Top 23 Pharmacy Benefit Management Firms in California
Top 23 Pharmacy Benefit Management Firms in California
Pharmacy benefit management companies are important participants in the healthcare industry, bridging the gap between health insurers and pharmacies. These firms typically focus on negotiating discounts, rebates from drug manufacturers as well as processing and paying prescription drug claims. They enable access to affordable drugs, maintain formulary standards and implement various tactics to manage drug utilization and costs. In California, there are several reputable pharmacy benefit management companies that are known for their roles in improving patient outcomes, lowering healthcare costs and providing innovative solutions. As the healthcare landscape continues to evolve, these companies are expected to navigate changes and challenges while maintaining patient-centric, quality care.
Top 23 pharmacy benefit management companies in California
1. MedImpact Healthcare Systems, Inc.
- Website: medimpact.com
- Headquarters: 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.
2. SmithRx
- Website: smithrx.com
- Headquarters: 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.
3. IPM - Integrated Prescription Management
- Website: rxipm.com
- Headquarters: Fresno, California, United States
- Founded: 2009
- Headcount: 51-200
- Latest funding type: Private Equity
Integrated Prescription Management (IPM) is a pharmacy benefit manager (PBM) that specializes in maximizing outcomes and minimizing costs through pharmacy benefit design and cost-containment solutions.
4. PRAM Insurance Services, Inc.
PRAM is a company that provides pharmacy benefit management services. They offer custom plan designs for insured and non-insured prescription benefit plans. With a focus on pharmacy benefit consulting and administration, PRAM works with distribution partners, brokers, insurance carriers, and reinsurance carriers. Their services include pharmacy locator, drug pricing tool, and fully-insured prescription benefit plans. PRAM is dedicated to delivering quality prescription products and assisting customers in optimizing their pharmacy benefits.
5. EmsanaRx, a Public Benefit Corporation
- Website: emsanarx.com
- Headquarters: San Francisco, California, United States
- Founded: 2021
- Headcount: 11-50
EmsanaRx is a pharmacy benefit management company that brings integrity, clarity, and trust to the healthcare industry. They offer innovative solutions to improve access to prescriptions, reduce costs, and enhance healthcare outcomes for employers and individuals. With a focus on transparency and clinical expertise, EmsanaRx aims to make pharmacy benefit programs easy to understand and navigate.
6. iSpace, Inc.
- Website: ispace.com
- Headquarters: El Segundo, California, United States
- Founded: 2000
- Headcount: 501-1000
iSpace is a premier technology and business process services company with strong industry experience in healthcare, automotive, entertainment, and financial services. With over 600 global professionals, we offer services such as data business process consulting, robotic process automation, revenue cycle management, and dental BPO services.
7. Optumrx Pharmacy, INC.
- Website: optumrx.com
- Headquarters: 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.
8. Pinnacle Claims Management, Inc.
- Website: pinnacletpa.com
- Headquarters: Irvine, California, United States
- Founded: 1996
- Headcount: 201-500
Pinnacle Claims Management, Inc. is a leading third-party administrator specializing in benefits administration, claims administration, and comprehensive reporting. They offer customized solutions for healthcare needs and have the flexibility to integrate with vendors. With over 20 years of experience, they prioritize client care and provide cost-effective plans.
9. Ramsell Corporation
- Website: ramsellcorp.com
- Headquarters: Oakland, California, United States
- Founded: 1967
- Headcount: 51-200
Ramsell Corp is a healthcare company that focuses on bringing clinically sound and patient-focused medication therapy management to each patient. They provide highly configurable pharmacy benefit management solutions, clinical services, and technology services to improve clinical outcomes and control costs.
10. WithMe Health
- Website: withmehealth.com
- Headquarters: San Mateo, California, United States
- Founded: 2018
- Headcount: 11-50
- Latest funding type: Series B
WithMe Health is a company that provides personalized medication guidance to individuals. They use smart technology, clinical expertise, and a team of pharmacists to guide people in choosing the right medications and supporting them throughout their medication journey.
11. PinnacleRx Solutions
- Website: prxsolutions.com
- Headquarters: Irvine, California, United States
- Founded: 2014
- Headcount: 51-200
PRxSolutions provides personalized, cost-effective pharmacy benefit solutions to meet the unique needs of companies and their clients. Their expert staff guides clients in selecting and managing comprehensive options.
12. Destinationrx, INC.
- Website: destinationrx.com
- Headquarters: Los Angeles, California, United States
- Founded: 1999
- Headcount: 51-200
DestinationRx.com is a company that provides technology-based solutions and services to the healthcare industry.
13. Mutual Rx
- Website: mutual-rx.com
- Headquarters: Irvine, California, United States
- Founded: 2018
- Headcount: 11-50
Mutual-Rx is a pharmacy benefit management company that leverages blockchain technology and machine learning for decentralized transactions without middlemen, ensuring truthfulness and equality in prescription drugs.
14. Wilkinson Benefit Consultants, Inc.
- Website: wbcbaltimore.com
- Headquarters: Burbank, California, United States
- Founded: 1991
- Headcount: 11-50
Wilkinson Benefit Consultants is an independent consulting service that offers advisory services to manage prescription drug costs for their clients. They provide contract review, RFP support, and formulary analysis to create the most cost-effective and member-friendly prescription drug benefit programs.
15. Surveyor Health
- Website: surveyorhealth.com
- Headquarters: Foster City, California, United States
- Headcount: 11-50
Surveyor Health is an artificial intelligence platform that evaluates multi-drug regimens, assessing risks posed by numerous medications, providing insight into complexities in high-risk patients, improves teamwide clinical consistency, reduces overall medication regimen risks, leading to a reduction in healthcare costs.
16. Insking Insurance Services
- Website: insking.us
- Headquarters: Pasadena, California, United States
- Founded: 2021
- Headcount: 11-50
INSKING is a drone and general business liability insurance provider. They offer on-demand liability insurance, covering six kinds of business insurance, including worker's compensation, general liability, and property damage. They also provide healthcare cost management, employee benefits analytics, and retirement plans.
17. RSD Consulting
- Website: rsdconsulting.com
- Headquarters: Riverside, California, United States
- Headcount: 11-50
RSD Consulting Services is a healthcare consultancy specializing in pharmaceutical, biotech, specialty pharmacy, drug distribution, and healthcare private equity and venture capital.
18. Care-Rx Health
- Website: carerxhealth.com
- Headquarters: Costa Mesa, California, United States
- Headcount: 11-50
Care-Rx Health is a hospice-focused pharmacy services provider that offers pharmacy benefits management, 24/7 triage and fulfillment, and compounding services. They provide vital pharmacy services for hospice professionals and their patients.
19. Chronic Care Policy Alliance (CCPA) Advocacy
- Website: chroniccarealliance.org
- Headquarters: Sacramento, California, United States
- Headcount: 11-50
Chronic Care Policy Alliance advocates for patients with chronic illnesses to improve public policy and access to healthcare.
20. CorVel Corporation
- Website: corvel.com
- Headquarters: Irvine, California, United States
- Founded: 1987
- Headcount: 1001-5000
- Latest funding type: Ipo
CorVel is a leading provider of workers' compensation solutions, offering comprehensive risk management programs for payors and employers. With a national pharmacy network of over 67,000 pharmacies, CorVel provides access to essential pharmacy services. The company specializes in innovative solutions and technologies that enable better outcomes and reduce risk. CorVel's services include workers' compensation, liability management, disability management, pharmacy benefit management, and alternative risk solutions.
21. Sutter Health Plus
- Website: sutterhealthplus.org
- Headquarters: Sacramento, California, United States
- Founded: 2013
- Headcount: 51-200
Sutter Health Plus is a healthcare coverage provider offering affordable health plans for individuals, families, small business owners, and large employer groups. They provide access to high-quality, personalized care and cover COVID-19 vaccines and screenings. Members have access to Sanvello, an app for stress, anxiety, and depression support. They have a Nurse Advice Line available 24/7 and offer services such as Walk-In Care and Pharmacy benefits.
22. Carpenters Southwest Administrative Corporation
- Website: carpenterssw.org
- Headquarters: Los Angeles, California, United States
- Founded: 2007
- Headcount: 51-200
Southwest Carpenters Trust Funds provides health, welfare, and retirement benefits for the men and women in the construction industry. They administer health, pension, and vacation benefits, offering medical plans, dental plans, vision coverage, life insurance, and disability coverage. They also provide support for claims and appeals procedures. Participant information is accessible through their MemberXG portal.
23. Pro Pharma Pharmaceutical Consultants, Inc
- Website: propharmaconsultants.com
- Headquarters: Northridge, California, United States
- Founded: 1984
- Headcount: 11-50
Pro Pharma Pharmaceutical Consultants, Inc. is a consulting firm specializing in analytics. They offer services that integrate both pharmacy and medical data to provide solutions for healthcare problems. Their services include managed care and pharmacy expertise, benefit and formulary design, medication review and therapy management, fraud, waste, and abuse prevention, and more.
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