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

Reviews pending
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Company Overview

Founded

1986

Employees

13,721

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

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

-

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

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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

Reviews pending
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Founded

2014

Employees

130

Funding Summary

Not Provided

Clients Your Size Clients Your Size

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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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Clients size is Locked

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

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

 ✓

Alternative drug sourcing
Show All Features

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
Company Overview
Alluma

Alluma

Reviews pending
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Founded

2019

Employees

222

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

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
Show All Features

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

0 RFI Questions Get access to vendor answered question RFIs.

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
Show All Features

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
Company Overview
Navitus Health Solutions

Navitus Health Solutions

Reviews pending
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Founded

2003

Employees

948

Funding Summary

None

Clients Your Size Clients Your Size

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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

Clients Your Size Clients Your Size

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
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
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
PharmPix Corp

PharmPix Corp

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Founded

2009

Employees

150

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

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

Clients Your Size Clients Your Size

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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
Prescryptive Health

Prescryptive Health

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Founded

2017

Employees

150

Funding Summary

26M Series A

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About Prescryptive Health

Founded in 2017 by Microsoft cloud veterans, Prescryptive Health is a healthcare technology company rewriting the script for the US pharmaceutical market. We believe that by empowering consumers to own their prescription, we can fundamentally change the prescription drug market.

Our mobile-first, blockchain-powered platform fosters fair pricing, patient access to medication, increased adherence, and patient engagement. Our goal: enable employers, health systems and health plans, pharma manufacturers, pharmacies, and consumers to connect and collaborate in a more equitable and transparent ecosystem.

Find out more at Prescryptive.com or on LinkedIn. #letsrewritethescript Show More
RxSense

RxSense

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Min. Group Size

1,000 eligible

Lives Serviced

4,500,000

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

✓

Manufacturer assistance fill-in

 ✓

Pass-Through, Admin Fee Only Contracts
✓

Rebate administration

 ✓

All Specialty Pharmacies Allowed
Show All Features

Not Provided.

Product Description

RxSense is not a PBM. However, we provide all the necessary tool to enable other PBMs. We currently partner with the following PBMs:

- Optum
- CVS/ Caremark
... Show More
Company Overview
UMR

UMR

4.2 (3)
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Founded

2008

Employees

3,800,000

Funding Summary

1 Corporate Round

Clients Your Size Clients Your Size

Clients size is Locked

About UMR

UMR recommends the most advanced products and technologies for integration into the customer’s solutions.

UMR is a third-party administrator (TPA), hired by your employer, to help ensure that your claims are paid correctly so that your health care costs can be kept to a minimum and you can focus on well-being.

UMR is not an insurance company. Your employer pays the portion of your health care costs not paid by you. Show More
Abarca Health

Abarca Health

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Founded

2005

Employees

0

Funding Summary

Not Provided

Clients Your Size Clients Your Size

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About Abarca Health

Abarca is igniting a revolution in healthcare. We are starting by redefining pharmacy benefits, but this is just the beginning. We built our company on the belief that with smarter technology and a straightforward approach to business, we can provide a better experience and greater value for payers and consumers.

For nearly a decade, we have challenged many industry conventions and trampled on a few. So call us a PBM for discussion purposes, but we are unlike any other company out there. And today, we manage over $2 billion in drug spending for millions of Americans, with... Show More
Aetna

Aetna

4.1 (1)
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Founded

1853

Employees

0

Funding Summary

Not Provided

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About Aetna

Here at Aetna, a CVS Health business, we are building a healthier world by making healthcare easy, affordable and all about you.

Founded in 1853 in Hartford, CT, Aetna is one of the nation's leading diversified health care benefits companies, serving an estimated 46.7 million people with information and resources to help them make better decisions about their healthcare.

As a health care leader, we believe that our corporate responsibility starts with helping people live healthier lives. And that means using our resources to make the communities and world we live in better... Show More
AmWINS Rx

AmWINS Rx

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Founded

2006

Employees

0

Funding Summary

Not Provided

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About AmWINS Rx

AmWINS Rx provides consultative pharmacy benefit management services that equip members with the information and advocacy needed to make informed decisions that ultimately improve member health and maximize plan savings. Show More
Anthem

Anthem

4.8 (1)
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Founded

November 30, 2004

Employees

10,700

Funding Summary

35.2M Series B

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About Anthem

At Anthem Blue Cross and Blue Shield we understand our health connects us to each other. What we all do impacts those around us. So Anthem is dedicated to delivering better care to our members, providing greater value to our customers and helping improve the health of our communities.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of... Show More
Archimedes

Archimedes

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Founded

2016

Employees

0

Funding Summary

Not Provided

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About Archimedes

Specialty drug spend is the single fastest growing healthcare expense. Recognizing the potential clinical value of these drugs, plan sponsors want to provide them to their enrollees—but to maintain an affordable, sustainable benefit in this rapidly changing environment, they must also control costs. To do this, plan sponsors need quantitative information about which strategies work to target drugs to those in need of them and they must minimize use of clinically ineffective therapies and reduce waste. However, the guidance and services provided to plan sponsors to achieve these goals is not always objective or complete.

Recognizing... Show More
ARMSRx

ARMSRx

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Founded

1991

Employees

0

Funding Summary

Not Provided

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About ARMSRx

ARMSRx – The people who know PBM (Pharmacy Benefit Management). ARMSRx Provides comprehensive guidance and leadership toward PBM solutions.

The ARMSRx team are experts in RFP Management, Claims Review, Contract Analysis, Audits, Modeling, Savings Analysis, and Increasing profitability for the most highly utilized benefit, pharmacy.

ARMSRx exposes the undisclosed methods of pricing, MAC lists, formulary and filters through ambiguous contract language. For Health Plans, TPA’s, Consultants and Employee Benefit Brokers.

ARMSRx serves as an extension of their staff and “Back Room” saving time and resources with devoted representation.... Show More
BCBS of Michigan

BCBS of Michigan

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Founded

Employees

0

Funding Summary

Not Provided

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About BCBS of Michigan

Blue Cross Blue Shield of Michigan is a nonprofit corporation and an independent licensee of the Blue Cross and Blue Shield Association.

BCBSM's commitment to Michigan is what differentiates it from other health insurance companies doing business in the state. That mission has never changed. Nearly 70 years ago, Blue Cross Blue Shield of Michigan started with a purpose to provide people with the security of knowing they have health care when they need it.

Today, that nonprofit mission is the same and the company is accomplishing it in many ways, including: Show More
Blue Shield of California

Blue Shield of California

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Founded

1939

Employees

0

Funding Summary

Not Provided

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About Blue Shield of California

Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable.

Blue Shield of California is a tax-paying, nonprofit, independent member of the Blue Shield Association with 4.7 million members, 7,800 employees, and $22.9 billion in annual revenue.

Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California.

Blue Shield of California complies with applicable state laws and federal... Show More
ClaimChoice Administrators

ClaimChoice Administrators

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Min. Group Size

-

Lives Serviced

100,000

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

 ✓

Alternative drug sourcing
Show All Features

Not Provided.

Product Description

Self-Funded Prescription Plans with our Pharmacy Benefit Management (PBM) partner ChoiceScripts allow employers the same flexibility they enjoy by self-funding their medical plan(s). to create plans that meet the specific needs of their... Show More
Company Overview
Florida Blue

Florida Blue

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Founded

Employees

0

Funding Summary

Not Provided

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About Florida Blue

Florida Blue is a subsidiary of a not-for-profit health solutions company dedicated to serving all Floridians in the pursuit of health.

Florida Blue is an independent licensee of the Blue Cross and Blue Shield Association, serving residents and businesses in the state of Florida.
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H-E-B, LP

H-E-B, LP

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Min. Group Size

-

Lives Serviced

135,438

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)

 ✓

Manufacturer assistance fill-in
✓

Alternative drug sourcing

 ✓

Pass-Through, Admin Fee Only Contracts
Show All Features

Not Provided.

Product Description

H-E-B RxTRA Advantage is a pharmacy benefit solution designed to deliver affordable prescriptions, flexible plan options, and measurable savings and all while maintaining the trusted, local care Texans expect from H-E-B. Built in... Show More
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Independence Blue Cross (IBX)

Independence Blue Cross (IBX)

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Founded

Employees

0

Funding Summary

Not Provided

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Kroger Prescription Plans

Kroger Prescription Plans

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Min. Group Size

50 eligible

Lives Serviced

400,000

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)

 ✓

Manufacturer assistance fill-in
✓

Alternative drug sourcing

 ✓

Pass-Through, Admin Fee Only Contracts
Show All Features

Not Provided.

Product Description

KPP was created by Kroger for their own employees. This drives us to provide cutting edge clinical programs with the purpose of cost savings, safety, and effective outcomes. We are able to use... Show More
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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
Meritain Health

Meritain Health

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Founded

1983

Employees

1,156

Funding Summary

Not Provided

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About Meritain Health

With 40 years of excellence as a third party health care benefits administrator and a proud subsidiary of Aetna® and Fortune 4 company CVS Health®, Meritain Health® delivers customized, cost-effective and convenient solutions. We’re ready to meet all of your self-funding challenges.

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National Script, LLC

National Script, LLC

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Founded

August/2014

Employees

8

Funding Summary

Not Provided

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About National Script, LLC

We are a PBM focused on reducing our client and their members' costs through transparent and honest plan governance. We provide plan flexibility and superior member service to deliver the plan management desired by the employer. Show More
Sav-Rx Prescription Services

Sav-Rx Prescription Services

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Founded

1966

Employees

350

Funding Summary

Not Provided

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About Sav-Rx Prescription Services

Sav-Rx Prescription Services, a wholly owned subsidiary of A&A Services, LLC, is the leading provider of lowest net cost Medication Benefit Management for employers and health plans nationwide. Sav-Rx serves millions of lives in all 50 states and Puerto Rico. After 50+ years in business, Sav-Rx remains 100% family-owned and operated, headquartered in Fremont, Nebraska, and anchored in the same community-based, patient-focused values we started with in 1966. Show More
Serve You Rx

Serve You Rx

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Founded

1987

Employees

0

Funding Summary

None

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About Serve You Rx

Serve You Rx is a full-service pharmacy benefit manager (PBM) with unquestionable flexibility and an unwavering commitment to doing what’s best for its clients. With a fervent focus on those it serves, including insurance brokers, consultants, third-party administrators, and their clients, Serve You Rx delivers exceptional service and tailored, cost-effective benefit solutions. Independent and privately held for over 36 years, Serve You Rx can implement new groups in 30 days or less and say “yes” to a wide variety of viable solutions. Known for its adaptability, quality, and client-centricity, Serve You Rx aims to be a benchmark for better client... 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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