharmacy transaction data

MADISON, Wis.--(BUSINESS WIRE)--As the pharmacy industry launches its most significant technology transition in decades, Navitus is helping clients and partners move to the new federal standard for claims and other information vital for all prescription transactions.

The switch to the National Council for Prescription Drug Programs’ new F6 standard affects every organization involved in real-time prescription transactions, including pharmacy benefit managers (PBMs) such as Navitus, pharmacies, health plans and technology vendors.

More than a routine upgrade, F6 introduces extensive changes to the data and functionality that support prescription operations. The new standard is designed to improve accuracy, flexibility and data exchanges of pharmacy transactions, while providing for evolving industry needs. Those needs include prior authorization, coordination of benefits, eligibility verification, specialty pharmacy and emerging care models, enabling health care organizations to better support timely, coordinated and affordable patient care.

With the transition set to begin August 14, 2027, and full industry compliance required by April 14, 2028, organizations across health care are upgrading their technology, operations and business systems and processes to meet the new standard.

"F6 is one of the most consequential changes in pharmacy transaction standards," said Darryl Munden, Chief Operating Officer at Navitus. "Beyond the technical conversion, organizations must understand how the new standard affects workflows, vendor integrations, testing strategies and stakeholder communications. Successful implementation will require coordination across health care."

Navitus has launched an enterprise-wide program involving experts in technology, operations, compliance, client services and industry standards. The company's industry standards team, for example, is engaged with industry organizations, discussing regulatory guidance and implementation with key stakeholders to help them understand what the new standard will mean.

The F6 transition will require extensive coordination among health plans, PBMs, pharmacies, vendors and technology partners to ensure service continuity during implementation. Key areas of focus include transaction testing, data exchange requirements, system interoperability and operational readiness.

"As organizations move from planning to execution, the industry will need practical guidance and collaboration," Munden said. "Our goal is not only to ensure readiness at Navitus but also to help clients and partners understand what changes are coming industry-wide and how they can prepare."

Navitus will continue providing updates, educational resources and implementation guidance to clients, partners and other stakeholders as the industry moves toward adoption of F6. Additional information is available at NCPDP.org.

Navitus experts involved in F6 work are also available for media interviews about this project and their experience with it.

About Navitus:
Navitus remains the nation’s first transparent, pass-through pharmacy benefit manager (PBM), serving more than 13 million lives nationwide. It uniquely brings clarity to drug pricing and removes costs from the drug supply chain. Unlike traditional PBMs that generate profit by retaining an undisclosed portion of rebates and discounts negotiated with drug manufacturers and pharmacies, Navitus passes along the complete savings to clients, enabling them to make medication more affordable for their members. The Navitus PBM was established 23 years ago by Navitus Health Solutions, LLC, a pioneering pharmacy solutions company. The organization delivers a range of services through portfolio brands including Navitus, Lumicera, Archimedes and Clarventa. Owned by SSM Health and Costco, Navitus Health Solutions serves nearly 20 million lives across 800 clients including employers, unions, government plans, payers and health systems.