The American healthcare system spends hundreds of billions of dollars annually on prescription drugs, yet few parties attempt to answer the foundational question of whether a drug will work for a given person. Drug selection is often driven by manufacturer rebates rather than clinical evidence — and this misalignment between financial incentives and patient outcomes results in suboptimal treatment selections, avoidable adverse events, and paradoxically higher total costs of care. This whitepaper explores how replacing formulary-driven decision making with data-driven clinical review improves outcomes for members, including how patients end up on the wrong drug in traditional models, what personalized clinical review looks like in practice, and real-world case studies on improved outcomes for members who underwent personalized clinical review.