PBM Companies

Express Scripts, a subsidiary of The Cigna Group, is a leading pharmacy benefit manager (PBM) in the U.S., serving over 100 million Americans. They work to make prescription medications more affordable and accessible by managing drug benefit programs for health plans, employers, and government agencies.  

Their services include negotiating drug prices, processing pharmacy claims, and offering home delivery options, all of which aim to simplify the prescription process and reduce employees' costs. 

EmpiRx Health is a clinically driven PMB company that focuses on value-based care. It uses advanced data and AI tools to deliver personalized medication therapy. 

Additionally, the provider's unique Member Care Advocacy program proactively supports employees with complex health needs, ensuring better medication adherence, improved health outcomes, and significant savings for employers and employees. 

Alluma offers employers a distinctive approach to pharmacy benefit management built around transparency and clinical collaboration. Unlike traditional PBMs, the provider aligns incentives across the entire pharmacy ecosystem, from drug purchasing to on-site pharmacies. 

Additionally, through its partnership with Mayo Clinic and Vizient, Alluma uses evidence-based expertise and data-driven insights to optimize pharmacy benefits, improve medication adherence, and deliver high-quality care. 

Capital Rx offers full-service PBM solutions for self-funded plan sponsors and customizable options for large employers, aiming to reduce costs and improve service.  

Central to its approach is the Clearinghouse Model, an ethical framework for drug pricing, and JUDI, a cloud-based system that integrates all aspects of PBM operations into a single, scalable platform. This unified system enhances patient engagement, boosts operational efficiency, and supports various plan types, including Medicare, Medicaid, and commercial plans. 

Navitus Health Solutions is a URAC-accredited PBM company that delivers cost-effective, transparent services. It operates on a zero-spread, pass-through model, ensuring all rebates and fees are passed directly to employers. 

The provider has a flexible approach to formulary management, using clinical data to maintain high-quality care while controlling costs. Its services include specialty drug management, utilization management, and member support, focusing on providing clarity and support to employers and employees. 

Prime Therapeutics is a pharmacy benefit manager (PBM) that collaborates with health plans to deliver innovative pharmacy solutions. Their services include managing prescription drug benefits, negotiating discounts with drug manufacturers, and providing clinical support to ensure employees receive appropriate medications. 

Overall, Prime Therapeutics offers flexible, customized partnerships and clinical expertise, aiming to support growth, retention efforts, and employee health. 

With years of experience, Abarca Health stands out from traditional PBMs by giving employers and self-insured groups more control over plan design, costs, and member engagement. 

The provider collaborates closely with organizations to develop and manage custom plan features, including formulary design, network administration, and member services, without requiring dedicated in-house staff or expertise. Its innovative strategies and advanced technology ensure seamless plan administration, helping employers optimize their pharmacy benefits and secure better employee care. 

CVS Health, a leading U.S. healthcare company, operates over 9,000 retail pharmacies and provides a wide range of health services. Its pharmacy benefit management division, CVS Caremark, offers more than basic services by providing personalized adherence counseling, negotiating drug prices, and managing prescription plans to help employees save on medication costs.  

By integrating retail, pharmacy, and insurance services, CVS Health has positioned itself as a top choice for effective pharmacy management solutions.