PBM Companies

Pharmacy benefit management companies (PBM) or third-party administrators of a prescription drug program that manage prescription drug benefits on behalf of health insurers.
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Express Scripts

Express Scripts

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Company Overview

Founded

1986

Employees

13,721

Funding Summary

Not Provided

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About Express Scripts

We’re a health care opportunity company, tackling the problems others don’t, won’t or can’t. Where some see obstacles, we see possibilities. At Express Scripts, we dare to imagine a better health care system, and we’re driven to make it happen. We’re challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all. We are Champions For Better.

Express Scripts has a deep history as an industry innovator, every day striving for better. Standing with those we serve, we collaborate with our clients and partners to develop... Show More
OptumRx

OptumRx

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Min. Group Size

-

Lives Serviced

-

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Product Features

Not Provided.

Product Description

Optum Rx is a PBM. Show More
Company Overview
MedImpact Healthcare Systems, Inc.

MedImpact Healthcare Systems, Inc.

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Founded

1989

Employees

1,606

Funding Summary

1 Corporate Round

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About MedImpact Healthcare Systems, Inc.

For more than 30 years, MedImpact has been lowering cost, improving care, and delivering better solutions for our clients. Today, we are the largest independent pharmacy benefit solutions company, investing millions of dollars in clinical programs, technology, operations, and analytics to provide clarity, control, and confidence.
Clarity
MedImpact's comprehensive pharmacy benefit solution includes innovative clinical programs and cost analytics with clear information empowering clients and their members in making the best care and cost decisions.
Control
MedImpact provides our capabilities, services, solutions, and products under any service model our clients desire allowing clients control and flexibility... Show More
EmpiRx Health

EmpiRx Health

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Founded

2014

Employees

130

Funding Summary

Not Provided

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SmithRx

SmithRx

5.0 (1)
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Founded

2016

Employees

0

Funding Summary

20M Angel Round

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About SmithRx

SmithRx is committed to providing a straightforward approach to reducing drug costs and improving health outcomes. We understand that reducing pharmacy costs is top of mind for us all. We utilize cloud technologies to deliver the most streamlined and cost-effective PBM solution: one that is modularized and can be tailored to meet individual needs.
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Transcarent

Transcarent

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Founded

2020

Employees

409

Funding Summary

4.5M Series D

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About Transcarent

Founded in 2020, Transcarent is a private health and care experience company aimed at simplifying access to high-quality, affordable care. Our integrated mobile and web platform offers a range of services, including everyday care such as instant provider consultations, behavioral health support, pharmacy services, home care, and comprehensive care for complex needs like surgery or cancer treatment.

What sets Transcarent apart is our commitment to accountability and transparency. We offer at-risk pricing models in which we assume financial responsibility for outcomes, with transparent impact reports that demonstrate measurable improvements in experience, health outcomes, and cost reduction. This... Show More
Rightway

Rightway

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Min. Group Size

500 eligible

Lives Serviced

100,000

Average Cost

Average Cost is Locked

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Product Features

✓

Balance Bill Protections

 ✓

Patient Assistance Program (PAP)
✓

Manufacturer assistance fill-in

 ✓

Alternative drug sourcing
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Not Provided.

Product Description

Rightway’s reimagined full-stack PBM solution dismantles the traditional PBM model and fundamentally redesigns the member experience, reducing total pharmacy spend, guiding members to optimal medication regimens, and proactively engaging high-risk and specialty members.... Show More
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Alluma

Alluma

Reviews pending
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Founded

2019

Employees

222

Funding Summary

None

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About Alluma

Alluma is shifting the focus back to patient care by creating a new entity that is uniquely aligned to the needs of its clients and their members. With a Pharmacy Benefits Illuminator, we negotiate on the same side of the table as our clients, helping them uncover opportunities that optimize their benefits programs while supporting better health outcomes.

We are a provider-led, provider-focused alternative developed in partnership between Vizient and Mayo Clinic. As the nation’s only member-owned, member-driven performance improvement company, Vizient is uniquely positioned to approach the PBM market with a provider lens. Mayo Clinic is... Show More
Capital Rx

Capital Rx

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

26 Specific Questions Specific Questions

Lock

Product Features

✓

Balance Bill Protections

 ✓

Patient Assistance Program (PAP)
✓

Manufacturer assistance fill-in

 ✓

Pass-Through, Admin Fee Only Contracts
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Not Provided.

Product Description

In 2018, Capital Rx redefined the role of a pharmacy benefit manager (PBM) and what it means to be a transparent PBM, bringing a unique level of financial alignment to the industry. Offering... Show More
Company Overview
BeneCard PBF

BeneCard PBF

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

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RFI questions number is Locked

26 Specific Questions Specific Questions

Lock

Product Features

✓

All Specialty Pharmacies Allowed

 ✓

Multiple formulary options
✓

Flexible plan design options

 ✓

Utilization management
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Not Provided.

Product Description

For over forty years, BeneCard PBF has been at the forefront of helping a diverse range of clients, from large corporations to small businesses and labor unions, to optimize their prescription drug programs.... Show More
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Navitus Health Solutions

Navitus Health Solutions

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Founded

2003

Employees

948

Funding Summary

None

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About Navitus Health Solutions

Navitus Health Solutions LLC is a full service, URAC-accredited pharmacy benefit management company. As a zero-spread, full pass-through pharmacy benefit manager (PBM), Navitus aligns performance with plan sponsors’ benefit goals to deliver comprehensive clinical programs and costsaving strategies that lower drug trend and promote good member health. Navitus provides its flexible services to individuals and group plans, including state employees, retirees and their dependents, as well as employees or members of managed care organizations, self-funded employers, coalitions and labor organizations.

Reminder: Please do not post personal health information on this site.

Navitus is committed... Show More
Prime Therapeutics

Prime Therapeutics

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Founded

1987

Employees

0

Funding Summary

None

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Clients size is Locked

About Prime Therapeutics

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.

In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 27+ million members throughout the US.

In addition to core PBM services, we... Show More
Evernorth

Evernorth

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Founded

2020

Employees

71,000

Funding Summary

Not Provided

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About Evernorth

Evernorth brings together a powerful set of health services strengths to advance innovation now and for the future. Evernorth will drive value for you by leveraging our game-changing capabilities, our deep understanding of health conditions and disease states, and our connections across the health ecosystem to deliver solutions designed with your specific needs in mind. Our unique open architecture will connect multiple point solutions across your portfolio, improving our ability to better meet your needs while providing you choice and optionality. Show More
Nomi Health

Nomi Health

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

26 Specific Questions Specific Questions

Lock

Product Features

✓

Patient Assistance Program (PAP)

 ✓

Alternative drug sourcing
✓

Pass-Through, Admin Fee Only Contracts

 ✓

Rebate administration
Show All Features

Not Provided.

Product Description

Nomi Health's Direct Pharmacy Program delivers affordable generic medications by sourcing directly from manufacturers and cutting out pricing complexities. The program saves employers and employees up to 50% on generic medication expenses when... Show More
Company Overview
Imagine360

Imagine360

5.0 (1)
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Founded

1968

Employees

1,400

Funding Summary

Not Provided

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About Imagine360

Imagine360 has 50+ years of combined experience. In 2020, Group and Pension Administrators (GPA) joined forces with ELAP Services, EBMS, and Imagine Health, which became sibling corporations through WaterStreet Healthcare Partners. This integration allows our organization to deliver the most experienced and first completely integrated health plan with reference-based pricing as its core.

Imagine360 delivers a fully integrated health plan with the savings of reference-based pricing built in and consistently generates 15–25% savings for 900+ self-funded employers. Imagine360 is entering its next phase of growth with a fresh infusion of capital to expand its comprehensive suite... Show More
PharmPix Corp

PharmPix Corp

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Founded

2009

Employees

150

Funding Summary

Not Provided

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About PharmPix Corp

Pharmpix is a full service URAC Accredited Pharmacy Benefit Management Company (PBM) with an adaptable business model for distinct pharmacy delivery solutions. We provide services to health plans who manage Medicare, Medicaid and commercial business. Our system and coordinated (PBM) services are also built for large employers/unions and worker’s compensation lines of business. The company is privately held and was organized in 2009 as a corporation. Our headquarters are located in Guaynabo, Puerto Rico.

Our main differentiation among others PBMs are that we operate as a technology focused PBM, serving cost-conscious pharmacy benefit payers and/or administrators... Show More
Drexi

Drexi

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Founded

Employees

0

Funding Summary

Not Provided

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About Drexi

Drexi is an independent, non-traditional pharmacy benefits manager.

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Health Action Council - CVS

Health Action Council - CVS

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Founded

09/1983

Employees

0

Funding Summary

Not Provided

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About Health Action Council - CVS

We recognize that a company’s employees are its greatest asset as well as its greatest liability in terms of the company’s success in the marketplace. Healthy employees are more productive and therefore able to contribute more to the success of their company and to the health of their communities. Health Action Council is a member-driven, not-for-profit organization . Our focus is on improving the relationship between business and health through thought leadership, innovative services, and collaboration. Our core business activities are Group Purchasing, Education and Health Improvement. Show More
MakoRx

MakoRx

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Founded

2019

Employees

5

Funding Summary

Not Provided

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About MakoRx

MakoRx provides cost-plus pharmacy benefits to employers via our PBM services and subscription-based plans. We strive to make medications accessible to everyone and bring transparency to the pharmacy benefits space. We are avid patient advocates with a dedicated team of pharmacists on-hand to assist with member questions. We work with healthcare partners to help them complete the care cycle by including free or low-cost medications. We also partner with consultants and employers looking to diversify and enhance traditional health benefit options. Show More
Maxor National Pharmacy Services, LLC

Maxor National Pharmacy Services, LLC

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Founded

1926

Employees

0

Funding Summary

None

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About Maxor National Pharmacy Services, LLC

Maxor is a market-leading Pharmacy Benefit Manager that delivers service excellence with innovative capabilities in clinical management, analytics, and member engagement to help clients lower pharmacy costs while improving health outcomes. Maxor’s PBM platform is complemented by Maxor Pharmacy Management & Consulting Services, a provider of outpatient pharmacy management solutions, and Maxor Specialty, a clinically-driven specialty pharmacy focused on rare and orphan diseases. These capabilities allow Maxor to offer customized solutions to diverse market segments including hospitals and health centers, employers, labor groups, and public entities. Show More

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Frequently Asked Questions

What is a PBM?

A PBM, or pharmacy benefit manager, is a third-party administrator that manages prescription drug benefits for health insurers and employers. PBMs negotiate drug discounts, maintain formularies, and help control drug costs while ensuring medication safety for plan members.

What does a PBM do?

A PBM, or pharmacy benefit manager, negotiates drug discounts, maintains formularies, and helps control medication costs for health insurance plans and employers. They also ensure medication safety and provide services for efficient prescription processing.

How does a PBM work?

A PBM negotiates drug discounts, manages prescription drug programs and formularies, controls medication costs, ensures medication safety, and facilitates efficient prescription processing by intermediating between pharmaceutical companies, pharmacies, and health plan sponsors.

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