Top 22 Pharmacy Benefit Management Companies in the US: Empowering Access to Medications
Top 22 Pharmacy Benefit Management Companies in the US: Empowering Access to Medications
The pharmacy benefit management industry focuses on the management and administration of prescription drug programs for various healthcare organizations. These organizations can include health plans, employers, and government entities. Pharmacy benefit management companies work to ensure cost-effectiveness, proper utilization, and safety of medications for individuals. These companies negotiate with drug manufacturers and pharmacies to secure lower prices and create formularies, which are lists of preferred medications for specific health conditions. Additionally, they implement strategies to improve medication adherence and offer clinical programs to promote better health outcomes. The industry is constantly evolving, with a growing emphasis on technology and data analytics to optimize the use of medications. As healthcare costs continue to rise, pharmacy benefit management companies play a crucial role in helping to control expenses and improve access to necessary medications.
Top 22 Pharmacy Benefit Management Companies in the US
1. Express Scripts
- Headquarter: St. Louis, Missouri, United States
- Headcount: 10001+
Express Scripts is a healthcare company that specializes in pharmacy benefits management and prescription drug management. They provide services to individuals, healthcare professionals, and pharmacists, offering resources, forms, and important notices related to pharmaceuticals and medication.
2. MedImpact Healthcare Systems, Inc.
- Headquarter: San Diego, California, United States
- Founded: 1989
- Headcount: 1001-5000
- Latest funding type: Seed
MedImpact is the largest independent pharmacy benefit solutions company that has been lowering costs, improving care, and providing innovative health solutions for clients for the past 30 years. They invest in clinical programs, technology, operations, and analytics to deliver efficient and reliable access to medications for their members.
3. Prime Therapeutics
- Headquarter: Eagan, Minnesota, United States
- Founded: 1987
- Headcount: 1001-5000
Prime Therapeutics is a pharmacy benefit management company that offers tools and resources to make pharmacy benefit management easy. They work with health plans, employers, and consultants to improve health outcomes and lower the total cost of care through effective PBM.
4. WellDyne
- Headquarter: Lakeland, Florida, United States
- Founded: 1990
- Headcount: 501-1000
WellDyne is a pharmacy benefit management company that offers modular pharmacy services to healthcare organizations. They provide mail order, central fill, specialty pharmacy, clinical programs, and leading technology platforms. WellDyne aims to make pharmacy services better by working with their clients. They believe in helping people own their health, understand their options, and make informed decisions to live a healthy lifestyle.
5. Maxor National Pharmacy Services, LLC
- Headquarter: Amarillo, Texas, United States
- Founded: 1926
- Headcount: 501-1000
- Latest funding type: Debt Financing
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.
6. BeneCard PBF
- Headquarter: Bonita Springs, Florida, United States
- Founded: 2008
- Headcount: 201-500
Benecard PBF is a privately owned pharmacy benefit manager (PBM) that focuses on putting patients first by providing lower drug prices and enhanced clinical programs while guaranteeing ethical and fair pricing. With a commitment to authenticity and individualized care, they offer tailored services to meet the specific needs of each member. As a PBM, they aim to improve healthcare outcomes and reduce costs for patients and providers.
7. PerformRx
- Headquarter: Pa, 19113, United States
- Founded: 1999
- Headcount: 201-500
PerformRx is a Pharmacy Benefit Manager (PBM) offering PBM solutions to managed care organizations, Medicaid, and Medicare Part D clients. They provide building better benefits, clinical services, client support services, drug therapy management, specialty pharmacy, and PBM technology offerings.
8. MeridianRx
- Headquarter: Detroit, Michigan, United States
- Founded: 2011
- Headcount: 201-500
MeridianRx is a healthcare company that offers pharmacy benefits management services. They provide transparent pricing and access to a wide range of prescription drugs for health plans, third party administrators, and employer groups.
9. SmithRx
- Headquarter: San Francisco, California, United States
- Founded: 2016
- Headcount: 51-200
- Latest funding type: Series B
SmithRx is a pharmacy benefits management company that offers transparent and affordable prescription drug pricing. They partner with known companies to deliver high-quality care and utilize a pass-through model to ensure fair pricing. With their modern and responsive healthcare technology, they aim to transform patients' lives. SmithRx has developed a Drug Acquisition Platform (DAP) to maximize drug savings for employers. They combine auditable technology and innovative sourcing pathways to lower pharmacy costs and aspire to be a trusted pharmacy benefit partner.
10. Southern Scripts
- Headquarter: Natchitoches, Louisiana, United States
- Founded: 2011
- Headcount: 51-200
- Latest funding type: Private Equity
Southern Scripts is a pharmacy benefit management company that offers real-time insight into plan utilization activity. They provide secure access to a client portal for full visibility to claims and contracts. Their services include clinical management, telehealth, mail order services, and a wide assortment of pharmacy benefits.
11. Serve You Rx
- Headquarter: Milwaukee, Wisconsin, United States
- Founded: 1987
- Headcount: 51-200
Serve Your Rx is an independent, privately held, full-service Pharmacy Benefit Management (PBM) company. Since 1987, we have provided innovative and cost-effective benefit solutions for managing drug spend. Our services include home delivery of medications and a member portal for accessing benefits and claims information.
12. Pharmacy Benefit Dimensions
- Headquarter: Buffalo, New York, United States
- Founded: 1998
- Headcount: 51-200
Pharmacy Benefit Dimensions (PBDRX.com) is a pharmacy benefit management company that provides information and services to help individuals optimize their prescription drug plans. They offer mail-order prescription delivery, formulary services, drug management and safety programs, and medication therapy management. PBDRX.com also works with employers and plan sponsors to provide comprehensive pharmacy benefits and wellness programs. They focus on delivering exceptional value and service to their members and are committed to quality care and improved patient outcomes.
13. Navitus Health Solutions
- Headquarter: Madison, Wisconsin, United States
- Founded: 2003
- Headcount: 1001-5000
Navitus is a pharmacy services company that focuses on providing affordable prescription drugs to its customers. They aim to make a real difference in their customers' lives by putting people first and treating each member as an individual. Navitus believes in disrupting the pharmacy industry by prioritizing transparency and trust. Their goal is to improve health outcomes and reduce costs for millions of people.
14. IngenioRx
- Headquarter: Morristown, New Jersey, United States
- Headcount: 1001-5000
IngenioRx is a member-focused pharmacy benefit manager that works to protect clients from fraud, waste, and abuse in specialty medications.
15. RxBenefits, Inc.
- Headquarter: Birmingham, Alabama, United States
- Founded: 1995
- Headcount: 501-1000
- Latest funding type: Private Equity
RxBenefits is a pharmacy benefits optimization company that offers world-class service and transparency in coverage. They provide a complete guide for maximizing pharmacy benefits in hospitals and health systems.
16. Abarca Health
- Headquarter: San Juan, United States
- Founded: 2005
- Headcount: 501-1000
Abarca Health is a pharmacy benefits management company that takes a transparent and straightforward approach to healthcare. They offer a net cost guarantee pricing solution called Assura and have a bold vision for the future of healthcare.
17. Optumrx Pharmacy, INC.
- Headquarter: Trabuco Canyon, California, United States
- Founded: 2015
- Headcount: 11-50
OptumRx is a company that offers pharmacy care services and solutions. They provide personalized medication management, prescription delivery, and online tools for managing medications. Their goal is to improve the health outcomes and overall experience of patients.
18. nirvanaHealth | RxAdvance
- Headquarter: Southborough, Massachusetts, United States
- Founded: 2013
- Headcount: 51-200
- Latest funding type: Series Unknown
Nirvana Health is a pioneering company in the healthcare industry, specializing in integrated Payer & PBM platform solutions. They automate core transactions, optimize financial outcomes, and provide actionable intelligence to all stakeholders. With their expertise in healthcare automation, robotic process automation (RPA), machine learning (ML), and artificial intelligence (AI), they deliver high-quality and cost-effective solutions.
19. Pharmaceutical Strategies Group - PSG
- Headquarter: Dallas, Texas, United States
- Founded: 1994
- Headcount: 51-200
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.
20. PillarRx Consulting
- Headquarter: Milwaukee, Wisconsin, United States
- Founded: 2018
- Headcount: 51-200
PillarRx is a leading firm dedicated to delivering pharmacy benefit consulting, PBM Auditing, and copay assistance services. They help companies better understand and control their prescription drug costs, maximize pharmacy benefit savings, and reduce compliance risks.
21. Citizens Rx
- Headquarter: Oak Park, Illinois, United States
- Founded: 2009
- Headcount: 51-200
- Latest funding type: Private Equity
Citizens Rx is a company that offers innovative pharmacy benefit management solutions. They focus on providing cost-effective and customizable prescription benefit plans to their clients. Through their expertise and technology, they help clients optimize their pharmacy benefits and improve healthcare outcomes.
22. MedOne Pharmacy Benefit Solutions
- Headquarter: Dubuque, Iowa, United States
- Founded: 1999
- Headcount: 51-200
MedOne is a pharmacy benefit solutions company that partners with pharmacy benefit administrators to provide comprehensive benefit solutions to clients. They offer prescription insurance through employers and family members’ employers, as well as mail order services. MedOne is dedicated to delivering high-quality prescription benefits to members and patients.
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