Top 10 PBM Solution Providers 2024

As the complexity of managing prescription drug benefits continues to grow, the demand for innovative PBM solutions that can navigate these challenges while enhancing patient care is at an all-time high.

Medhealth Outlook Magazine’s latest edition shines a spotlight on some of the top PBM solution providers who are at the forefront of this industry transformation, delivering groundbreaking services that are reshaping the way healthcare is delivered and experienced. The companies featured in this edition are not just keeping pace with the changes in the healthcare industry; they are driving the change, setting new benchmarks for excellence.

What makes these PBM providers outstanding is their ability to deliver personalized and flexible solutions that cater to the unique needs of their clients. They understand that no two healthcare providers or patient populations are the same, and they tailor their services accordingly. Whether it’s through innovative clinical management programs, robust data analytics, or comprehensive specialty pharmacy services, these companies are ensuring that patients receive the right medications at the right time, leading to better health outcomes and reduced healthcare costs.

Moreover, the featured companies are champions of transparency and accountability in an industry that is often criticized for its opacity. They are committed to providing their clients with clear insights into their PBM operations, enabling healthcare providers and payers to make informed decisions that benefit both their patients and their bottom line.

CarelonRx

Management:

Amy Mulderry

Designation:

Interim President

Headquarters:

Morristown, NJ

Website:

carelonrx.com

Born from one of America’s largest healthcare companies, CarelonRx is launched with a bold vision and unique proposition - to help members and plan sponsors think differently, keep members at the center of decision-making, and maximize the value of personalized pharmacy care. Leveraging the power of new technologies, CarelonRx's strong, clinical-first lens and deep pharmacy expertise are actively defining its innovative role in the industry.

CerpassRx

Management:

Greg Buscetto

Designation:

CEO

Headquarters:

The Colony, TX

Website:

cerpassrx.com

CerpassRx stands as the first true alternative to the traditional pharmacy benefit management (PBM) model. With a focus on patients and service rather than profits, CerpassRx provides flexible solutions uniquely tailored to each client, including clinical, analytic, and specialty management. The company has developed a member-centric service model that, when combined with their white glove client service, delivers quality that is unmatched in the industry.

CVS Caremark

Management:

Karen S. Lynch

Designation:

President & CEO

Headquarters:

Woonsocket, RI

Website:

caremark.com

CVS Caremark is a leading pharmacy benefit management (PBM) company in the United States, serving millions of plan members. As part of CVS Health, Caremark provides comprehensive services, including prescription drug plan management, mail-order pharmacy services, and specialty pharmacy solutions. The company focuses on improving access to affordable medications, enhancing patient care, and optimizing health outcomes through innovative solutions.

LucyRx

Management:

David Blair

Designation:

CEO

Headquarters:

Bethesda, MD

Website:

lucyrx.com

LucyRx is a modern, full-service pharmacy benefit management (PBM) company that makes prescription management more accessible, understandable, and personal. While the traditional PBM model reinforces complex pricing and leads to unchecked drug costs, its solutions provide enhanced transparency in drug pricing, reduced claims processing complexity, and a high touch service model, addressing clear gaps in the market.

PDC Rx

Management:

Paul Hagen

Designation:

President & CEO

Headquarters:

Tulsa, OK

Website:

pdcrx.com

For 22 years, PDC Rx has been helping hospices all over the nation. As one of the very last privately-owned and operated hospice PBMs, PDC Rx is proud to still be able to serve hospice organizations with the same passion and purpose that we’ve had since the beginning of our company. The services and solutions PDC Rx provided then are just as simple as they are today. The solutions are fluid and designed to be customized.

Phoenix Benefits Management

Management:

Dan Chapman

Designation:

Chairman

Headquarters:

Cumming, GA

Website:

phoenixpbm.com

Phoenix is a modern pharmacy benefits management (PBM) company that helps brokers, TPAs, and consumers benefit from scalable, individualized pharmacy plans that save money on prescription medications and keep people healthy. The company is known for the highest standards of customer responsiveness and care because they are committed to listening well and innovating solutions that bridge the gap between complex healthcare solutions, clients, and consumers.

Prime Therapeutics

Management:

Mostafa Kamal

Designation:

CEO

Headquarters:

Eagan, MN

Website:

primetherapeutics.com

Prime Therapeutics is a leading pharmacy benefit manager (PBM) dedicated to improving health outcomes and reducing healthcare costs. Owned by 19 Blue Cross and Blue Shield health plans, Prime serves millions of members across the United States. The company offers a range of services, including prescription drug management, specialty pharmacy solutions, and clinical support. With a focus on patient-centered care, Prime Therapeutics leverages innovative strategies to enhance medication access, affordability, and overall health.

RxBenefits

Management:

Wendy Barnes

Designation:

CEO

Headquarters:

Birmingham, AL

Website:

rxbenefits.com

"As the benefit industry’s first and only pharmacy benefits optimizer (PBO), RxBenefits exists to ensure EBCs can offer employers and their members a cost-effective pharmacy benefit solution combined with a Fortune 100 service experience. Its unique approach to partnering with the Big 3 PBMs is enabled by the market-leading purchasing power, independent clinical solutions, and high-touch superior service. "

RxPreferred Benefits

Management:

Jeff Malone

Designation:

Founder & CEO

Headquarters:

Mount Juliet, TN

Website:

rxpreferred.com

RxPreferred is a fully transparent, pass-through Pharmacy Benefits Administrator that provides customized pharmacy solutions to maximize savings for plan sponsors and align with their goals. We specialize in cost-containment strategies, plan collaboration, and emphasize community and own-resource capitalization in a data-driven environment. Headquartered in Nashville, Tennessee, RxPreferred is a mission-driven organization, dedicated to outperforming the expectations of our clients and members.

ScriptGuideRX

Management:

Ime Ekpenyong - Ph.D.

Designation:

CEO

Headquarters:

Grosse Pointe Park, MI

Website:

sgrxhealth.com

ScriptGuideRX, Inc (SGRX), an independent corporation, has been providing Pharmacy Benefit Management (PBM) & Third-Party Administrator (TPA) services to private and public entities nationwide, since 2001. The company's client base includes Employer Groups, Health Plans, State Drug Assistance Programs & Nonprofit organizations.