Pharmacy Benefit Management (PBM) companies are firms that operate in the healthcare industry, specifically around the management of prescription drug programs. These companies are intermediaries between insurers, drug manufacturers, and pharmacies, offering a range of services that include formulary management, drug utilisation review, and claims processing. In Texas, there are several PBM companies that have dominated the industry, providing innovative and cost-effective solutions to health plans, insurers, and government entities among others. The future sees these Texas-based companies optimising healthcare delivery through strategic collaborations, value-based strategies, and leveraging advanced technologies.


Top 19 pharmacy benefit management companies in Texas

1. HealthSmart

  • Website: healthsmart.com
  • Headquarters: Irving, Texas, United States
  • Founded: 1983
  • Headcount: 1001-5000
  • Latest funding type: Private Equity
  • LinkedIn

HealthSmart is a premier provider of innovative, customizable, and scalable solutions for employers, brokers, and payers. They offer health plan benefit administration, care management, pharmacy benefit management, provider networks, and casualty claims solutions. They also provide business intelligence, onsite employer clinics, health and wellness initiatives, and web-based reporting.


2. PharmPix Corp

  • Website: pharmpix.com
  • Headquarters: Irving, Texas, United States
  • Founded: 2009
  • Headcount: 51-200
  • LinkedIn

Pharmpix is a state-of-the-art pharmacy benefits information and management provider that offers innovative services for health plans, insurers, employers, union groups, and government health programs. They specialize in saving companies money on healthcare by providing flexible and cost-effective solutions. With their advanced technology and user-friendly system, Pharmpix helps establish deeper connections between beneficiaries and providers, while also ensuring security, transparency, and efficiency savings.


3. Heritage Health Solutions

Heritage Health Solutions is a healthcare management company that specializes in providing comprehensive pharmacy benefit management and specialized services to government entities like the Department of Veterans Affairs. They offer integrated coverage for both medical and pharmacy services, with a focus on reducing costs and improving patient care.


4. CerpassRx

CerpassRx is a pharmacy benefits management company that offers high-touch member experience and customized benefit design and clinical strategy. They provide pharmacy discount cards and workers' compensation services. They serve clients, members, and offer 24/7 support.


5. Eho360

  • Website: ehorx.com
  • Headquarters: Belton, Texas, United States
  • Founded: 1993
  • Headcount: 11-50
  • LinkedIn

EHO-Rx Benefits is a pharmacy benefit management company providing prescription drug benefit plans and services.


6. PCA Rx

  • Website: pcarx.com
  • Headquarters: San Antonio, Texas, United States
  • Founded: 2020
  • Headcount: 11-50
  • LinkedIn

PCA Rx is a full-service Pharmacy Benefit Manager (PBM) that delivers a flexible, high-touch benefit supported by innovative clinical programs designed to improve member outcomes while reducing cost.


7. Maxor National Pharmacy Services, LLC

  • Website: maxor.com
  • Headquarters: Amarillo, Texas, United States
  • Founded: 1926
  • Headcount: 501-1000
  • Latest funding type: Acquired
  • LinkedIn

Maxor National Pharmacy Services is a leading company in the pharmacy industry, dedicated to transforming the industry and delivering better care. With multiple divisions and a strong focus on innovation, Maxor offers a range of services including specialty pharmacy, pharmacy management, and pharmacy benefit management. They bring pharmacies, providers, and patients together to improve health outcomes and provide better value.


8. Pharmaceutical Strategies Group - PSG

  • Website: psgconsults.com
  • Headquarters: Dallas, Texas, United States
  • Founded: 1994
  • Headcount: 51-200
  • Latest funding type: Acquired
  • LinkedIn

PSGConsults is a pharmacy consulting firm that provides technology solutions and intelligence to help health plans, employers, and pharmacy benefit programs improve their performance. They offer data and analytics services, drug management solutions, benefit consulting, and specialty management to hospitals and other healthcare organizations.


9. Health Delegates, LLC

Health Delegates is a company specializing in rebate and formulary management. They offer actionable insights and control over net drug costs, providing extensive reporting to track every rebate dollar. With a pass-through model, clients retain all rebates, admin fees, and price protection. The company helps clients optimize their formulary and rebate programs, recover lost dollars, and achieve the lowest possible net drug cost.


10. Cogneta

  • Website: cogneta.com
  • Headquarters: Plano, Texas, United States
  • Founded: 2019
  • Headcount: 51-200
  • LinkedIn

Cogneta is a healthcare management company that offers a revolutionary approach to managing pharmacy benefits by providing unprecedented transparency, optimizing clinical oversight, and proactively controlling costs for self-funded employers.


11. PersonalMed

PersonalMed is a provider network of compounding pharmacies that offers third-party payers services to manage and process claims for compounded medications through its Preferred Provider Network and PAGO platform.


12. BioCure Rx

  • Website: biocurerx.com
  • Headquarters: Houston, Texas, United States
  • Founded: 2012
  • Headcount: 51-200
  • Latest funding type: Acquired
  • LinkedIn

BioCure is a full-service pharmacy and infusion suite management company that offers comprehensive services to healthcare practices. They provide medication management, a supportive atmosphere, and consistent customer focus. Additionally, BioCure assists in billing for pharmacy and medical benefits, allowing practices to optimize revenue streams.


13. Coeur Plan Services, LLC

Coeur is a healthcare benefits administrator that offers self-funded solutions to employers, with a focus on providing flexible benefit plans that truly benefit people. They prioritize hands-on, high impact customer service, processing claims correctly and efficiently to achieve cost savings.


14. Employers Health Network

Employers Health Network (EHN) offers a curated network of local providers, clinics, and hospitals in partnership with Whole Foods Market. They provide healthcare services through their Whole Health Plan, administered by WebTPA. Members gain access to claims, deductible balances, and customer support.


15. The OccuNet Company

  • Website: occunet.com
  • Headquarters: Amarillo, Texas, United States
  • Founded: 1998
  • Headcount: 51-200
  • LinkedIn

OccuNet is an innovative healthcare cost containment company that offers a variety of solutions and technology to help payers manage and reduce rising healthcare costs. With a focus on out-of-network solutions, OccuNet empowers clients to take control of their healthcare costs and achieve the best possible patient care at the most affordable price.


16. Superior HealthPlan

Superior HealthPlan is a company that offers health insurance plans and healthcare services to individuals and families. They provide a comprehensive range of coverage options and work with a network of healthcare providers to ensure high-quality care.


17. Script Care, Ltd.

ScriptCare is a company that offers specialized pharmacy services and healthcare solutions. They provide access to restricted formularies and assist in managing the rising costs of specialty drugs. They prioritize patient care and offer personalized services to their customers.


18. RxEBATE

  • Website: rxebate.com
  • Headquarters: Houston, Texas, United States
  • Headcount: 11-50

RxEBATE provides prescription benefit services to long term care and skilled nursing facilities, offering a suite of rebates and discounts to increase revenue. They also offer a cash discount program for prescription refills at over 50,000 pharmacies nationwide.


19. Alluma

Alluma is a Pharmacy Benefits Illuminator that focuses on shifting the focus back to patient care. They negotiate on the same side of the table as their clients, uncovering opportunities to optimize benefits programs while supporting better health outcomes. Their solutions include clinical collaboration, pharmacy resource optimization, robust transparency, and insights & intelligence.


Want to find more pharmacy benefit management companies?


If you want to find more companies that offer healthcare-optimizing services like formulary management, prescription claims processing, and drug utilization reviews you can do so with Inven. This list was built with Inven and there are hundreds of companies like these globally.


With Inven you'll also get to know the company's:


  • Ownership: Which of these are private equity backed? Which are family-owned?
  • Contact data: Who are the owners and CEO's? What are their emails and phone numbers?
  • Financials: How do these companies perform financially? What are their revenues and profit margins?

...and a lot more!