The pharmacy benefit management industry in Pennsylvania is a dynamic landscape that involves several firms providing different healthcare-related solutions. These companies offer services like specialty pharmacy fulfillment, copay assistance programs, cost-saving solutions, and clinical support to ensure the generic drugs' availability and reduce the healthcare system's costs. The industry is currently witnessing an increase in the use of innovative digital tools that help improve patient care and carrier's efficiency.


Top 19 pharmacy benefit management companies in Pennsylvania

1. AscellaHealth LLC

AscellaHealth is a specialty pharmacy that supports patients with custom programs for an enhanced therapy journey. They offer specialty pharmacy benefit management services, specialty pharmacy fulfillment services, and financial & copay assistance programs. They specialize in providing access to specialty medications and optimizing clinical outcomes for patients with chronic or complex conditions. AscellaHealth collaborates with drug manufacturers to ensure access to rare, ultra-orphan, and cell and gene therapies.


2. Gateway Health Partners

Gateway Health Partners is a company that offers solutions for maximum cost savings through deep expertise, industry-wide relationships, and large-scale volume positions. They negotiate best-in-class contractual positions, both bundled and standalone, to make it work seamlessly for clients.


3. Enclara Pharmacia

  • Website: enclarapharmacia.com
  • Headquarters: Philadelphia, Pennsylvania, United States
  • Founded: 2006
  • Headcount: 501-1000
  • Latest funding type: Acquired
  • LinkedIn

Enclarapharmacia.com is a pharmacy benefit manager specifically focused on hospice care. They offer flexible medication access, innovative digital tools, and expert clinical support to improve patient care and reduce costs. Enclara Pharmacia is more than just a pharmacy; they are part of the hospice care team, providing personalized customer service.


4. BusinessOne Technologies

BusinessOne Technologies is a company that specializes in providing managed markets data and pharmaceutical-focused business intelligence solutions to life sciences companies. They help these companies optimize contracting, managed markets, marketing, and sales to expand access to treatments for people in need. They offer integrated data that covers nearly 293 million lives in the U.S., including detailed coverage policy information on more than 98 percent of covered lives.


5. Creative Benefits, Inc.

Creative Benefits Inc. is a company that offers account management, compliance and healthcare reform consultation, employee assistance and support services. They are committed to giving back and providing client-focused solutions.


6. Brown & Brown of Pennsylvania

  • Website: bbofpa.com
  • Headquarters: Conshohocken, Pennsylvania, United States
  • Founded: 1986
  • Headcount: 51-200
  • LinkedIn

Brown & Brown's Personal Insurance team offers comprehensive insurance for your lifestyle.


7. Punch

  • Website: punchpbm.com
  • Headquarters: Philadelphia, Pennsylvania, United States
  • Headcount: 1-10

Pharmacists United to Necessitate Change (PUNCH) is a LLC formed for the sole purpose of contemplating a lawsuit against OptumRX (formerly Catamaran), one of the largest Prescription Benefit Managers (PBMs), and their onerous business practices towards Independent Pharmacy. PUNCH has engaged the law firm Jacobs Law Group, P.C., who are skilled in handling national mass action lawsuits and arbitrations. All communications with PUNCH and Jacobs Law Group, P.C. are for purposes of obtaining legal advice and prospective representation and such are protected by the attorney-client privilege. Established in 1996, Keystone Pharmacy Purchasing Alliance (Keystone) is a Group Purchasing Organization headquartered in Philadelphia and wholly owned by a non-profit association of community pharmacies established in 1898, the Philadelphia Association of Retail Druggists (PARD). Together both groups work hand-in-hand on legislative issues and on lowering a stores cost of goods. Keystones commitment is to Independent Pharmacy as they work in cooperation with their State Association (PPA), the Federation of Pharmacy Networks (FPN) and other Pharmacy organizations throughout the country.


8. AllSpire Health Partners

  • Website: allspire.org
  • Headquarters: Conshohocken, Pennsylvania, United States
  • Founded: 2013
  • Headcount: 11-50
  • LinkedIn

AllSpire.org is a healthcare organization dedicated to clinical excellence and economic sustainability. They offer knowledge transfer, collaboratives, and workgroups to promote best practices and improve patient outcomes. With a focus on pharmacy benefit management, AllSpire utilizes strategic sourcing and distribution to provide cost-effective solutions for their members.


9. KeyScripts, LLC

Developed through 40 years of experience in workers’ compensation and auto claims management, KeyScripts is a workers’ compensation pharmacy benefit manager. We help insurance carriers, third party administrators, agents and self-insureds reduce their workers’ compensation costs through well-designed and effectively managed prescription benefit plans, delivered with uncompromising service. Based in Pennsylvania, we serve customers nationwide, with no out-of-pocket expense to injured workers when filling their prescriptions. Our innovative clinical programs and superior customer service have grown out of our years of experience helping American businesses manage their workers’ compensation and auto claims, and have enabled us to achieve industry-leading levels of client satisfaction while reducing pharmacy costs for our clients.


10. Highmark Wholecare

Highmark Wholecare is a company that offers healthcare solutions and services. They provide Medicare plans, Medicaid benefits, and formulary medications. Their aim is to improve the health and well-being of individuals by offering comprehensive coverage and access to healthcare resources.


11. PharmaForce

PharmaForce is a comprehensive Pharmacy Solutions Provider trusted by the industry. They offer cost-effective and workflow-efficient administration and management solutions, with a focus on delivering high-quality care and service. Their customizable pass-through solution transforms pharmacy compliance and pricing. With their future-forward technology, they provide transparency and lower costs to pharmacies, providers, and patients. PharmaForce specializes in 340B administration and offers contract pharmacy services, split billing, cash cards, referral claim capture, and more.


12. Independence Blue Cross

  • Website: ibx.com
  • Headquarters: Philadelphia, Pennsylvania, United States
  • Founded: 1938
  • Headcount: 5001-10000
  • LinkedIn

Independence Blue Cross is a healthcare insurance company that provides affordable, comprehensive coverage for individuals, families, and employers. They offer a wide range of health and wellness benefits, including access to doctors and hospitals, prescription drug information, and behavioral and emotional health support.


13. Marsh McLennan Agency - East

  • Website: mmaeast.com
  • Headquarters: King Of Prussia, Pennsylvania, United States
  • Founded: 1999
  • Headcount: 5001-10000
  • LinkedIn

MMA East is a financial services company that offers retirement plan solutions, employee health and benefits consulting, and technology consulting. They provide services such as plan vendor consulting, investment due diligence, fiduciary governance, and employee communication, specializing in retirement plans for healthcare organizations and governmental bodies.


14. villaNOVA Insurance Partners

villaNOVA Insurance Partners is a full-service insurance brokerage and consulting firm who truly works for our clients. We bring years of experience, new ideas, service and most importantly we bring the flexibility that the larger firms cannot provide. Insurance is not a “one size fits all” industry and we know that. We consider ourselves an extension of you. Whether you are a business client or individual client, you will hear from us year- round—not just when you have issues.


15. Doyle Alliance Group

Doyle Alliance Group is a hands-on benefits consulting firm with the capabilities of a top 10 U.S. insurance brokerage. They offer comprehensive services and advice in the employee benefits arena, focusing on cost containment, strategic planning, financial analysis, alternative funding, pharmacy management, and value-added services.


16. BCC - Benefit Coordinators Corporation

BCC Benefit Solutions is a leading provider of solutions connecting Human Resources, Benefit Management, Specialty Administrative Services, and Private Benefit Exchanges. They offer a full suite of services including benefits administration, billing and invoicing, claims processing, health and wellness programs, and data analytics. With their experienced professionals and innovative technology, they deliver personalized support and top-notch service to their clients. BCC serves brokers, employers, and employees, providing flexible solutions that meet their specific needs.


17. Sentric

  • Website: sentrichr.com
  • Headquarters: Pittsburgh, Pennsylvania, United States
  • Founded: 1994
  • Headcount: 51-200
  • LinkedIn

SentricHR is an all-in-one Human Resources Information System (HRIS) that provides a cloud-based software solution for managing and empowering employees. It offers features such as onboarding, payroll processing, benefits management, talent management, time tracking, and data analytics. With industry-leading technology and security measures, SentricHR ensures the protection of data. The company's certified brokers and all-in-one technology make it easier than ever to evaluate, administer, and deliver top-notch employee benefits.


18. CTR Payroll Services

  • Website: ctrhcm.com
  • Headquarters: Warrendale, Pennsylvania, United States
  • Founded: 1964
  • Headcount: 51-200
  • LinkedIn

CTR is a payroll and human resources management company that offers streamlined HR tools and resources. They provide services such as payroll tax filing, pay options, paperless processing, and benefits administration. With a focus on teamwork and dedication, CTR aims to make businesses and their employees happy by delivering value and peace of mind.


19. Ahedd

  • Website: ahedd.org
  • Headquarters: Camp Hill, Pennsylvania, United States
  • Founded: 1977
  • Headcount: 51-200
  • LinkedIn

AHEDD is an organization dedicated to improving employment outcomes for people with disabilities. They provide exceptional service to their customers and have been serving communities in Pennsylvania for over 40 years. AHEDD assists businesses with talent onboarding and offers employment services throughout the state. They offer customized plans of service that include skill assessments, career exploration, job placement, and benefits management consultation.


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