PBM Directory
AffirmedRx
Founder/CEO
Greg Baker, founder and CEO
Date founded
March 2021
Number of employees
100
Description
A public benefit corporation that partners with employers, health plans, hospital systems; charges flat administration fee and has a pass-through pricing model.
Formulary
Yes. Prioritizes biosimilars and generics
Transparency efforts
Clients have access to all claims and financial data; unrestricted access to data
CVS Caremark
Founder/CEO
Group President, Prem Shah Ed DeVaney, President of CVS Caremark
Date founded
CVS acquired Caremark in 2007
Number of employees
More than 300,000
Description
Uses an integrated model
Formulary
Plan sponsors can choose approach; the PBM has option to move away from rebate-dependent formulary
Transparency efforts
New programs include: CVS CostVantage and CVS Caremark TrueCost
EmpiRx Health
Founder/CEO
Bill Resnick, founder; Danny Sanchez, CEO
Date founded
2014
Number of employees
325
Description
A pharmacist-led PBM model that focuses on value and on improving patient health outcomes
Formulary
Open formulary developed and managed by company's P&T committee.
Transparency efforts
Provides a Clinical Savings Guarantee, which identifies and tracks opportunities for savings
Liviniti (formerly Southern Scripts)
Founder/CEO
Founders LeAnn Boyd and Steven T. Boyd
Date founded
April 2011
Number of employees
450
Description
Serves self insured employers, unions, hospitals, TPAs, state and local governments
Formulary
Yes. Focused on lowest net cost; 100% pass through rebates
Transparency efforts
Rebate details, network contracts and audit information available for client review
LucyRx
Founder/CEO
CEO David Blair
Date founded
2023
Number of employees
200
Description
Independent, fee-based fiduciary PBM serving self-insured employers
Formulary
No fixed formulary; will customize for each client
Transparency efforts
Provide real-time insights that support evidence-based clinical decisions and clear pricing
MedImpact Healthcare Systems Inc.
Date founded
1989
Number of employees
More than 2,000
Description
Clients can choose a fully managed end-to-end program, a self-service bundle, or from an array of best-in-class services, solutions, and technologies to meet their needs
Formulary
Offers a suite of formulary options, all of which are designed to provide payers flexibility and low net costs
Transparency efforts
Technology that gives payers real-time insights into care and costs
Navitus Health Solutions
Founder/CEO
Robert Palmer, founder; David Fields, CEO
Date founded
2003
Number of employees
2,050
Description
Passes 100% of rebates and discounts on to plan sponsors and health plans
Formulary
yes
Transparency efforts
Clients have full access to their data, down to the individual claim level.
Prime Therapeutics
Founder/CEO
Blue Plans in North Dakota, Wyoming and Kansas; Mostafa Kamal, CEO
Date founded
1998
Number of employees
7,400
Description
Provides transparent solutions for pharmacy benefit management, specialty and medical drug management, and state government solutions
Formulary
Yes. P&T committee recommends which drugs are placed on drug benefit formulary.
Transparency efforts
Doesn’t steer people to own pharmacies or pursue the highest margins
Rightway
Founder/CEO
Jordan Feldman, Dr. Ted Feldman
Date founded
2017
Number of employees
About 500
Description
Transparent PBM supported by care navigation
Formulary
Offers a clinically-led, cost-optimized formulary that supports better health outcomes; managed by company's own P&T committee
Transparency efforts
Disclose all revenue, including any manufacturer payments, and 100% pass through of rebates; full visibility into drug costs, utilization, and performance, no black boxes, no hidden fees.
RxBenefits Inc.
Founder/CEO
Bill Gunnells, founder; Robert Gamble, CEO
Date founded
1995
Number of employees
More than 1,000
Description
Focused on self-funded plans with an independent and flexible approach; flat-fee based
Formulary
Tailored options; new program Illuminate Rx provides formulary options, including specialty generics and biosimilar focused formulary and customizable open formulary
Transparency efforts
Provides flat fees, data and shared insights, along with advocacy for long-term cost containment.
Serve You Rx
Founder/CEO
Justin Jasniewski, CEO
Date founded
1987
Number of employees
103
Description
Full-service PBM with flexibility offerings; clinical programs focus on lowest net cost and trend management; pass-through contract model
Formulary
Three formulary options managed by a P&T committee
Transparency efforts
Pass-through contract model validated by The Validation Institute; no hidden spread pricing; precise contract definitions; robust data access and audit provisions
SmithRx
Founder/CEO
Jake Frenz, founder and CEO
Date founded
2016
Number of employees
530
Description
Full-service PBM with pass-through pricing and savings programs for self-insured businesses; flat fee-based with a model centered on fiduciary alignment
Formulary
Yes
Transparency efforts
Clients can access detailed claim and pricing information, fees, and rebate arrangements
Ventegra Foundation
Founder/CEO
Robert T. Taketomo, Pharm.D., founder and CEO
Date founded
2004
Number of employees
200
Description
Provides integrated medical/pharmacy benefit administration
Formulary
Yes
Transparency efforts
Transparency on claims data and costs (include discounts and rebates; has a 90-day “no cause” termination
