David Blair | PBMI Innovator

David Blair

For David Blair, technology is a tool that can be leveraged to better engage with members. As founder, chairman and CEO of LucyRx, he wants to bring clinical expertise and technological innovation to pharmacy benefits and engage with partners who can bring empathy and agility to the process.

Pharmacists are the key to creating this new dynamic, where pharmacy benefits are reimagined. Blair believes pharmacies can be health centers for patients, helping them with chronic care management, wellness screenings, and vaccinations.

“There are 400,000 pharmacists in the United States; 200,000 of them work retail. What an unbelievable asset that is from a clinical perspective,” he says. “The AMA [American Medical Association] has said they project a shortage of 100,000 primary care doctors, and we have this huge asset of pharmacists. There is this mismatch that we can connect.”

Managed Healthcare Executive and the Pharmacy Benefit Management Institute (PBMI) selected Blair for the inaugural PBMI Innovators Award, which recognizes professionals in the industry who are leading innovation in pharmacy benefits.

Blair, 55, has more than 25 years of experience operating companies in the

healthcare services industry. He and his cofounders started LucyRx in 2022 to provide an alternative to larger pharmacy benefit managers (PBMs) with the same national scale but also transparency about its process and costs of managing prescription drugs.

The company launched with $500 million in equity that it earmarked for strategic acquisitions, including the December 2024 acquisition of Citizens Rx. The acquisition of Citizens Rx’s pharmacy benefit operations brought more than 100,000 new members from 35 self-insured organizations to LucyRx. The company currently serves more than 1,200 clients nationwide.

“When we started LucyRx, we asked ourselves, if you didn’t have to protect a $100 billion market cap, what would you do? How could we deliver prescriptions in the most caring, cost-effective way?” he says.

He says they wanted to put patients first, partner with pharmacists and become a PBM with fiduciary responsibility. LucyRx partners with more than 65,000 pharmacies and has made significant investments in technology. Blair says the company’s emphasis on patient care has led it to hire a disproportionate number of clinicians, including nurses and pharmacists.

“When I face a complex decision, I think back to those early conversations at the [family] dinner table and ask, ‘Does this direction make healthcare more accessible? Are we putting patients’ interests first? Are we treating our clients’ money as if it were our own? Would my dad be proud?’ If the answers are yes, I know we are on the right path.”

Blair lives in Potomac, Maryland, with his wife, Mikel, and they have a combined family of six children. They are devoted philanthropists. They founded the David and Mikel Blair Family Foundation, which supports dozens of organizations, including initiatives to drive sustainability, promote healthy living, empower children with disabilities and expand access to early childhood education.

For 10 years, David Blair has served on the board of the Partnership for a Healthier America, the nonprofit launched alongside former first lady Michelle Obama. “It is really remarkable how many drugs we take in this country as a result of not eating well. If we just ate better, we could save on medications. It’s interesting to see the interplay between my involvement with the Partnership for Healthier America, which is all about quality and access to food, and my business.”

Blair’s public-mindedness led to forays into electoral politics. In 2018 and 2022, he ran for the Democratic nomination for Montgomery County executive, a high-
profile job in Maryland politics. Both times, his self-funded campaigns came up a handful of votes short — in 2022, by 32 — of winning the nomination.

His destiny

A career in healthcare was always the plan for Blair. Growing up in Darnestown, Maryland, an affluent area in Montgomery County, he was exposed to healthcare through his father, Thomas Blair, who started several healthcare organizations that worked with regional health plans to help them earn federal qualification as health maintenance organizations.

He said family discussions often centered on the challenges in the healthcare system. “We discussed how to improve outcomes, align business interests with patient needs and drive innovation beyond antiquated practices. We debated responsibility, equity and the role of public versus private players. But we always came back to one shared conviction: Healthcare is a fundamental human right,” he says.

While at Clemson University, where he majored in finance, Blair took several healthcare policy classes and interned with his father’s company, America’s Health Plan. There, he noted that clients would often choose hospitals as part of the provider network based on the discount offered.

After he finished college, Blair and his partners saw a similar dynamic within pharmacy benefits, with PBMs favoring rebates over the lowest net cost drugs. Early in his career, Blair founded and served as CEO of Catalyst Health Solutions, which aimed to provide employers and health plans with transparent pharmacy benefits. That company grew from a startup to a Fortune 500 company with more than $6 billion in annual revenue and was acquired by SXC Health Solutions in 2012 for $4.8 billion. Renamed Catamaran Corp., it was acquired by UnitedHealth Group in 2015 and is now Optum Rx, one of the “big three” PBMs that dominate the pharmacy benefit management sector.

With LucyRx, Blair says he aims to bring transparency to how pharmacy benefits are managed and to the underlying economics. The company’s name is a reference to “lux,” the Latin word for light. Blair says the vertically integrated model has created conflicting business priorities, limited patient choice and added unnecessary complexity.

Blair says he sees LucyRx as a prescription care partner, removing hidden costs, increasing access and creating transparent, accountable options for care. He says he and his co-founders—Martin Payne and Josh Lynn — wanted to approach pharmacy benefits differently. He points to LucyRx’s program for the glucagon-like peptide 1 (GLP-1) drugs.

“Everyone has a GLP-1 program, and they’re all pretty much the same: a couple of lifestyle programs with a drug benefit. A lot of our employers can’t pay that. We’ve reached out directly to drug manufacturers for direct-to-consumer products that we get for $495, but we can capture the claims data on that,” Blair says.

Additionally, the company has launched specific programs for specialty care and women’s health. LucyRx’s women’s health initiative focuses on perimenopause and menopause. “This is a huge area that has not been addressed by PBMs,” he says. “We have a specific program designed just for women for things such as hormone replacement therapy.”

For specialty care, LucyRx has partnered with more than 130 accredited specialty pharmacies embedded within leading health systems, including Northwestern Medicine, Boston Children’s Hospital and City of Hope. “Ultimately, our goal is to help people live healthier lives by healing the prescription care system and making it easier, more affordable, and more human,” he says.

Looking to the future, Blair said the vertically integrated PBMs will likely split apart. “I don’t know how they can dodge as many bullets as are being fired at them today from federal and state regulatory officials,” he says, citing the Arkansas law that goes into effect in January 2026, prohibiting PBMs from owning pharmacies.

“Twenty-five years ago, Merck owned Medco and Eli Lilly owned PCS, and the FTC [Federal Trade Commission] came out and said this was anticompetitive,” he says. “The FTC made them set up independent review boards. This was anticompetitive 25 years ago, and it’s still anticompetitive.”