Pharmacy Benefit Managers

A pharmacy benefit provider is a third-party administrator of prescription drug programs that offers services of prescription drug benefit management for employees.
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Product Info
Company Overview

Founded

2017

Employees

500

Funding Summary

130M Corporate Round

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About Rightway

Rightway’s human-led clinical care navigation solution guides over one million members to the highest-quality care by inserting clinicians into the member care journey. Powerful technology enables personalized and proactive clinical support at a fraction of the cost of other solutions and is proven to lower healthcare costs by 15%.

Rightway works with benefits leaders to identify top healthcare-related objectives for their population and helps them control how their members use healthcare. Our live guides deliver care decision support, benefits education, steerage to high-quality providers, and billing advocacy. By providing complete healthcare support for members, Rightway helps benefits...
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Product Info
Company Overview

Founded

1991

Employees

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....
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Product Info
Company Overview

Founded

1987

Employees

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
Product Info
Company Overview

Founded

1990

Employees

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

About WellDyne

WellDyneRx is a full-service, independent Pharmacy Benefit Manager (PBM) that makes the little things matter for our clients, employees, partners, and members.

Because we are an independent PBM—meaning we are not owned by a pharmacy, drug company, or health insurance provider—we are able to negotiate freely on your behalf to keep costs low and quality of care high for our clients and members.

As early pioneers in clinical pharmacy, WellDyneRx has a history of caring for patients differently and always from a pharmacological perspective. We don’t just fill prescriptions. We constantly manage and optimize...
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Product Info
Company Overview

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...
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Product Info
Company Overview

Founded

2000

Employees

Funding Summary

Not Provided

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About Appro-Rx

Appro-Rx is a growing Health Information Technology (HIT) company dedicated to payer medical cost reduction and improvement in patient health outcomes via their provider network. Through the use of Pharmacy Benefit Management (PBM) technologies, Appro-Rx provides customers with prescription drug claims processing, prescription benefit management tools and other IT needs.

The principals of Appro-Rx believe strongly that the PBM model is broken, and we have set out to be industry game changers. We are targeting current practices – spread pricing on prescription drugs, manufacturers’ rebates and mandatory mail order programs that benefit PBMs instead of employers and...
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Product Info
Company Overview

Founded

1989

Employees

525

Funding Summary

Not Provided

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Clients size is Locked

About BeneCard PBF

BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our transparent business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace.

Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care.

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Product Info
Company Overview

Founded

2016

Employees

20

Funding Summary

750K Seed Round

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Clients size is Locked

About Best Money Moves LLC

Best Money Moves is a mobile-first financial wellness program that combines technology, information, tools and live money coaching to help employees measure their level of financial stress in 15 categories, and then sends relevant information and tools to help them reduce that stress. An ongoing engagement strategy keeps usage well above EAP rates.

Employees use the program’s point-based rewards system, which assigns point values to every action possible: setting up income and expenses inside the budget tool, reading articles, measuring stress, etc. All of these items, plus the leaderboard, are seen on the Employee Dashboard.
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Product Info
Company Overview

Founded

2019

Employees

5

Funding Summary

Not Provided

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Clients size is Locked

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
Product Info
Company Overview

Founded

May 2019

Employees

Funding Summary

110M Series A

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Clients size is Locked

About Nomi Health

From patient care to provider payments, we're rebuilding no-nonsense healthcare that is truly direct and affordable by changing how healthcare is delivered, purchased, and paid for. Show More
Product Info
Company Overview

Founded

2017

Employees

150

Funding Summary

26M Series A

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Clients size is Locked

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
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Product Info
Company Overview

Founded

2005

Employees

Funding Summary

Not Provided

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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...
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Product Info
Company Overview

Founded

2018

Employees

29

Funding Summary

Not Provided

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About ClaimChoice Administrators

ClaimChoice Administrators is one of the largest independent administrators of self-funded union, traditional and association health plans in the country bringing more than 30 years of staff experience in delivering integrated, customized benefit solutions, that blend flexibility and customization, unlike anyone else in the marketplace. Show More
Product Info
Company Overview

Founded

1986

Employees

13,721

Funding Summary

Not Provided

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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...
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Product Info
Company Overview

Founded

1993

Employees

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

About Kroger Prescription Plans

Kroger Prescription Plans is dedicated to providing pharmacy benefit management services and innovative clinical programs that focus on engagement, choice, and cost savings. Built on personalized care solutions that simplify health, wellness and nutrition, Kroger Prescription Plans is the catalyst to combining a full suite of Kroger Health entities to improve health and deliver savings. The company provides pharmacy benefit management services to a wide range of employers across the United States, including The Kroger Co., the 4th-largest employer in the United States.
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Product Info
Company Overview

Founded

2021

Employees

Funding Summary

Not Provided

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Clients size is Locked

About ManifestRx

ManifestRx strives to provide price transparency and a frictionless pharmacy experience. ManifestRx is removing the barriers, frustration, and confusion associated with third-party contracting and delivering a convenient, simple solution. The family of companies delivers integrated pharmaceutical delivery with Manifest Pharmacy and enterprise pharmacy benefit solutions through ManifestRx.

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Product Info
Company Overview

Founded

1999

Employees

80

Funding Summary

Not Provided

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Clients size is Locked

About MedOne Pharmacy Benefit Solutions

MedOne is your key to the pharmacy benefit marketplace. We unlock the most appropriate prescription at the most affordable price for organizations and their health plan members nationwide. The MedOne 100% pass-through model delivers real prescription savings by cutting out the traditional "PBM" middlemen and facilitating direct relationships between health plans and high-performing pharmacies. Once we establish a transparent and aligned marketplace, we partner with organizations to optimize "where" and "what" members fill to reduce pharmacy costs and improve health outcomes.
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Product Info
Company Overview

Founded

August/2014

Employees

8

Funding Summary

Not Provided

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Clients size is Locked

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
Product Info
Company Overview

Founded

2003

Employees

948

Funding Summary

None

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Clients size is Locked

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...
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Product Info
Company Overview

Founded

1989

Employees

243

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

About OptumRx

Since our inception in 1989, we have worked closely with our customers to provide high-quality pharmacy care services designed to promote optimized care. We manage over two billion pharmacy claims annually and serve more than 62 million members across a broad spectrum of customers, including public and government entities, health plans, Medicare and Medicaid plan sponsors, employer groups, collective bargaining groups and third-party administrators. We are more than a pharmacy benefit manager—we are a pharmacy care services company focused on driving transformative change and delivering quality holistic care. Show More

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Frequently Asked Questions

What Is Pharmacy Benefit Management?

Pharmacy benefit management (PBM) is a service that coordinates and administers prescription drug benefits on behalf of health insurers, employers, pharmacies, and other payers. PBM providers act as intermediaries, negotiating lower drug costs, processing claims, and administering pharmacy networks to ensure cost-effective and efficient medication delivery.

What Is a Pharmacy Benefit Manager?

Pharmacy Benefit Managers (PBMs) are third-party administrators who operate and manage prescription drug benefits for health plans. They create formularies, negotiate rebates, process claims, manage pharmacy networks, and review drug utilization.

How Pharmacy Benefit Management Works?

Pharmacy benefit management serves as a bridge between all parties involved in delivering medications to the patient. The managers negotiate lower drug prices and rebates with drug manufacturers. They manage prescription drug plans for insurers and ensure pharmacies are reimbursed. Then, PBMs handle prescription claims processing, making it easier for patients to get their medications.

What Is the Difference Between Medical Benefits and Pharmacy Benefits?

Medical benefits typically include doctor visits, hospitalization, surgeries, and other medical procedures. On the other hand, pharmacy benefits specifically cover prescription medications and related services, including drug formulary management and medication distribution through pharmacy networks.

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